TRACK B RAPPORTEUR REPORT

Washington D.C., USA, 22-27 July 2012www.aids2012.org

TRACK B RAPPORTEUR REPORT

JOSE R ARRIBAS on behalf of…

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Washington D.C., USA, 22-27 July 2012www.aids2012.org

WHEN TO START

Washington D.C., USA, 22-27 July 2012www.aids2012.org

HPTN-052

STARTING > 350 vs <250 (229). AIDS + Non-AIDS: No differenceAIDS: better (TB) >500 better than < 350 ?

Grinsztejn. THLBB05

Washington D.C., USA, 22-27 July 2012www.aids2012.org

WHAT TO START

Washington D.C., USA, 22-27 July 2012www.aids2012.orgRaffi. THLBB04

SPRING-2

Washington D.C., USA, 22-27 July 2012www.aids2012.orgRaffi. THLBB04

No difference by NUCs or high viral loadsNo INI mutations nor NRTI mutations were detected through 48 weeks on DTGNo withdrawals due to renal events Small increase in creatinine due to blockade of Cr secretion in DTG arm

DOLUTEGRAVIR QD NEW OPTION

NO RESISTANCE “UNPRECEDENTED”

Washington D.C., USA, 22-27 July 2012www.aids2012.org

DOLUTEGRAVIR POSSIBLE FOR

TEEN/KIDS(RALTEGRAVIR ALSO)

“CHEWING” RAL

Hazra. TUAB0203

Washington D.C., USA, 22-27 July 2012www.aids2012.orgGallant. TUAB0103

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Gallant. TUAB0103

No development of PI resistance in either group. Similar lipidsExpected small increase in serum creatinine (≈0.1 mg/dL) Iin the COBI armLow and comparable discontinuation rates due to renal AE Similar discontinuation rates due to bilirubin-related AEs

COBI AND RITONAVIR

CAN YOU SPOT THE DIFFERENCES?

Washington D.C., USA, 22-27 July 2012www.aids2012.org

HOW TO SWITCH

Washington D.C., USA, 22-27 July 2012www.aids2012.orgPalella. TUAB0104

Lower rate of virologic non-suppression in FTC/RPV/TDF (17/17 with transmitted K103N suppressed)Switching: improvement in fasting lipids and 10-year Framingham Risk Score

FTC/RPV/TDFStrong/simple switch option

Washington D.C., USA, 22-27 July 2012www.aids2012.org

In these three ARV trials < 15%

females. We need to do better!

Washington D.C., USA, 22-27 July 2012www.aids2012.org

RESISTANCE

Washington D.C., USA, 22-27 July 2012www.aids2012.org

0% 5% 10% 15% 20% 25% 30% 35% 40%0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Eastern AfricaSouthern AfricaWestern and Central AfricaSouth-East Asia RegionWestern Pacific Regionother

Antiretroviral therapy coverage: % of people living with HIV receiving ART

Prev

alen

ce o

f NN

RTI r

esis

tanc

e m

u-ta

tions

: % o

f gen

otyp

es

Transmitted HIVDR (WHO surveys) Relationship between transmitted resistance to NNRTI and

ART coverage

MORE COVERAGE,

MORE OPTIONS, more (different)

resistanceBertagnolio. TUAB0305

Washington D.C., USA, 22-27 July 2012www.aids2012.org

TB

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EFAVIRENZ C min % < 400 copies/mL

Luetkemeyer. TUAB0104

Do not support weight-based increase of EFV

during rifampin treatment

Washington D.C., USA, 22-27 July 2012www.aids2012.org

RAL new option for ART during TB treatment.

Optimal RAL dose yet to be defined

N. De Castro. THLBB01

Washington D.C., USA, 22-27 July 2012www.aids2012.org

HCV

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Lo Re. WEAB0102

Despite ART, HIV/HCV pts had higher risk of

hepatic decompensation than HCV-monoinfected pts

Washington D.C., USA, 22-27 July 2012www.aids2012.org

AGING/COMORBIDITIES

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Schouten. THAB0205

Comorbidities more prevalent amongst

HIV-positives compared to uninfected controls

of similar age

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Schouten. THAB0205

Death rates in people with access to care

AIDS still leading cause of death

Non AIDS cancers leading non-AIDS cause

of death

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ADJUSTING TO TIME

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ADJUSTING TO SPACE