HIV TREATMENT SCALE-UP, IMMUNOPATHOGENESIS, AND THE CLINICAL IMPLICATIONS OF AGING EXAMINED AT 4TH IAS CONFERENCE ON IN SYDNEY
Sydney, 23 July 2007 - Scientists, HIV clinicians and community leaders assembled at the 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention today heard reports from some of the leading researchers involved in basic, clinical and prevention science. Plenary presentations included an update on the roll out of antiretroviral treatment in the developing world and the need for research to inform treatment scale-up; an overview of current knowledge and future research on the mechanisms of T-cell loss leading to immune deficiency; and the clinical implications of the increasing prevalence of HIV in older populations. Other conference sessions focused on such issues as the treatment of early HIV disease, HIV/TB co-infection, and ethical and practical issues related to HIV prevention research.
"The science being presented here in Sydney is not only about new advances in treatment and prevention -- as important as those are -- but also about how to support developing countries in strengthening health delivery systems to make those advances a reality for people in need and at risk," said IAS President Dr. Pedro Cahn, International Conference Co-Chair and Director of Fundación Huesped in Argentina.
"At the conference, we will hear reports of new and better drugs, showing advances in existing treatments, as well as whole new classes of HIV medications," said Prof. David Cooper, IAS 2007 Local Co-chair and Director of the National Centre in HIV Epidemiology and Clinical Research, University of New South Wales. "If studies on early treatment, such as the proposed START trial, show the value of starting therapy early, then these drugs give us the tools to achieve the goal of lifelong management of HIV disease."
Antiretroviral Treatment Rollout and Research Issues in the Developing World
Expanded access to antiretroviral therapy (ART) in developing countries must be informed by operational research to ensure that new treatment programmes are evidence-based, cost-effective and sustainable, according to Dr. Debrework Zewdie, Director of the World Bank's Global HIV/AIDS Program. In her plenary remarks, Zewdie gave a report on the progress of ART roll out in the developing world, and identified some of the complexities related to treatment scale-up in particular regions and among vulnerable populations, such women and injecting drug users. She argued that the intellectual distinction between treatment and prevention is a false dichotomy and called for greater integration of the two programme areas.
Understanding CD4 T-cell Loss and Recovery
While there is no doubt that HIV is the cause of AIDS, we still do not understand exactly how HIV infection causes progressive immune deficiency, according to Dr. Michael Lederman, Professor of Medicine and Professor of Pathology, Molecular Biology/Microbiology and Biomedical Ethics at Case Western Reserve University.
There is increasing evidence that immune activation -- the process by which a person experiences a boost in virus replication when their immune system is activated by a stimulus such as a parasite, other micro-organism, or HIV itself -- is an important driver of the loss of white blood cells leading to progressive immune deficiency. In his remarks, Lederman explained how unraveling the mechanisms whereby HIV infection results in immune activation and cell losses may help to identify strategies that could block the progression of immune deficiency in early infection, enhance immune responses in persons who have had incomplete immune restoration after suppressive antiretroviral therapy (ART), and help restore immune responses in those who fail ART.
Aging and AIDS
Prior to the advent of ART, the immunological changes associated with HIV mirrored those seen in the elderly, suggesting that HIV per se may accelerate the process of aging, according to Dr. Brian Gazzard, founder and chairperson of the British HIV Association and a consultant at St. Stephen's Centre at the Chelsea and Westminster Hospital. The availability of ART, particularly in developed countries, has led to increased HIV prevalence in older age groups. Gazzard described how many of the "geriatric giants," such as cardiovascular disease, cancer and dementia, are associated with HIV infection, and posits that it there may be a synergistic interaction between the effects of HIV and aging that induces an accelerated rate of these degenerative diseases.
Over 5,000 delegates from 133 countries are participating in IAS 2007. Over 3,100 original abstracts were submitted for consideration and 978 were accepted for oral or poster presentation. This represents more than a 50 per cent increase in the number of abstracts submitted to IAS 2003 held in Rio de Janeiro in 2005. For more information about the conference, including details about the programme, visit www.ias2007.org.
For more information about the conference, including details about the programme, visit
About the Organizers:
The International AIDS Society (IAS) is the world's leading independent association of HIV professionals, with over 10,000 members from 153 countries (www.iasociety.org). Founded in 1987, the Australasian Society for HIV Medicine (ASHM) is one of the first HIV medicine societies in the world (www.ashm.org.au).
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Reproduced with permission - "International AIDS Society (IAS)"
International AIDS Society (IAS)