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CROI has changed a lot since the first meeting — a small national affair held at a Washington DC hotel — says guest author Dr. Carlos del Rio. In HIV and ID Observations, he notes that although CROI initially had little international focus, the global epidemic is now a critical part of the conference. Furthermore, with HIV-infected persons now living longer, conditions such as lipodystrophy, cardiovascular diseases, and bone disorders have presented new challenges. As a result, CROI has become more than a meeting of ID researchers.