Conference review – CROI 2012, Seattle
The 19th Conference on Retroviruses and Opportunistic Infections (CROI) took place from 5 to 8 March in Seattle. Here’s a small selection of the many topics that were discussed:
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Over the past two years it has been shown that prophylactic use of antiretroviral medication (PrEP, pre-exposure prophylaxis) can prevent infection with HIV. Tenofovir is most commonly used as PrEP, sometimes in combination with emtricitabine. The FEM-PrEP trial among over 2000 women in South Africa, Kenya and Tanzania showed that there was no effect of treatment with tenofovir. It was finally shown that less than 50% of the participants had measurable levels of tenofovir in plasma. Low adherence was probably the reason that PrEP had no effect.
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Curing HIV is currently a topic in the spotlight. The possibility of curing HIV is complicated by the presence of reservoirs of virus that are inaccessible to medication. Also, combination therapy may not always be capable of halting replication of the virus completely. A third obstacle is the presence of infected long-living latent cells. The first tentative trials are underway to see if these latent cells can be activated, for example with vorinostat, so that they can then be destroyed by the immune system. Research is also being carried out on making cells resistant to infection by preventing the expression of CCR5.
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There are many misconceptions concerning accelerated aging of HIV patients. Amy Justice of the Veterans Aging Cohort Study in the US showed that aging is actually not too severe. HIV-infected individuals have a higher risk of age-related disorders than non-HIV-infected peers. This is, however, mainly due to the presence of other risk factors such as smoking. Age-related events occur on average only a couple of years earlier than in HIV-negative individuals and not around 20 years earlier as some believe.
- James Stein’s presentation delved further into the question of whether HIV increases the risk of cardiovascular disease. Classic risk factors in HIV-negative individuals such as smoking, gender and age are also strong predictors in HIV-infected individuals. It is not yet known what contribution HIV-infection makes. The many biological markers that are associated with HIV as well as cardiovascular disease have little additional predictive value. The group of HIV patients in this study, however, are relatively young and need to age before useful research on HIV-related risk factors for cardiovascular disease can be carried out.
More information on CROI 2012? Visit: http://retroconference.org/