Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Best posters of the day
The best posters of the day were invited to give a 5 minute speech. I thought these two might interest you as much as they did me.
1) Charpentier et al looked at outcomes of patients in France with a HIV VL 20 copies/ml (a level many labs are now using), to those with a VL 20-50copies/ml over a 12 months period. She found no statistical evidence of a greater likelihood of ultimately developing virological failure in the 20-50 copies/ml group. Although I did think the power was pretty limited to detect this... In fact 4% of the <20 groups developed virological failure, compared to 8% of the 20-50 group... So no p-value to speak of, but maybe something that merits repeating with bigger numbers.
2) Finally Gale et al presented a study looking at whether we need to bother measuring CD4 counts after viral suppression. This was actually done by Chilton et al in the UK some years ago, but this study was from the US. In short, if the VL as undetectable, if the CD4 was >300 then less than 1% of patients had a CD4 drop to below 200 cells over 4 yrs of follow-up. Further CD4 did not lead to any clinical management changes that could not have been foreseen by measuring only VL. The exceptions of course are those starting IFN therapy, chemotherapy or other medical reasons to expect a possible CD4 drop that might require prophylaxis of OIs.