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Conference
"2nd IAS Conference on HIV Pathogenesis and Treatment: A commentary with Dr. Harold Dion" Dr. Harold Dion (biography) English - 2003-07-16 - 13 minutes
(10 slides)
Summary : Dr Dion makes here some generalized comments on the 2nd IAS Conference that took place in Paris from July 13-17. Former President of South Africa Nelson Mandela made a strong case in advocating for HIV treatment in Africa, and the rest of the conference featured high quality talks on advances in HIV treatment.
The transmission rate of resistant virus in primary HIV infection is quite high, and resistance testing guidelines are due to be modified accordingly. One of the newer molecules, tenofovir is promising in its apparent ability to reduce the impact of M184V and K65R mutations.
An interesting debate ensued on whether ART has an effect on cardiovascular disease. As the average age of patients taking ART is only 38 years, an emphasis was placed on risk assessment for CVD by checking for factors such as smoking, family history, being overweight etcetera, and then modifying lifestyle and/or prescribing lipid-lowering agents to decrease risk. If those measures failed it was advised to then change the treatment for one having a better lipid profile.
With regard to using STI in chronic infection it was determined that more studies are needed to establish its suitability and how to use it. A number of phase III vaccines will be tested in the coming year. These vaccines will target viral replication but not necessarily prevent transmission.
Entry inhibitors such as T-20 and T-1249 were discussed. T-20 seems to work well in patients who have a CD4+ count of above 100, a viral load of <100,000 and having 2 or 3 recently active drugs in their regimen. T-1249, which also binds gp41 but on a different site, was proposed as an alternative to T-20 when that no longer worked.
With regard to Hepatitis B and C treatment, it was said that to treat these as soon as possible would be better, to avoid the rapid progression of cirrhosis and hepatocellular carcinoma, especially in HIV patients.
Learning objectives : The participant will receive an update on selected highlights from the 2nd IAS Conference in July 2003:
- Due to the high transmission rates of resistant virus, resistance testing guidelines are due to be modified.
- Tenofovir seems to reduce the impact of M184V and K65R mutations.
- Risk assessment and lifestyle modification should be the first line of recourse in patients on ART at risk for CVD.
- Several phase III vaccines are being tested in the coming year, which target viral replication.
- T-20 works well in patients who have a CD4+ count of above 100, a viral load of <100,000 and having 2 or 3 recently active drugs in their regimen.
- T-1249 is an alternative to T-20 when that no longer works.
Hep B and Hep C should be treated as soon as possible to avoid rapid progression of cirrhosis and hepatocellular carcinoma, especially in HIV patients.
Bibliographic references : MECHANISMS OF HIV DRUG RESISTANCE F. Clavel
Monday July 14th, 2003 – Session 3FO – Abstract 5
USE AND CLINICAL IMPACTS OF DRUG RESISTANCE TESTING IN HIV INFECTION D. Kuritzkes
Monday July 14th, 2003 – Session 3FO – Abstract 6
COMBINING TENOFOVIR TO OTHER NRTIs: IMPACT ON RESISTANCE
AND VIRAL FITNESS AT THE MOLECULAR LEVEL
B. Canard1, J. Deval1, K.L. White2, M.D. Miller2, J. Courcambeck3, B. Selmi1, J. Boretto1 1CNRS, Marseille, France, 2Gilead, Foster City, USA,
3Genosciences, Marseille, France
Monday July 14th, 2003 - Session 2PL - Abstract 7
SHOULD WE MODIFY ANTIRETROVIRAL TREATMENT BASED ON CARDIOVASCULAR RISK?
