And now at #CROI2023, a special session on #monkeypox/#mpox.
John Brooks of @CDCgov: Mpox decline has not been even in all places -- we need to keep our eye on places where it hasn’t declined as much & need to stay vigilant for reemergence.
I'm not going to try to live-tweet this one & didn't request advance permission to share slides.
John Brooks (@CDCgov): Let’s get people vaccinated against #monkeypox/#mpox now, before spring & summer. Summer means Pride, Pride means a lot of fun, a lot of fun means a lot of sex. #CROI2023
I'm not going to learn orthopox (#monkeypox/#mpox virus family) virology this morning. My notes from Stuart Isaacs' (@PennMedicine) talk just say "Much viral life cycle & genealogy wonkery."🙂 #CROI2023
Interesting: Isaacs says #mpox fills up cells like a "bag of marbles." TPOXX targets a very early step & changes the virus/host balance back to the host so the immune system clears it. That’s why we’re seeing bad outcomes in immunocompromised people. aidsmap.com/news/feb-2023/…
Stuart Isaacs: The #monkeypox/#mpox outbreak in Nigeria really was a missed opportunity -- it was clear something different was happening. If the world had focused on that, we might not have had the 2022 global outbreak. #CROI2023
Sharon Frey's #CROI2023 talk on history of smallpox & #mpox vaccination is fascinating. In US, smallpox vaccination ended in 1972. In 2003, a plan to vaccinate in the absence of disease was hatched due to fear of bioterrorism during Iraq war. #CROI2023
Comment from gay member of HVTN advisory board: LGBTQ community felt very let down. Felt abandoned & had to take care of ourselves. If you’d asked the community, we could have told you what was going on.
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It's been a long day at #CROI2023, but I'll attempt to live-tweet @MichaelPelusoMD's presentation on #longCOVID. Though mainly an #HIV meeting, CROI also includes the hot infectious diseases of the day. (Thanks Dr Peluso for providing advance slides & permission to share.) 1/
.@MonicaGandhi9 presents promising results from @ZSFGCare@SF_DPH SPLASH program to treat disadvantaged safety-net population at Ward 86 with long-acting injectable antiretrovirals -- even if not virally suppression at outset. #CROI2023 1/
Among those without viral suppression (ie, outside FDA indication for Cabenuva), 55 out of 57 achieved undetectable VL after starting monthly injectables -- comparable to rates seen in pivotal clinical trials. 2/
.@MonicaGandhi9: We need innovations in #HIV treatment for this population. "If used creatively & used boldly, long-acting ART could really make a dent in the HIV epidemic." #CROI2023 3/
Susan Buchbinder (@SF_DPH@BridgeHIV) & Larry Corey (@fredhutch) discuss where we are with #HIV vaccines after Mosaico trial failure. Buchbinder says it's "a very vibrant time" in HIV vaccine research. Corey adds that the science is "terrifically fascinating." #CROI2023 1/
I think his characterization of sophisticated novel HIV vaccine approaches as "a little bit more complicated" & going to "take a little more time" is an underestimate. It's certainly a lot more complicated to explain versus traditional vaccines! 2/ poz.com/article/hiv-va…
But it's good to hear they're optimistic. I've been kind of discouraged about the #HIV vaccine research field since doing this @pozmagazine overview a couple years ago. #CROI2023 3/ poz.com/article/shot-d…
.@profchloeorkin presents disturbing data on #monkeypox/#mpox among HIV+ people w/low CD4 counts. High rate of complications & death. Concludes mpox is an opportunistic pathogen & severe necrotizing form is an AIDS-defining condition, @CDCgov & @WHO should include. #CROI2023 1/
Concern about IRIS for people who start antiretrovirals once severe symptoms are underway -- can make worse. But unclear whether ART would be beneficial if started at beginning of mpox symptoms. 2/
The good news is no #HIV+ people with a CD4 count >200 died, nor did anyone who received #mpox vaccine. 3/
#DoxyPEP prevented STIs in gay men, but Jenell Stewart reports this was not the case for cisgender women. May be due to differing drug concentrations in vaginal/cervical vs rectal tissue or low adherence. We’ve seen something similar with TDF/FTC PrEP for women. #CROI2023
Jennell Stewart (@drjenellstewart): "Stigma is a major issue regarding sexual health, STIs & HIV. It needs to be addressed if were going to make progress in this area." #DoxyPEP presenters at #CROI2023
Since it's that time of year, here's a selection of some of my favorite articles I wrote in 2022.
My main focus is #HIV. Here, for @pozmagazine, a look at advances in antiretroviral treatment & prospects for a functional cure. 1/ poz.com/article/long-w…
For @aidsmap, a report from #AIDS2022 about a 5th person cured of #HIV after a stem cell transplant. (The 4th such case was reported earlier in the year at #CROI2022/#CROI22). 2/
I did a couple articles on #HIV vaccines, which remain elusive. But mRNA technology is advancing that effort & also showing promise for cancer vaccines. 3/