Discover and read the best of Twitter Threads about #CROI2023
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THREAD
De très rares cas d’infections à VIH difficiles à expliquer sont survenues chez six personnes qui ont pris la Prep injectable. C’est ce que les chercheurs-ses ont appelé le syndrome de LEVI (Long Acting Viral Inhibition syndrome).
#CROI2023
aidsmap.com/news/feb-2023/…
De très rares cas d’infections à VIH difficiles à expliquer sont survenues chez six personnes qui ont pris la Prep injectable. C’est ce que les chercheurs-ses ont appelé le syndrome de LEVI (Long Acting Viral Inhibition syndrome).
#CROI2023
aidsmap.com/news/feb-2023/…
Rappel : Le 20 décembre 2021, la FDA (l’agence du médicament américaine) annonçait que la Prep injectable était autorisée aux États-Unis sous le nom commercial Apretude (laboratoire Viiv Healthcare). Il s'agit d'injections intramusculaires de cabotégravir, tous les deux mois.
Pour rappel, ce traitement a été testé dans l’essai HPTN 083 qui comparait l’efficacité de la Prep injectable à base de cabotégravir avec la Prep en comprimés quotidiens de ténofovir et d’emtricitabine (FTC/TDF ou Truvada).
Resumen #CROI2023
1.- Ovación de más de un minuto a Anthony Fauci en la conferencia inaugural, a quien le hubiera gustado haberse retirado habiéndose logrado la vacuna y la cura del VIH.
2. Cada vez son más frecuentes las investigaciones sobre la curación de la enfermedad por VIH. Más de 60 comunicaciones se relacionan con interrupciones estructuradas de tratamiento, controladores de élite, reservorios del virus…
Dr. John Brooks, an internist at CDC office of prevention, speaks about #mpox. He notes that we've seen declines worldwide in new cases. 2/ 
Mpox likely transmitted most via contact with skin and the anorectal area. #CROI2023 3/
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.
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
Just presented at #CROI2023: We counted the number of kids and adults fully masked at school and compared it to wastewater in covid. After correcting for background vaccination and case rates, masking was significantly associated with lower probability of covid+ 💩 (1/x)
This genuinely surprised me! I was not expecting to see such a big effect! (2/x)
But here's what's very cool - these kids were not wearing fit tests n95s. They were kids wearing kid masks (mostly fabric) like kids do (damply). And yet we still saw a dramatic effect. Why? A few thoughts (3/x)
Later today @rkfmiller will present a study on school masking for #COVID, showing that a 10% increase in kids wearing masks was associated with about a 50% decrease in the likelihood of detecting SARS-CoV-2 in wastewater from schools. #CROI2023 1/
Interesting thing about this study is they sent people to observe actual mask use during school pickup (about 40% of kids wore them) rather than focusing on mask policies or requests to wear them. 2/
.@rkfmiller: "These were 7 year-olds wearing masks their moms bought at Target" & they still saw an effect. "It can be effective even with real-world masking strategies. It doesn’t have to be all-or-nothing -- even small amount helps." #CROI2023 3/
@RKFMiller of @UCSDHealth @ #CROI2023 looked at elementary school wastewater & observed masking of kids at pickup, found: for each 10% incr in proportion of masking, chance of 1 Covid case on campus in next 5 days ⬇️ by 50%.
Rebecca Fielding-Miller @rkfmiller of @UCSDHealth on masking kids: She worries about #longCovid in kids, and each Covid case in kids means parent can't go to work for 5-10 days. “It’s just better for kids to be less sick so parents can have the money to take care of their kids.”
Meanwhile, the #CROI2023 organizers are not messing around with their Covid masking policy.
