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XVI International AIDS Conference, Aug. 13-18, 2006

XVI International AIDS Conference

The International AIDS Society's XVI International AIDS Conference took place Aug. 13-18 in Toronto, Canada. The meeting drew more than 24,000 attendees from 170 nations and included about 4,500 abstracts covering issues ranging from HIV prevention to new treatments for the estimated 39 million people worldwide who are infected with HIV.

"The meeting's theme, 'Time to Deliver,' shows the urgency involved," said Mark Wainberg, Ph.D., director of the McGill University AIDS Center in Montreal, Canada, and the conference's co-chair. "We have been relatively successful in turning the tide in North America because of our education and awareness programs. But clearly we have not done that internationally. There are over 20 million HIV-infected people in Africa alone who have virtually no access to antiretroviral drugs. 'Time to Deliver' means getting these people the drugs they need in order to stay alive."

In addition to several clinical trials showing the success of community-based programs in countries such as Zambia and Rwanda, the conference presented promising research on two new classes of HIV drugs: integrase inhibitors and CCR5 inhibitors.

Marty Markowitz, M.D., of Rockefeller University's Aaron Diamond AIDS Research Center in New York City, presented results of a phase II study of Merck's novel integrase inhibitor MK-0518. "He showed that viral loads went down faster than with any other drug we've ever seen," Wainberg said. "It's compelling research. A drug like this may even affect the ability of the virus to establish reservoirs, which would really be significant." (Abstract)

Howard Mayer, M.D., of Pfizer Global Research and Development in New London, Conn., presented results of a phase 2b exploratory trial on Pfizer's novel CCR5 antagonist Maraviroc, which showed significant increases in CD4 counts. "Hopefully, both the Merck and Pfizer drugs will get approved by the U.S. Food and Drug Administration during 2007," Wainberg said. (Abstract)

Another phase II study, by Roy Gulick, M.D., of the Weill Cornell Medical Center in New York City, evaluated the safety and efficacy of the novel CCR5 inhibitor vicriviroc in HIV-infected treatment-experienced subjects. The "encouraging" results, Wainberg said, demonstrated potent 14-day virologic suppression and sustained antiretroviral activity over 24 weeks. (Abstract)

Despite promising developments in the fight against AIDS, particularly the drug companies' reversal of their long-standing opposition to the distribution of cheaply priced generic drugs in developing nations, Wainberg pointed out that "we still have a long way to go in regard to having enough physicians, prescribers and caregivers in Africa to do the job. These are political issues and they need a political response."

At the close of the conference, Stephen Lewis, the United Nations' special envoy on HIV/AIDS, issued a blistering attack on the government of South Africa, where some top officials continue to deny that HIV causes AIDS and promote natural remedies over antiretroviral drugs. Wainberg seconded that opinion. "How many additional millions of cases of HIV transmission are ostensibly due to the fact that the president of the largest and richest country in Africa has failed to show leadership on what has to be the most important issue for all of his people and for the African continent?" he asked.

AIDS: Antiretroviral Therapy Improves Survival in Children

THURSDAY, Aug. 17 (HealthDay News) -- In children and adolescents infected with HIV, the use of highly active antiretroviral therapy, or HAART, significantly reduces mortality, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada. Previous studies, which were observational, were confounded by severity because the sickest patients tend to start HAART earlier, according to the researchers.

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AIDS: Rwandan Women Show Long-Term HIV Survival

THURSDAY, Aug. 17 (HealthDay News) -- Contrary to predictions of current natural history models of HIV infection in Africa, HIV-positive Rwandan women have higher-than-expected rates of long-term survival despite a genocidal war, but most still show evidence of disease progression, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada.

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AIDS: Trichomonas Vaginalis a Significant HIV Risk Factor

WEDNESDAY, Aug. 16 (HealthDay News) -- African women with trichomonas vaginalis have a fourfold higher risk of acquiring HIV than women without the infection, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada.

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AIDS: Male Circumcision Could Prevent Many HIV Infections

WEDNESDAY, Aug. 16 (HealthDay News) -- Male circumcision is associated with a significantly lower rate of HIV infection among men and increasing the numbers of males who are circumcised could reduce the prevalence of HIV infections over the next 20 years in sub-Saharan Africa, according to two studies presented this week at the 16th International AIDS Conference in Toronto, Canada.

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AIDS: Simpler HIV Maintenance Therapy Promising

TUESDAY, Aug. 15 (HealthDay News) -- In select patients with HIV, maintenance treatment with a single, boosted protease inhibitor instead of the standard three-drug regimen may be an effective strategy that results in less complexity, pill burden, long-term complications and cost, according to preliminary research presented this week at the 16th International AIDS Conference in Toronto, Canada. The study results are also published in a special HIV/AIDS-themed issue of the Journal of the American Medical Association.

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AIDS: Good Outcomes Seen in Zambian HIV Program

TUESDAY, Aug. 15 (HealthDay News) -- A massive scale-up of free antiretroviral therapy services in Zambia shows that good outcomes are possible in sub-Saharan Africa, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada. The findings are also published Aug. 16 in a special HIV/AIDS-themed issue of the Journal of the American Medical Association.

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Editorial

AIDS: Panel Updates HIV Treatment Recommendations

TUESDAY, Aug. 15 (HealthDay News) -- The 16-member International AIDS Society-U.S.A. panel has issued updated HIV treatment recommendations based on recent advances in potent combination antiretroviral therapies, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada. The guidelines are also published in the Aug. 16 special HIV/AIDS-themed issue of the Journal of the American Medical Association.

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AIDS: Formula As Risky As Breast Milk for HIV+ in Africa

TUESDAY, Aug. 15 (HealthDay News) -- Breast-feeding plus six months of infant zidovudine prophylaxis is not as effective as formula-feeding plus one month of infant zidovudine prophylaxis at preventing postnatal HIV transmission, but is associated with a significantly lower seven-month infant mortality rate, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada. The study is also in the Aug. 16 special HIV/AIDS-themed issue of the Journal of the American Medical Association.

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AIDS: Medication Adherence Is Higher in Older HIV Patients

MONDAY, Aug. 14 (HealthDay News) -- Because older HIV patients have good-to-optimal adherence to antiretroviral therapy, their outcomes equal those of younger patients after three years of treatment. But they have higher rates of toxicities, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada.

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AIDS: Depression Has Variable Effect on HIV Outcomes

MONDAY, Aug. 14 (HealthDay News) -- Depressed HIV-positive patients who take selective serotonin reuptake inhibitors (SSRIs) may have worse clinical outcomes than depressed patients who aren't treated with SSRIs, although this finding could be due to selection bias, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada.

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AIDS: Four-Drug HIV Combo Shows No Added Benefit

MONDAY, Aug. 14 (HealthDay News) -- Adding a third nucleoside to a standard three-drug combination does not result in more effective control of HIV/AIDS, according to research presented this week at the 16th International AIDS Conference in Toronto, Canada.

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