TY - JOUR
T1 - Overview of the XIX international AIDS conference
AU - MacArthur, Rodger D.
N1 - Funding Information:
Five-year efficacy and safety results were presented for two antiretrovirals: raltegravir (LBPE19 and TUPE025) and maraviroc (TUPE029 and TUPE026). The significance of these presentations was to support the long-term safety and efficacy of raltegravir and the long-term safety of maraviroc. Another presentation worth noting concerned early versus delayed initiation of antiretroviral therapy in HIV-infected persons in Africa, Asia, and South America (THLBB05). Presented by Beatriz Grinsztejn of Brazil, the study randomized 1,761 persons with CD4+ cell counts between 350 and 550 cells/μL to immediate initiation of antiretroviral therapy or to delayed initiation until the CD4+ cell count dropped below 250 cells/μL. After a median follow-up of 2.1 years, delayed antiretroviral therapy was associated with a shorter time to an AIDS-defining clinical event, a shorter time to development of tuberculosis (TB), and a higher incidence of TB. These findings support immediate initiation of antire-troviral therapy in HIV-infected persons with CD4+ cell counts under 550 cells/μL. However, it is worth noting that an even larger international trial of timing of antiretroviral initiation, the U.S. National Institutes of Health (NIH)-funded START trial, still is ongoing. That trial will enroll approximately 4,000 HIV-infected persons with CD4+ cell counts above 500 cells/μL by the end of April 2013 and will follow them for an estimated median of 4.5 years. Participants are randomized to immediate initiation of antiretroviral therapy versus delayed initiation until the CD4+ cell count drops below 350 cells/μL.
PY - 2013/2
Y1 - 2013/2
N2 - The XIXth IAC concluded in late July after more than 5 days devoted to showcasing over 3,600 poster and oral presentations. While no "major" breakthroughs were reported, it was clear that progress has been made on multiple fronts. A true "cure" (i.e., complete eradication of HIV from the body) may be decades away, but the premise no longer is dismissed as fantasy. Antiretroviral "scale-up" efforts have already had a positive impact on the health of HIV-infected persons in developing countries, although death rates from TB, in particular, remain unacceptably high. Earlier initiation of therapy has decreased the rate of other infections and has shown promise as a strategy for reducing the transmission rate of HIV (i.e., "treatment as prevention"). Undoubtedly, obstacles to more widespread success, such as limited access to care and insufficient medication adherence, still exist.Nevertheless, the progress that has been made in 31 years truly is astounding. This year's IAC did a fantastic job of communicating those achievements to a very engaged worldwide audience.
AB - The XIXth IAC concluded in late July after more than 5 days devoted to showcasing over 3,600 poster and oral presentations. While no "major" breakthroughs were reported, it was clear that progress has been made on multiple fronts. A true "cure" (i.e., complete eradication of HIV from the body) may be decades away, but the premise no longer is dismissed as fantasy. Antiretroviral "scale-up" efforts have already had a positive impact on the health of HIV-infected persons in developing countries, although death rates from TB, in particular, remain unacceptably high. Earlier initiation of therapy has decreased the rate of other infections and has shown promise as a strategy for reducing the transmission rate of HIV (i.e., "treatment as prevention"). Undoubtedly, obstacles to more widespread success, such as limited access to care and insufficient medication adherence, still exist.Nevertheless, the progress that has been made in 31 years truly is astounding. This year's IAC did a fantastic job of communicating those achievements to a very engaged worldwide audience.
KW - Brief report
KW - International AIDS Conference
KW - Overview
UR - http://www.scopus.com/inward/record.url?scp=84873081337&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873081337&partnerID=8YFLogxK
U2 - 10.1007/s11908-012-0310-4
DO - 10.1007/s11908-012-0310-4
M3 - Article
C2 - 23212722
AN - SCOPUS:84873081337
SN - 1523-3847
VL - 15
SP - 1
EP - 3
JO - Current Infectious Disease Reports
JF - Current Infectious Disease Reports
IS - 1
ER -
