By Michael Smith, North American Correspondent, MedPage Today
Published: March 02, 2012
SEATTLE -- HIV is usually the main focus -- as the name suggests -- of the Conference on Retroviruses and Opportunistic Infections.
And this year will be no exception, according to Scott Hammer, MD, of Columbia University in New York City, co-chair of the scientific program committee.
"Other retroviruses come into play," he told MedPage Today, "but the bulk of the meeting is HIV and its related complications, both opportunistic and non-opportunistic."
But if the overall focus is not much changed, this year's meeting will narrow its gaze to three main areas, Hammer said:
- Preventing HIV infection, a topic that has included both good news and bad in the past year
- Treating the major co-infections, tuberculosis and hepatitis C
- Examining the potential for curing the infection
That last is "not fantasy, it's good science," Hammer said, although for years researchers and clinicians thought the best they could do was make HIV a chronic disease.
Now, though, many leading scientists think it may soon be possible to reach into the reservoirs where HIV hides in the body and eradicate the virus, although exactly how remains a matter of active investigation.
It's unlikely that this meeting will see any reports of a breakthrough in the area – "there aren't going to be any show-stoppers," as Hammer puts it – but he's expecting some incremental progress.
On the other hand, meeting-goers are likely to get more information on using anti-retroviral drugs to prevent HIV infection in the first place, Hammer said.
That field has been spurred by results from several trials, showing that treating people at risk of infection and also treating partners of infected people reduces the risk of infection.
But other trials – some looking at using anti-retroviral drugs in vaginal gels, for instance – have reported disappointing results, so that the overall picture remains unclear, Hammer noted.
"There's a lot of excitement, but also a lot of discussion points," he said.
For instance, the annual N'Galy-Mann lecture, which recognizes important epidemiological or clinical research, will be given this year by the husband-and-wife team of Quarraisha Abdool Karim, PhD, of the Centre for the AIDS Program of Research in South Africa (CAPRISA) and Salim Abdool Karim, MBChB, PhD, of the University of KwaZulu-Natal in Durban, South Africa.
The pair were investigators on the CAPRISA 004 trial, which showed for the first time that a microbicide gel could reduce the risk of infection for women.
Hammer also said he expects to learn more about the prospects for a vaccine, as researchers report on the so-called correlates of risk associated with protection during the RV-144 vaccine trial conducted in Thailand.
That trial, again for the first time, showed a small but significant benefit for a vaccine candidate and researchers want to know why, in the hope that they can tweak some factors and get a better result.
Hammer said he also expects to get some data on new agents and new combinations of agents that are in the clinical trials process, including the so-called quad pill and the integrase inhibitor dolutegravir.
The other major theme will be ways of dealing with some of the major diseases that march in step with HIV – tuberculosis (TB) and hepatitis C.
Hammer said he's looking forward to hearing more about new direct-acting agents against hepatitis C, which present their own challenges when they are used in people with an HIV co-infection.
But the novel agents – two of which have already been approved – have the potential to increase hepatitis cure rates, while reducing the toxicity that complicates therapy and the time it takes to treat the virus.
TB remains a major challenge, especially in resource-poor regions where appropriate treatment of people with co-infection is often difficult to obtain. Meeting attendees will hear about community-based approaches to treatment in Africa.
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