The CDC's #ACIP meeting on #mpox/#monkeypox is going on. Some interesting stats! Cases have remained overwhelmingly among men who have sex with men. Cases in kids have been extremely rare. Vaccine uptake has been racially inequitable. 🧵⬇️
The CDC estimates the Jynneos mpox vaccine efficacy based on 9,544 mpox cases among men 18-49 from July 31-Oct 1. Mpox rates were 7.4 times higher than those with 1 dose of the vax and 9.6 times higher than those with 2 doses. No difference based on subdermal vs intradermal. 2/
More mpox stats: 3/
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/
@MichaelPelusoMD .@MichaelPelusoMD & colleagues' SCOPE cohort at @UCSF + international collaborators have now studied more than 700 people with #longCOVID 2/
Mpox (monkeypox) can devastate people with advanced HIV disease, leading to severe skin and genital lesions and causing death in perhaps as many as 1 in 4 of those with a highly compromised immune system, I report for @NBCNews @NBCOUT. #CROI2023
nbcnews.com/nbc-out/out-he…
nbcnews.com/nbc-out/out-he…
At #CROI2023 today, @profchloeorkin described the especially devastating case of a young man with advanced HIV and a very low CD4 count who had severe lesions and lung disease. He died following a bowel perforation 113 days after his first mpox symptom. nbcnews.com/nbc-out/out-he…
Check out Dr. Orkin's thread on her presentation.
@profchloeorkin
**MAJOR trigger warning**
If you look at @TheLancet paper to which she links, p. 8 has devastating photos of mpox lesions. But she feels they're important for clinicians to see.
@profchloeorkin
**MAJOR trigger warning**
If you look at @TheLancet paper to which she links, p. 8 has devastating photos of mpox lesions. But she feels they're important for clinicians to see.
.@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…
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…
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/
📣 📣 Our global case series on MPOX in people with advanced HIV infection is at #CROI2023 and in @TheLancet today: 382 cases of human MPOX infection in PLWH with CD4 counts <350 cells/mm3 in 19 countries
**We found MPOX is an opportunistic pathogen** /1
thelancet.com/journals/lance…
**We found MPOX is an opportunistic pathogen** /1
thelancet.com/journals/lance…
BACKGROUND: Limited evidence on MPOX outcomes in advanced HIV disease. Two Nigerian reports suggested more severe/prolonged symptoms. Two @CDC reports showed worse rectal disease, complications & some deaths #CROI2023 /2
SITES: We collaborated with sites from the global SHARE-Net & Skin NTDS and STI HUGTiP networks with high numbers of MPOX diagnoses. 44 contributing sites from 19 different countries. #CROI2023 /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
Here's my report for @eBARnews on the #doxyPEP study in gay & bi men & trans women presented last year.
ebar.com/story.php?3193…
ebar.com/story.php?3193…
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
La #CROI2023 élargit le champ au-delà du #VIH aux défis actuels de la #santéglobale (#onehealth).
Kevin DeCock y a dressé une liste des regrets sur la façon dont la #pandémie #sarscov2 a été adressée.
Avec une diapositive intitulée #NeverAgain ... COVID Regrets
1/
Kevin DeCock y a dressé une liste des regrets sur la façon dont la #pandémie #sarscov2 a été adressée.
Avec une diapositive intitulée #NeverAgain ... COVID Regrets
1/
Voici donc la liste des #erreurs dont il s'agirait maintenant d'apprendre - et mon sentiment est que malheureusement nous sommes (bien) loin de la cible 😔 :
🔹 évaluations prépandémiques (de la #menace)
🔹 reconnaissance tardive de la gravité de la maladie & de la propagation
2/
🔹 évaluations prépandémiques (de la #menace)
🔹 reconnaissance tardive de la gravité de la maladie & de la propagation
2/
de personne à personne, (même si ces dernières sont) asymptomatique(s), et aéroportée
🔹tests
🔹masques
🔹(mythe de) l'"immunité collective"
🔹 Équipements de Protection Individuelle
🔹communication
🔹politisation, désinformation
🔹iniquité vaccinale et nationalisme
3/
🔹tests
🔹masques
🔹(mythe de) l'"immunité collective"
🔹 Équipements de Protection Individuelle
🔹communication
🔹politisation, désinformation
🔹iniquité vaccinale et nationalisme
3/
