Meeting report: CROI 2017

The annual Conference on Retroviruses and Opportunistic Infections (CROI) took place in Seattle from 13-16 February 2017. During the conference, there were presentations on recent developments in various fields, including treatment, prevention, and co-infections.

In terms of treatment, one particular study showed promising results with a new once-daily integrase inhibitor, Bictegravir, which appears to be both effective and well-tolerated. From the field of prevention, Demetre Daskalakis of New York City Department of Health and Mental Hygiene presented the results of New York’s strategy to halt the HIV epidemic in the city, saying “When you combine political will, biological interventions and harm reduction, you can get zero”. He revealed that, while the number of new HIV diagnoses is dropping in New York, there remain differences based on origin, age and gender.

In another prevention study, this time from the Netherlands, Elske Hoornenborg and Godelieve de Bree described a participant in the Amsterdam PrEP study with acute HIV infection despite high tenofovir blood concentrations, emphasising the importance of regular HIV testing among PrEP users.

In terms of hepatitis C virus co-infection, Natasha Martin showed that the incidence of HCV in HIV-positive MSM in San Diego has risen between 2000 and 2015, in contrast to the reduction in HCV incidence reported in the Netherlands by Bart Rijnders. This decrease may be the result of the new anti-HCV agents that were recently made available without restrictions in the Netherlands. 

Stichting HIV Monitoring at CROI

Stichting HIV Monitoring also made a contribution to the conference, with data from SHM’s ATHENA cohort being involved in the following studies presented at CROI:

• Anne Boerekamps (Erasmus MC) presented the HCV cascade of care for the Netherlands. Her results showed that, within just over a year of the new HCV agents becoming available without restrictions, a large proportion of individuals with an HIV/HCV co-infection have been treated for, and cured of, HCV.
• Rosan Van Zoest (AMC) presented the results of a mathematical model that investigated the impact of various interventions to prevent cardiovascular disease in people living with HIV in the Netherlands. The model found that intensive monitoring and treatment of hypertension and dyslipidaemia in people with a moderate to high risk of cardiovascular disease appear to be most effective in reducing cardiovascular disease and also seem to be the most cost-effective.  
• SHM researcher, Ard van Sighem, presented a poster about a mathematical model of HIV transmission, disease progression and the effects of cART on the HIV epidemic in MSM in the Netherlands. The main finding was that early diagnosis, immediate start of HIV treatment, and limited virological failure can contribute to reducing the number of HIV infections in the Netherlands, despite a rise in risk behaviour.
• A poster presentation by Ingeborg Wijting (Erasmus MC) summarised a study that examined the association between integrase inhibitors and the risk of immune reconstitution inflammatory syndrome (IRIS) in HIV-positive patients who had started HIV treatment at a CD4 count <200 cells/mm³. The study found that, in this group of individuals, the use of integrase inhibitors is a risk factor for developing IRIS.
• Casper Rokx (Erasmus MC) presented a poster about the risk of first and second venous thrombosis events in HIV-positive individuals. While these individuals have an increased risk of venous thrombosis, the results showed that the incidence in those people with a CD4 count > 500 cells/mm³ approaches that seen in the general population.  However, the risk of a second venous thrombosis event was elevated in HIV-positive individuals with a persistently low CD4 count and a previous venous thrombosis event that could not be linked to the classic risk factors for venous thrombosis.

In addition to these Netherlands-based studies, SHM also contributed data to the European collaborations summarised below.

D:A:D study group

• Cessation of cigarette smoking and the impact on cancer incidence in the D:A:D study, by Leah Shepherd et al.
• Association between cardiovascular disease and contemporarily used protease inhibitors, by Lene Ryom et al.
• Darunavir/r use and incident chronic kidney disease in HIV-positive persons, by Lene Ryom et al.
• Body mass index and the risk of serious non-aids events: the D:A:D study, by Amit Achhra et al.

COBRA

• Longitudinal analysis shows no evidence for accelerated brain ageing in treated HIV, by James Cole et al.

Cohere in EuroCoord

• Stopping secondary TE prophylaxis in suppressed patients with CD4 100-200 is not safe, by Jose Miro et al.

Follow this link to view the abstracts for the above-listed presentations.