XVII International AIDS Conference, Aug. 3-8, 2008
XVII International AIDS Conference
AIDS 2008, the XVII International AIDS Conference, took place Aug. 3-8 in Mexico City and attracted more than 24,000 attendees from 194 nations. Convened every other year by the International AIDS Society -- the world's leading independent association of HIV professionals, with more than 10,000 members in 172 countries -- the conference featured a mix of political advocacy and new research on treatment and prevention strategies.
"AIDS 2008 is taking place at a unique moment in the epidemic, when there is widespread consensus on the urgency of ensuring universal access to HIV prevention, treatment, care and support by 2010," AIDS 2008 International co-chair Pedro Cahn, M.D., president of the International AIDS Society (IAS) and Fundacion Huesped in Buenos Aires, Argentina, said in a statement.
Speakers warned that stigma and the denial of human rights, including gender inequality -- combined with a pervasive fear of violence, discrimination and unwarranted prosecution -- continue to prevent many at-risk people from seeking HIV testing and treatment.
Speakers included former U.S. President Bill Clinton. "Universal action on AIDS is blocked not only by inequalities and economics, health care and education, but also by widespread, persistent, gender inequity and violence," Clinton said during a keynote address. "They too contribute to the spread of HIV and AIDS in much of the world. That is why I have decided to support the current effort of many governments and advocates to create a new United Nations agency for women."
One of the major themes of the conference was "treatment as a prevention tool," and one of the most talked-about studies was "Expanded Access to Highly Active Antiretroviral Therapy: A Potentially Powerful Strategy to Curb the Growth of the Epidemic." Presented by researchers from British Columbia, Canada, and published in the Journal of Infectious Diseases, the study employed a novel mathematical model to show that increased treatment coverage among HIV-positive Canadian patients from the current level of 50 percent to 75, 90 or 100 percent would reduce the annual number of new HIV diagnoses by 30, 50 and 60 percent, respectively, over the next 25 years.
"We still have millions of people in need of treatment," Stephen Lewis, co-director of Aids-Free World, said in a statement. "We have two years to reach universal access. This study proves why we should be working harder towards that goal. Antiretroviral therapy as a prevention tool represents an opportunity to galvanize decision makers but we also need to take into account as always that treatment needs to be part of a comprehensive approach -- there's no point having effective antiretroviral therapy in African communities, for instance, if nutrition and food security concerns are not addressed at the same time."
Another major theme of the conference was confronting tuberculosis, a disease that co-infects at least one-third of the 33 million HIV-infected patients worldwide. Without treatment, about 15 percent of these co-infected individuals develop active tuberculosis each year and up to 90 percent of such cases die within a few months, according to scientists from the Advocacy to Control TB Internationally (ACTION) coalition who spoke at the conference and urged widespread screening.
During an overview of the challenges presented by the dual epidemics of HIV and tuberculosis, Chakaya Jeremiahm, M.D., chief research officer of the Center for Respiratory Diseases Research at Kenya Medical Research Institute, recommended implementation of the 3 "I's" recommended by the World Health Organization: intensified case finding; isoniazid preventive therapy; and tuberculosis infection control.
Some research presented at the conference proved disappointing. For example, scientists from the Tulane National Primate Research Center showed that antibodies fail to control simian immunodeficiency virus, which complicates the search for a human HIV vaccine. Other research suggested that certain antiretroviral drugs -- especially nucleoside analogs -- may disrupt mitochondrial function and contribute to HIV dementia.
In other developments, researchers from GlaxoSmithKline -- which manufactures abacavir -- presented a meta-analysis of 54 clinical trials showing that abacavir does not increase the risk of myocardial infarction. But another study showed that abacavir was associated with a higher risk of cardiovascular disease than other nucleosides, possibly because it increases vascular inflammation.
AIDS: Global Initiative Needed to Prevent HIV Infections
WEDNESDAY, Aug. 6 (HealthDay News) -- To combat the worldwide HIV/AIDS epidemic, comprehensive prevention strategies are urgently needed, according to a series of six articles published online Aug. 6 in The Lancet and presented at AIDS 2008, the International AIDS Conference held Aug. 3 to 8 in Mexico City.
Abstract - Merson
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Abstract - Padian
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Abstract - Piot
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AIDS: Heterosexual Infectivity Rates Vary by HIV Risk Factors
TUESDAY, Aug. 5 (HealthDay News) -- Among heterosexual couples in which one partner is HIV positive, the commonly accepted infectivity rate of one transmission per 1,000 sexual contacts does not take into account risk factors that can increase the rate by up to several hundred times, according to a review published online Aug. 5 in The Lancet Infectious Diseases and presented at AIDS 2008, the International AIDS Conference held Aug. 3 to 8 in Mexico City.
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AIDS: Growth Hormone Improves HIV-Related Obesity
MONDAY, Aug. 4 (HealthDay News) -- In HIV patients who experience treatment-related abdominal obesity and growth hormone deficiency, treatment with low-dose growth hormone improves fat, blood pressure and other cardiovascular measurements but also worsens glucose levels, according to a report published in the Aug. 6 issue of the Journal of the American Medical Association and presented at AIDS 2008, the International AIDS Conference held Aug. 3 to 8 in Mexico City.
AIDS: Group Offers Guideline Updates for HIV Management
MONDAY, Aug. 4 (HealthDay News) -- Updated guidelines for antiretroviral therapy in adult HIV infection from the International AIDS Society-USA offer recommendations for starting therapy, choosing an initial regimen and other vital issues, and are published in the Aug. 6 issue of the Journal of the American Medical Association and presented at AIDS 2008, the International AIDS Conference held Aug. 3 to 8 in Mexico City.
AIDS: HIV Therapy Beneficial in Injection Drug Users
MONDAY, Aug. 4 (HealthDay News) -- New research dispels the commonly held belief that HIV-infected injection drug users are less likely to benefit from highly active antiretroviral therapy than non-injection drug users, according to the results of a study published in the Aug. 6 issue of the Journal of the American Medical Association and presented at AIDS 2008, the International AIDS Conference held Aug. 3 to 8 in Mexico City.
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AIDS: New U.S. HIV Incidence Highest Among Gay Men, Blacks
MONDAY, Aug. 4 (HealthDay News) -- New testing technology can be used to calculate nationwide incidence of HIV, and it has shown that new HIV infections in the United States are still highest among men who have sex with men and black individuals, according to study findings published in the Aug. 6 issue of the Journal of the American Medical Association and presented at AIDS 2008, the International AIDS Conference held Aug 3 to 8 in Mexico City.
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AIDS: Anti-TB Therapy Lowers Effectiveness of HIV Therapy
MONDAY, Aug. 4 (HealthDay News) -- In developing countries, HIV patients who receive rifampicin-based anti-tuberculosis therapy are more likely to experience virological failure after starting nevirapine-based antiretroviral therapy than those who start the more costly efavirenz-based antiretroviral therapy, according to a report published in the Aug. 6 issue of the Journal of the American Medical Association and presented at AIDS 2008, the International AIDS Conference held Aug 3 to 8 in Mexico City.
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