Australasian Society for HIV Medicine

The coverage of the 15th Conference on Retroviruses and Opportunistic Infections (CROI 2008, Boston, Massachusetts, 3-6 February) includes a wide array of individual presentations and symposia, as well as summaries of some of the hottest topics in HIV research. Links to some of the reports are given below.

(1) Goldman B (2008) Immune Reconstitution May Trigger Hepatic Flares in HIV/Hepatitis B Coinfected Patients Starting HAART Interview with Megan Crane
A discussion about the phenomenon of flares in HIV/HBV coinfected patients shortly after beginning HAART treatment with Megan Crane from Monash University in Melbourne.
Link to press conference transcript:
http://www.thebodypro.com/content/news/art45025.html
Reference: Crane M, Oliver B, Matthews G, et al. Immunopathogenesis of hepatic flares after initiation of ART in HIV/HBV-co-infected individuals. In: Program and abstracts of the 15th Conference on Retroviruses and Opportunistic Infections; February 3-6, 2008; Boston, Mass. Abstract 1033.

(2) Presence of Lactobacillus May Reduce HIV Concentration in Vaginal Fluid. A Study Summary by Jane Hitti.
The summary discusses lactobacillus role in reducing vaginal HIV viral load.
Link to transcript: http://www.thebodypro.com/content/news/art45027.html
Reference: Hitti J, Paul K, Agnew K, et al. Protective effect of vaginal lactobacillus on genital HIV-1 RNA concentrations: Longitudinal data from a United States cohort study. In: Program and abstracts of the 15th Conference on Retroviruses and Opportunistic Infections; February 3-6, 2008; Boston, Mass Abstract 27LB.

(3) Acyclovir for HSV-2 Treatment Fails to Curtail HIV Acquisition. A Study Summary by Connie Celum
A discussion about the results from a study examining whether the use of acyclovir to treat herpes simplex virus type-2 infection can, in turn, help reduce a person's risk of HIV acquisition.
Link to transcript: http://www.thebodypro.com/content/news/art45029.html
Reference: Celum C, Wald A, Hughes J, et al, and HPTN 039. HSV-2 suppressive therapy for prevention of HIV acquisition: Results of HPTN 039. In: Program and abstracts of the 15th Conference on Retroviruses and Opportunistic Infections; February 3-6, 2008; Boston, Mass Abstract 32LB.

(4) Rapid Liver Fibrosis Occurring More Frequently Among HIV-Infected Men Newly Coinfected With Hepatitis C: An Interview with Daniel Fierer
Link to interview: http://www.thebodypro.com/content/news/art45011.html
Reference: Fierer D, Uriel A, Carriero D, et al, and A Branch. An emerging syndrome of rapid liver fibrosis in HIV-infected men with acute HCV infection. In: Program and abstracts of the 15th Conference on Retroviruses and Opportunistic Infections; February 3-6, 2008; Boston, Mass. Abstract 1050.

(5) CCR5 Inhibitors in Development: New Data on SCH532706 and Vicriviroc
This is a transcript of a press conference with Sarah Pett, (University of South Wale) and then Barry Zingman ( Montefiore Medical Center in New York).
Link to interview: http://www.thebodypro.com/content/confs/retro2008/art45010.html
References: Pett S, Emery S, MacRae K, et al. Safety and activity of SCH532706, a small molecule chemokine receptor 5 antagonist in HIV-1-infected individuals. In: Program and abstracts of the 15th Conference on Retroviruses and Opportunistic Infections; February 3-6, 2008; Boston, Mass. Abstract 38.

Zingman B, Suleiman J, DeJesus E, et al. Vicriviroc, a next generation CCR5 antagonist, exhibits potent, sustained suppression of viral replication in treatment-experienced adults: VICTOR-E1 48-week results. In: Program and abstracts of the 15th Conference on Retroviruses and Opportunistic Infections; February 3-6, 2008; Boston, Mass. Abstract 39LB.

(6) Carter M (2008) CROI: People receiving TB treatment no more likely to die than others who start ARVs
People receiving treatment for pulmonary TB are no more likely to die if they start antiretroviral treatment than their counterparts without TB according to research by Westreich et al.
Link to aidsmap report: http://www.aidsmap.com/en/news/3EFDDF87-F10E-4313-A934-61C63A76792B.asp
Reference: Westreich D et al. The influence of TB on early mortality in the Themba Lethu clinical cohort, Johannesburg, South Africa. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 145, 2008.