Pro speaker: Marc van der Valk
Con speaker: Sam Bozette
Monday July 14th, 2003 – Session 18CO – Abstract 101
ANALYSIS OF VIROLOGICAL RESPONSE OF ENFUVIRTIDE IN
TORO: IMPLICATIONS FOR PATIENT MANAGEMENT
J. Montaner1, R. DeMasi2, J. Delehanty2, J. Chung3,
Z. Gafoor2, M. Salgo3, on behalf of the TORO 1 and TORO 2
study groups
1University of British Columbia, Vancouver, Canada,
2Trimeris, NC, USA, 3Roche, NJ, USA
Tuesday July 15th, 2003 – Session 23 FO – Abstract 116
FAILURE OF STRUCTURED TREATMENT INTERRUPTION (STI)
TO CONFER BENEFIT IN THE SETTING OF TREATMENT FAILURE:
CPCRA 064 RESULTS BY BASELINE CD4 COUNT AND PHENOTYPIC
SENSITIVITY SCORE (PSS) SUBGROUPS
J. Lawrence1, K. Huppler Hullsiek2, D. Mayers3, D. Abrams1, R. Reisler4, L. Crane5, B. Schmetter6, T. Dionne7, J. Saldanha8, M. Jones1, J. Baxter9, the CPCRA 064 Study
Team for the Terry Beirn Community Programs for Clinical Research on AIDS
1Univ. of California, San Francisco, CA, USA, 2Univ. of
Minnesota, Minneapolis, MN, USA, 3Henry Ford Hospital,
Detroit, MI, USA, 4Univ. of Maryland, Baltimore, MD, USA,
5Wayne State Univ., Detroit, MI, USA, 6Social and Scientific
Systems, Inc., Silver Spring, MD, USA, 7VA Medical Center,
Washington, DC, USA, 8Denver Public Health Department,
Denver, CO, USA, 9Cooper Hospital/RWJ Medical School,
Camden, NJ, USA
Tuesday July 15th, 2003 – Session 23FO – Abstract 119
ATTENUATION OF SIVMAC239 AND SHIV89.6P INFECTIONS BY
REPLICATION-DEFECTIVE ADENOVIRUS VACCINES
J.W. Shiver1, D.R. Casimiro1, X. Liang1, W.A. Schleif1,
F. Wang1, Z. Zhang1, A. Bett1, M. Davies1, L.G. Tussey1,
J.H. Condra1, T. Fu1, L. Handt1, A.B. McDermott2,
D.I. Watkins2, E.A. Emini1
1Merck Res. Labs., West Point, PA, USA, 2Univ. Wisconsin,
Madison, WI, USA
Tuesday July 15th, 2003 – Session 33OA – Abstract 178
MEASLES VACCINE AS A POTENTIAL VECTOR FOR AIDS VACCINATION
F. Tangy1, C. Combredet1, V. Labrousse1, C. Lorin1, L. Mollet1,
M. Brahic1, B. Hurtrel2
1Unité des Virus Lents, 2Physiopathologie des Infections
Lentivirales, URA-CNRS 1930, Pasteur Institute, Paris,
France
Tuesday July 15th, 2003 – Session 33OA – Abstract 179
EFFICACY OF DNA AND FOWLPOXVIRUS PRIME/BOOST VACCINES
FOR HIV-1 AND SHIV
S.J. Kent1, C.J. Dale1, R. De Rose1, I. Stratov1, S. Chea1,
D.F.J. Purcell1, I.A. Ramshaw2, S. Thomson2, D.B. Boyle3,
B. Coupar3, A.J. Ramsay4, R. Ffrench5, M. Law5, S. Emery5,
D.A. Cooper5, for the Australian HIV Vaccine Design and
Development Team
1University of Melbourne, Melbourne, Australia, 2Australian
National University, Canberra, Australia, 3CSIRO animal health,
Geelong, Australia, 4University of Newcastle, Newcastle,
Australia, 5University of New South Wales, Sydney, Australia
Tuesday July 15th, 2003 – Session 33OA – Abstract 180
Th1 PLASMID CYTOKINE ENHANCEMENT OF RNA OPTIMIZED
PLASMID DNA VACCINE POTENCY IN NON HUMAN PRIMATES
SUGGESTS ATTAINMENT OF A CRITICAL MILESTONE IN DNA
VACCINE AND IMMUNE THERAPY DEVELOPMENT
