David Griffin 🦠🧫💉

Important #latebreaker study at #CROI2025 SCORPIO-PEP phase III RCT showed ensitrelvir (Day 1: 375mg, Day 2-5: 125mg) reduced PCR positive, symptomatic #COVID19 in HHC if started w/in 72 hrs of index case symptomatic C19 by 67%. Including in those with high risk progression. Need ICH and RACF data!

Pharmacokinetics and safety of once-yearly lenacapavir: a phase 1, open-label study Following administration of once-yearly intramuscular lenacapavir, median plasma concentrations exceeded those associated with efficacy in phase 3 studies of twice-yearly subcutaneous lenacapavir for ...

#CROI2025

Published today:

#Pharmacokinetics and safety of once-yearly lenacapavir: a phase 1, open-label study www.thelancet.com/journals/lan...

Great to see truly “long acting” therapies for HIV and PrEP emerging. the bar for #HIV #vaccines is ever higher!

Calling Our Patients “High Risk” Hurts Them

"Being called risky or associated w risk b/c of your sexual health decisions makes most people feel ashamed. And that shame is nothing more than another barrier to care. "

A banger op-ed by @jncherabiemd.bsky.social
www.thebodypro.com/hiv/calling-...

Cervical cancer mortality in US women younger than 25 years significantly declined between 2016 and 2021, likely due to the widespread adoption of HPV vaccination.

ja.ma/4i9ghPC

Progress in reducing new HIV diagnoses much slower for Black men in the US Lifetime risk of acquiring HIV has decreased for Black gay and bisexual men in the US, from 1 in 2 from 2010 to 2014 to 1 in 3 from 2017 to 2021, according to data presented to the Conference on Retro...

100%

There was some really interesting data presented at #CROI2024 which explored racial disparities in the lifetime risk of acquiring HIV and highlighted some of those issues of intersectionality.

www.aidsmap.com/news/mar-202...

#HIVsky #IDsky

Ten Americas: a systematic analysis of life expectancy disparities in the USA - @thelancet.bsky.social

Somber update on the 8 Americas study; highlights growing inequities in life expectancy, impact of structural racism and disproportionate impact of #COVID19

www.thelancet.com/journals/lan...

Dr Eloise Williams gave an important update confirmatory testing for #HIV in Australia.

#MicroSky #HIVsky #IDsky
#HIVinFocus

- Use of accredited NAAT in diagnostics (cf monitoring) on separate sample to initial serology
- p24 Ag immunoassay (no longer available)
- (traditional) western blot

Vikas Parwani from HIV/AIDS Legal Center shares a brief insight into immigration to Aus for #PWH.

Immigration exempt from discrimination laws that protect #PWH.

#HIV can be barrier due to perceived cost, but opportunities for ‘health waiver’ exist. HIV not the only barrier #PWH face. #HIVinFocus

None, though I don’t have many people on injectables at this stage.

I think more will be inclined to switch, once LAI are Q6M, or can be self administered. (LEN + ? 👀)

Frequent clinical attendance and frequent injections seem major deterrents.

Cab-LA not yet funded as PrEP here either.

A/Prof. Mina John from Royal Perth Hospital, presents Western Australian data on implementation LAI ART in hard to reach populations, mirroring #UCSF data; improved retention in care and virological suppression.

Multiple other benefits.

#HIVsky #IDsky

👍🏼

Same! (Plus Simva-, and Pravastatin, thou not sure why anyone would use these preferentially…)

We have:
Rosuvastatin 5-40mg
Atorvastatin 10-80mg

I typically start with rosuvastatin 10mg, unless pt on boosted PI (then typically half)

Do you have access to pitavastatin?

Australian cardiovascular disease risk calculator | AusCVDRisk

Interesting!

We use www.cvdcheck.org.au/calculator which is based on the NZ PREDICT-1° equation.

I mostly use it in conversations about risk and impact of risk factor modification (eg smoking cessation). None of our calculators incorporate HIV, ART, etc, and likely underestimate risk.

3/ #HIVinFocus

International guidelines recommend implementing the #Reprievestudy findings with different thresholds of #CVD risk statin therapy.

Australian guidance most closely aligns with the EACS recommendation.

2/ Australian CVD risk calculators typically assign a lower risk to #PWH than AHA/ACC score.

International guidelines recommend implementing this evidence differently.

A/Prof Janine Trevillyan from #AustinHealth describes the challenges of applying the #REPRIEVEstudy in Australia; we don’t have pitavastatin and use different risk calculators. #IDsky #HIVsky

Atorva- and rosuvastatin reduce surrogates of CVD risk, though choosing ideal biomarker can be challenging.

6/ #REPRIEVEstudy also highlighted that #CVD risk calculators tend to overestimate CVD risk in developing countries, but underestimate risk in women.

5/ #REPRIEVEstudy showed that statins were safe (pitavastatin was chosen because it doesn’t interact with PIs), with a non-sig trend towards incident #diabetes, though glycaemic control was curiously unchanged.

4/ #REPRIEVEstudy demonstrated definitively that statins reduce CVD risk in people with #HIV 35% with low to moderate #ASCVD risk at baseline.

3/ mechanistically statins reduce CVD risk through several mechanisms; LDL lowering, plaque stabilization, dampening inflammation. Interestingly #REPRIEVEstudy proteomic analysis suggested PCOLCE may be important in pitavastatin impact on collagen deposition.

2/ importance of identifying and addressing lifestyle factors, social and psychological determinants of health to reduce #CVD risk

Day 2 #HIVinFocus

Prof. Currier from #UCLA offering insights into CVD risk in #PWH.

First, association between clonal hematopoiesis and #CVD risk in #HIV demonstrated in several cohorts.

#HIVsky #IDsky

Remember cystatin C as an alternative to creatinine for estimating renal function in people with HIV with elevated creatinine on INSTI and/or cobicistat.

- nephrologist, Dr Nichita GAVRILESCU #HIVinFocus

Great talk by Endocrinologist A/Prof. Priya Sumithran at #HIVinFocus symposium.

- weight loss is an uphill battle
- pharmacological management available with additional health benefits
- questions remain about functional impact of muscle loss
- meds only work while taking them!
#IDsky #HIVsky

Prof. Jenny Hoy, summarises ART and weight gain at #HIVinFocus symposium at Alfred Health.

#HIVSky

As a Melburnian, I had no idea VIDRL performed this assay. Not surprised though, they seem to have PCRs for everything!

‘Gamechanger’ HIV prevention drug to be made available cheaply in 120 countries Gilead Sciences announces deal to manufacture generic versions of lenacapavir, but critics say it excludes many countries where incidence is highest

Lower-cost versions of the #HIV prevention drug lenacapavir to be made available in 120 low- & middle-income countries.

#IDSky #GlobalHealth #PublicHealth #PrEP

www.theguardian.com/global-devel...

One can try to slice the data however they will, but the ⬇️ in morbidity, mortality and incidence of several infectious diseases due to #vaccination is irrefutable.

We’ve seen time and again, the consequences of disruption of immunisation programs (e.g. MMR in Samoa), and ⬇️ in herd immunity #IDsky

Allen Yung's Golden Rules of ID. Copied over from the Other Place for @kottonnelson.bsky.social #IDSky

Similar to @paulsaxmd.bsky.social, I recall a pt with documented negative serology 18 months prior to first ADI.

Rapidity of progression is associated with virologic set point, the immune response to HIV, and a list of host and viral factors.