Really Rapid Review: International AIDS Conference 2018, Amsterdam

The International AIDS Conference -- or "AIDS 2018" -- returned to Amsterdam for the first time since 1992.

It's worth pausing, with gratitude, to remember that 26 years ago antiretroviral therapy consisted of three available drugs -- zidovudine (AZT), didanosine (ddI), and zalcitabine (ddC).

All were marginally effective, with limited durability and significant toxicity. In fact, the big debate in the early 1990s was whether treatment of HIV before symptom onset was worthwhile at all.

We had no NNRTIs, PIs, or integrase inhibitors. Aside from recommending condom use and abstinence, we had no strategies to prevent HIV among sexually active adults.

Fast-forward to today, where the goal is to have everyone with HIV on treatment for both their individual benefit and to end the epidemic.

Gratitude indeed!

Here are some highlights from the meeting which took place last week, a Really Rapid Review© of important (or just interesting) studies that caught my eye. Apologies ahead of time for missing your favorite -- as always, let me know in the comments section what I missed!

Amsterdam remains a gem, a marvelous city with distinctive architecture, great food, nice people, picturesque canals, and incredible museums. It was even better than the last time I was here -- seemed cleaner, bustling but less congested (at least with car traffic), and decidedly less seedy. The fact that it was unbelievably hot didn't deter many of us (including me) from biking around town, joining the throngs who regularly take advantage of the flat terrain and the extensive bike lanes.

But visitors beware -- when it's time to go home, the airport is a chaotic, crowded mess. The warnings to arrive 3 hours before departure time should not be taken lightly. I'd call the airport a zoo, but that might be insulting to some zoos!

.@KLM: Worst airline & cust svc experience ever. Long lines @Schiphol, checked in, then >45 min line for baggage drop. Still 30 min pre-takeoff, told to rebook bcs too late to check baggage, but no seats avail x2days! So, to LHR on BA, hotel, int'l change fee to ATL=$1800!

-- Melanie Thompson (@drmt) July 28, 2018

Poor Melanie! Hartsfield will seem downright peaceful by comparison.

Next year's meeting will be in Mexico City, July 21-24, 2019. It too is a wonderful, vibrant city (and where I've had some of the best restaurant meals in my life) -- but based on the traffic the last time we were there, bike transport seems highly unlikely!

So what did I miss?

[Note from TheBodyPRO: This article was originally published by NEJM Journal Watch on July 29, 2018. We have cross-posted it with their permission.]