D.B. Weiner1, J. Boyer1, M. Kutzler1, R.R. MacGregor1,
T. Robinson1, A. Choo1, M. Chattergoon1, K. Muthumani1,
S. Calarota1, M. Otero1, M. Lewis4 ,N. Letvin5,
E.B. Schadeck2, M. Sidhu2, M.A. Egan2, G. Pavlakis3,
Z. Israel2, J. Eldridge2
1University of Pennsylvania, Philadelphia PA, USA,
2Department of Viral Vaccines Immunology, Wyeth Research,
Pearl River, NY, USA, 3National Cancer Inst., Frederick MD,
4SRI, Virginia, 5Harvard Medical School, Boston, USA
Tuesday July 15th, 2003 – Session 33OA – Abstract 181
HIV-1 VACCINES THAT INCLUDE NOVEL ENVELOPE STRUCTURES
INDUCE BROAD AND POTENT ANTI-VIRAL IMMUNE RESPONSES
S.W. Barnett1, I. Srivastava1, L. Stamatatos2, J. Zur Megede1,
G. Otten1, D. Montefiori3, S. Engelbrecht4, E. Janse van
Rensburg4, D. O’Hagan1, J. Polo1, J. Ulmer1, J. Donnelly1
1Chiron Corporation, Emeryville, CA, United States, 2Seattle
Biomedical Research Institute, Seattle, WA, United States,
3Duke University, Durham, NC, United States, 4University of
Stellenbosch, Tygerberg, South Africa
Tuesday July 15th, 2003 – Session 33OA – Abstract 182
LENTIVIRAL VECTORS AS POTENTIAL TOOLS FOR DENDRITIC
CELL-MEDIATED THERAPEUTIC VACCINATION AGAINST AIDS
C. Iglesias1, L. Mollet2, K. Courbeyrette1, F. Tangy2,
P. Langlade-Demoyen3, F. Lemonnier3, P. Charneau1
1Groupe de Virologie Moleculaire et Vectorologie, 2Unité de
Virus Lents, 3Unité d’Immunité Cellulaire Antivirale, Institut
Pasteur, Paris, France
Tuesday July 15th, 2003 – Session 33OA – Abstract 183
MODELING IMMUNE INTERVENTION STRATEGIES FOR HIV-1
INFECTION OF HUMANS IN THE MACAQUE MODEL
G. Franchini
Basic Research Laboratory, NCI, NIH, Bethesda,
Maryland, USA
Tuesday July 15th, 2003 – Session 33OA – Abstract 184
HIV-RECOMBINANT CANARYPOX VACCINE BOOSTS AND BROADENS
HIV-SPECIFIC CD4 AND CD8 T-CELLS IN THE VACCITER
ANRS094 THERAPEUTIC IMMUNISATION CLINICAL TRIAL
G. Carcelain1, R. Tubiana2, M. Legarff1, C. Dalban3,
C. Rabian4, V. Calvez5, R. Elhabib6, C. Katlama2, B. Autran1,
the Vacciter study group
1Cell Immunology Inserm U543, 2Infectious Diseases,
3Inserm EMI 0214, Pitie-Salpetriere University Hospital,
Paris, 4Immunology Saint-Louis University Hospital, 5Virology,
6Aventis Pasteur, Marcy l’Etoile, France
Tuesday July 15th, 2003 – Session 33OA – Abstract 185
DOES HCV CO-INFECTION INCREASE THE INCIDENCE OF
NONALCOHOLIC CIRRHOSIS AND HEPATOCELLULAR CARCINOMA?
A COHORT STUDY OF HIV-INFECTED US VETERANS, 1992-2001
T.P. Giordano1-2, J.R. Kramer3, J. Souchek1-2,
P.A. Richardson2, H.B. El-Serag1-2
1Houston Veterans Affairs Medical Center, 2Baylor College of
Medicine, 3University of Texas Houston School of Public
Health, Houston, Texas, USA
Wednesday July 16th, 2003 – Session 41FO – Abstract 213
ENFUVIRTIDE TORO STUDIES: 48 WEEK RESULTS CONFIRM 24 WEEK FINDINGS Katlama et al
Wednesday July 16th, 2003 – Late Breakers – Oral LB2
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