(7) Additional CROI Headlines and links from aidsmap:
(7a) CROI: Darunavir found effective and tolerable in treatment-experienced children and adolescents at 24 weeks
Link to aidsmap report: http://www.aidsmap.com/en/news/14EAB0E9-5D4E-4E93-8F85-7E86C0D0B378.asp
Reference: Bologna R et al. Safety and efficacy of darunavir co-administered with low-dose ritonavir in treatment-experienced children and adolescents at Week 24. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 78LB, 2008.

(7b) CROI: AIDS vaccine: additional infection risk restricted to uncircumcised men
Link to aidsmap report: http://www.aidsmap.com/en/news/E30B88ED-2A6C-44D3-9AF6-61DB62FD9D0D.asp
References: Robertson M, Buchbinder S et al. Efficacy results from the STEP Study (Merck V520 protocol 023/HVTN 502): a phase II test-of-concept trial of the MRKad5 HIV-1 gag/pol/nef trivalent vaccine. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, abstract 88LB, 2008.

Robertson M et al. Immunological characterization of subjects from the STEP Study: a phase IIB test-of-concept trial of the MRKad5 HIV-1 gag/pol/nef trivalent vaccine. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, abstract 89LB, 2008.

Desrosiers R. Scientific obstacles to an effective HIV vaccine. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Plenary presentation 91, 2008.

Nathanson N. AIDS vaccine at the crossroads. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, plenary presentation 92, 2008.

(7c) CROI: Could earlier ART reduce risk of death from non-AIDS related illnesses in people with HIV?
Link to aidsmap report: http://www.aidsmap.com/en/news/F6DE0FBF-584C-4057-87C7-BE1D7769E39B.asp
Reference: Phillips A. Morbidity and mortality in the HAART era. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, 2008. .

(7d) CROI: Sustained response to hepatitis C treatment lowers liver complications and death in HIV/HCV coinfected people
Link to aidsmap report: http://www.aidsmap.com/en/news/F35C5DEA-E996-40C3-B173-C5E0B2714546.asp
Reference: Berengeuer J et al. Sustained virological response to interferon plus ribavirin reduces liver-related complications and mortality in HIV/HCV co-infected patients. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, oral abstract 60, 2008.

(7e) CROI: Extended infant nevirapine prophylaxis reduces HIV transmission through breastfeeding
Link to aidsmap report: http://www.aidsmap.com/en/news/860CAC18-31FF-4E2C-BDDB-ECCE72E532BB.asp
References: Taha T et al. Extended infant post-exposure prophylaxis with antiretroviral drugs significantly reduces postnatal HIV transmission: The PEPI-Malawi study. 15th Conference on Retroviruses and Opportunistic Infections, Boston, abstract 42LB.

Sastry J et al. Extended-dose nevirapine to 6 weeks of age for infants in Ethiopia, India, and Uganda: a randomized trial for prevention of HIV transmission through breastfeeding. 15th Conference on Retroviruses and Opportunistic Infections, Boston, abstract 43, 2008.

(7f) CROI: HAART use in mothers substantially reduces HIV infections in breastfeeding infants in Kisumu, Kenya
Link to aidsmap report: http://www.aidsmap.com/en/news/F85145EF-AA4C-4813-AD30-CAB68955F8C4.asp
Reference: Thomas T et al. PMTCT of HIV-1 among breastfeeding mothers using HAART: the Kisumu breastfeeding study, Kisumu, Kenya, 2003-2007. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 45aLB, 2008.

(7g) CROI: Lactobacillus supplementation could help reduce vaginal HIV
Link to aidsmap report: http://www.aidsmap.com/en/news/C20869A7-FB55-4C87-A7B2-9E9A047E6466.asp
Reference: Hitti J et al. Protective Effect of Vaginal Lactobacillus on Genital HIV-1 RNA Concentrations: Longitudinal Data from a US Cohort Study. 15th Conference on Retroviruses and Opportunistic Infections, Boston, abstract 27LB, 2008.

