HIV Neurology spring uprising in Seattle 2012

It's official: there has been an HIV Neurology spring uprising in Seattle. This conference saw over 60 posters, two themed discussions, an oral abstract session and a presentation on HIV neurology in the closing clinical session- all devoted to HIV neurology. Early CNS infection, screening for HAND, Aging and neurocognitive impairment, identifying biomarkers in plasma and CSF for HAND diagnosis, neuroimaging studies and HAND in longterm virologically suppressed populations were the key themes. The two leading topics in HIV neurology at the moment are (1) whether high CNS penetrating regimens are superior to low penetrating regimens for patients with HAND and (2) whether asymptomatic neurocognitive impairment (ANI) leads to more severe symptomatic HAND. The latter was in a presentation from the CHARTER group (Poster 77) wherein patients with ANI and the symptomatic minor neurocognitive disorder (MND) were likelier to have neurocognitive decline over 36 months than neurocognitively normal controls. Not all patients with ANI/MND were virologically suppressed. Given that ANI is the commonest form of HAND in our populations, if it is shown to lead to MND or HIV dementia this will be a finding of import at a patient and population health level. Abstracts came from a number of groups including Alan Winston's group at Imperial College London, Johns Hopkins, (Justin McArthur) the CHARTER group, the Belgian group led by Bernard Du Pasquier, Serena Spudich's group at Yale, Richard Price from UCSF, Magnus Gisslen from Gothenberg, Beau Ance's group from Washington University, Lucette Cysique and Bruce Brew from Sydney, UNSW, Victor Valcour (UCSF) and Brad Navia from Tufts. It was an enjoyable meeting but, as always, too much to take in at once- hence jump onto the CROI website and watch some of the presentations and search for the abstracts also. Signing off for now.