A very quick overview of Conference on Retrovirology and Opportunistic Infections (CROI) 2011 from The Body Pro by Paul Sax, MD:

1. A large amount of papers and discussion on HIV PRE-Exposure Prophylaxis (HIV PREP). Essentially, it works if you take it, but lots of people in the iPrEx study didn't fully adhere (especially in non-U.S. sites). And bone density goes down a bit in those receiving  tenofovir/emtricitabine [ (TDF/FTC) / Truvada ], long term implications unknown. Not many physicians are prescribing it (anecdotally).
2. Chronic Hepatitis C treatment is about to get MUCH more effective....and much more complicated. While the treatment success rates will make a big jump in the right direction, the new regimens just add another new drug to the existing challenging regimen of pegylated interferon and ribavirin. Telaprevir and boceprevir are the first two HCV-specific protease inhibitors (it was the first HIV-specific protease inhibitor that revolutionized HIV care in the mid 1990's). Drug-drug interactions with exisitng antiretroviral drugs and these new HepC-specific protease inhibitors will be really challenging to traverse for the healthcare provider. Great webcast here of a plenary given by Stefan Zeuzem that summarizes a lot of the key issues.
3. Once daily raltegravir (Isentress) doesn't work quite as well as twice daily raltegravir (which we have known for a while, but new detailed data were presented). On a raltergravir side note: 25% of HIV poz people (with no history of taking ARV drugs) that were put on boosted darunavir (Prezista) and raltegravir experienced drug failure. Since these are both two of our "best" drugs, this finding was confusing for many and has yet to be explained.
4. New drug alert: S/GSK1349572 (aka 572) is now called "dolutegravir" or DTG which has antiviral activity against some HIV which is resistant to raltegravir.
5. Two papers (here and here) show that blacks in the U.S. do worse than whites in clinical trials. The explanation must be (at least in large part) due to socioeconimic disparities, since clearly Africans are doing just as well on HIV therapy as people in resource-rich settings. It is critical to figure out why this disparity exists.
6.  Inflammation and immune activation continue to be hot topics. This is a field of HIV study that is relatively new and incredibly confusing. Summed up as "some markers/tests go up; others decrease; no one knows why; no one knows the clinical implications. This is an incredibly energized area of research these days.
7. If you have Tuberculosis (TB) and advanced HIV-related immune dysfunction (CD4 less than 50), the time to start HIV treatment is sooner rather than later. Untreated advanced AIDS is worse than the potential Immune reconstitution inflammation syndrome (IRIS) that can occur shortly after initiating HIV therapy in these patients.
8. Zinc finger nucleases are back being talked about again (see earlier ACG blog post)
9. Does protease-inhibitor based therapy in HIV positive pregnant women cause premature delivery? Europeans have been saying this for a while, and a new study from Botswana seems to support that view. The questions remain: how clinically important is this and what are the best alternatives to this therapy?