(7h) CROI: Vicriviroc appears safe and effective at higher doses in treatment-experienced patients after 48 weeks
Link to aidsmap report: http://www.aidsmap.com/en/news/9DA77736-AB60-4373-B9F3-F7377D37867B.asp
References: Zingman B et al. Vicriviroc, a next generation CCR5 antagonist, exhibits potent, sustained suppression of viral replication in treatment-experienced adults: VICTOR-E1 48-week results. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, abstract 39LB, 2008.

Zingman B et al. Vicriviroc in combination therapy with an optimized ART regimen for treatment-experienced subjects: VICTOR-E1. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, poster abstract 795, 2008.

(7i) CROI: CCR5 antagonist SCH532706 shows potent activity and good tolerability in small trial
Link to aidsmap report: http://www.aidsmap.com/en/news/D73DF6A8-B8D0-4A6E-8E75-33158C3D1C15.asp
Reference: Pett S et al. Safety and activity of SCH532706, a small molecule chemokine receptor 5 antagonist in HIV-1-infected individuals. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 38, 2008.

(7j) CROI: Risk of treatment interruption persists after restarting HAART
Link to aidsmap report: http://www.aidsmap.com/en/news/C3E70421-4BB4-40E5-90F0-309FFB25EF2A.asp
Reference: El-Sadr W et al. Re-initiation of ART in the CD4-guided ART interruption group in the SMART study lowers risk of opportunistic disease or death. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 36, 2008.

(7k) CROI: Recurrent hepatitis C in HIV-positive gay men: relapse or reinfection?
Link to aidsmap report: http://www.aidsmap.com/en/news/848705DE-9F36-41CD-BE35-A1095DA49AC1.asp
Reference: Jones R et al. Hepatitis C viremia following sustained virological response to pegylated interferon and ribavarin in HIV+ men who have sex with men -re-infection or late relapse? Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 61LB, 2008.

(7l) CROI: Pegylated interferon maintenance therapy demonstrates no benefit in HIV/hepatitis C coinfected individuals
Link to aidsmap report: http://www.aidsmap.com/en/news/28BF0177-46A2-4FEC-BFEB-4050A8855DC4.asp
Reference: Sherman K et al. Sustained long-term antiviral maintenance with pegylated interferon in HCV/HIV co-infected patients: early viral response and effect on fibrosis in treated and control patients. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, oral abstract 59, 2008.

(7m) CROI: Once-daily boosted atazanavir comparable to twice-daily Kaletra in treatment-naive patients, with better lipid profile
Link to aidsmap report: http://www.aidsmap.com/en/news/E6812A35-2BC4-4957-8ADB-3B8828CACF2A.asp
Reference: Molina J-M, et al. Efficacy and safety of once-daily atazanavir/ritonavir compared to twice-daily lopinavir/ritonavir, each in combination with tenofovir and emtricitabine in ARV-naïve HIV-1-infected subjects: the CASTLE study, 48-week results. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 37, 2008.

(7n) CROI: Acyclovir treatment for genital herpes does not reduce HIV acquisition in men or women, major trial shows
Link to aidsmap report: http://www.aidsmap.com/en/news/AB30B830-260F-466D-A7FC-494D23C49FA0.asp
Reference: Celum C et al. HSV-2 suppressive therapy for prevention of HIV acquisition: results of HPTN 039. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston, abstract 32LB, 2008.

(7o) CROI: Circumcising HIV positive men may increase HIV infections in female partners, but fewer STIs seen
Link to aidsmap report: http://www.aidsmap.com/en/news/CA7B4AB2-765A-4AAC-A08F-A0297B44B030.asp
References: Wawer M et al. Trial of circumcision in HIV+ men in Rakai, Uganda: effects in HIV+ men and women partners. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 33LB. 2008.

Tobian A et al. Trial of male circumcision: prevention of HSV-2 in men and vaginal infections in female partners, Rakai, Uganda. Fifteenth Conference on Retroviruses and Opportunistic Infections, Boston. Abstract 28LB. 2008.

(8) Webcast Session Coverage of CROI 2008 located on the conference web site for Sunday, February 3 to Wednesday 6th.
Link: http://www.retroconference.org/2008/data/files/retro2008_frameset.htm

Footnote: ASHM Members are invited to contribute to ASHM Latest News page with articles under headings of Education, Training, Clinical Issues, Conferences, Resources, International and Research. Please forward information to Paul McQueen (email: paul.mcqueen@ashm.org.au).