CNS: Latest clinical update on management of HIV infection at CART 2011

Globally acknowledged leaders in clinical management of HIV infection, including those from India, participated in the vibrant academic exchange and discussions at the recently concluded Chennai ART Symposium (CART 2011) in Chennai, India (8-9 January 2011). CART 2011 was organized by one of the most experienced agencies in clinical management of HIV in India, Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE), in collaboration with Centre for AIDS Research (CFAR), Brown University, National Institute of Health (NIH), University of California (San Diego), Karolinska Institute, and HIV Medicine Association of India (HIVMAI).

"CART 2011 provides the latest clinical update on the management of HIV infection and updates the practicing clinicians on the current concept of antiretroviral (ARV) therapeutics, newer drugs, resistance and toxicities" said Dr N Kumarasamy, Chief Medical Officer (CMO), YRG CARE Voluntary Health Services (VHS), who was also the Organizing Chairperson of CART 2011.

"YRGCARE has provided HIV related services to more than 16,000 patients and has acquired enough clinical and research experience to advise other clinicians. We are documenting what is happening to these patients over a period of time" said Dr Kumarasamy.

A significant number of patients are failing 2nd line antiretroviral therapy (ART). Also with better AIDS care services available, the issue of ageing among people living with HIV (PLHIV) is also posing challenges in terms of clinical management and care.

CART 2011 had a rich discussion on a range of issues around clinical management of HIV including: pathogenesis of HIV disease, principles of ART, updates on when to start ART, what drugs to start ART with, when to switch to other drugs, what drugs to consider for ART before switching over to different regimens, toxicities of ARV drugs, Immune Reconstitution Syndrome, drug resistance, principles in drug resistance, genotyping, interpretation of result, management of treatment experienced patients, new drugs and targets, HIV-TB co-infection, hepatitis B (HBV) and HIV co-infection, hepatitis C (HCV) and HIV co-infection, HIV and ageing, ARVs in prevention, ART in pregnancy, manangement of adolescent and paediatric HIV infection, HIV medication adherence, psychosocial and behavioural changes, cost-effectiveness of ART, among others.

The CART 2011 faculty included: Dr Constance A Benson, University of California, San Diego, USA; Dr Carlos Del Rio, Emory University, Atlanta, USA; Dr Charles Farthing, Merck, Hong Kong; Dr Davey Smith, University of California, San Diego, USA; Dr Christine Wanke, Tufts University, Boston, USA; Dr Jorge Villacian, VIRCO, Brussels, Belgium; Dr Karen Tashima, Brown University, USA; Dr Kenneth Mayer, Brown University, USA; Dr Kenneth Freedberg, Harvard University, Boston, USA; Dr Rami Kantor, Brown University, USA; Dr. Robert T Schooley, University of California, San Diego, USA; Dr. Anders Sonnerberg, Karolinska Institute, Stockholm, Sweden; Dr Scott Letendre, University of California, San Diego, USA; Dr Shruti Mehta, Johns Hopkins University, USA; and Dr Susan Cu-Uvin, Brown University, USA.

Noted HIV physicians from India who have been on the forefront of clinical management of HIV were also part of the CART 2011 faculty, including: Dr Suniti Solomon, founder-Director YRGCARE; Dr Atul Patel, Institute of Infectious Diseases (IID) Ahmedabad; Dr Anita Shet, St Johns Medical College, Bangalore; Dr P Balakrishnan, YRGCARE, VHS, Chennai; Dr N Kumarasamy, YRGCARE, VHS, Chennai; Dr Raman Gangakedhkar, NARI, Pune; Dr BB Rewari, National AIDS Control Organisation (NACO), New Delhi; Dr Sanjay Pujari, Institute of Infectious Diseases (IID), Pune; Dr Srikanth Tripathy, National AIDS Research Institute (NARI), Pune; Dr Sunil Suhas Solomon, YRGCARE Chennai; among others.

CNS wrote on-site from CART 2011 and watch out www.citizen-news.org for more issue-specific articles this week.