The IAS conference was used to launch several publications that each cover important aspects of HIV treatment or access. Here are a few that caught our attention. MSF must get the award for most prolific.
Officially announced at a pre-conference symposium on the 20-21 July preceding the International AIDS conference, the IAS "Towards an HIV Cure" Global Strategy represents a thorough and comprehensive framework for cure-related research in the future.
It aims to use a "bottom-up" approach whereby the scientists themselves dictate research areas and allows for more communication and collaboration between researchers underneath the umbrella of cure research.
The strategy acknowledges the success of antiretroviral therapy (ART) in controlling HIV infection, but recognises that this is not a cure, defined as either "functional" (long term control of HIV in the absence of ART) or "sterilising" (elimination of HIV from the body). Currently, ART fails to eradicate the reservoir of latently infected resting cd4+ T cells, which host stably integrated HIV-1 provirus. This on its own leads to viral persistence but there is also the possibility of on-going low-level replication in other tissues of the body.
The report then identifies seven main research priorities in how best to overcome HIV persistence before a cure (functional or sterilising) can be realised. These are:
At the report launch, Steven Deeks, co-chair of the IAS cure working group, said "Our basic understanding of the mechanisms of HIV persistence in latent reservoirs is far superior than it was a decade ago. We are entering a stage in the epidemic in which we can seriously begin testing drugs that either prevent latency or which force the virus out of its hiding place, making it susceptible to our current drugs."
The IAS initiative also aims to co-ordinate new donor funding for this research globally.
The International AIDS Society scientific working group on HIV cure. Towards an HIV cure: a global scientific strategy, full recommendations report, July 19, 2012.
A supplementary opinion article can be found in Nature Reviews Immunology 12, 607-614 (August 2012) by Steven Deeks.
A review of current knowledge and research concerns relating to HIV and aging, presented as a report to the NIH Office of AIDS Research and published as a supplement in the Journal of AIDS.1
Rather than a focus on the recent benefits of HAART that have extended life expectancy by 50 years, the authors are more concerned with the complex interplay of social and medical circumstances that mean that "on average, a 20 year old initiating ART may already have lost one-third of the expected remaining years of life compared to similar HIV uninfected persons."
The report highlights the concerns about Inflammation, co-infection (including CMV), reviews current data on biomarkers (IL-6, CRP, d-dimer, soluble CD14 and markers of T-cell activation and senescence), highlights current knowledge gaps and suggests priority areas of future research.
High KP et al. for the OAR working group on HIV and aging. HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH Office of AIDS Research by the HIV and aging working group. JAIDS. Volume 60 Supplement 1, S1-S18. (01 July 2012). Free access.
The Lancet has published a series of articles highlighting the ongoing growth of the HIV epidemic in men who have sex with men (MSM).
The series explores some of the unique aspects of the epidemic in MSM, which are driving transmission among this population.
The articles cover both the science and culture behind the MSM epidemic. One comment piece examines "The irony of homophobia in Africa," which is reflected in a review of the recently released film "Call me Kuchu" which looks at the life and death of David Kato in Uganda.
The scientific papers include a review of the "Successes and challenges of HIV prevention in men who have sex with men." The article emphasises the importance of combining biomedical and behavioural approaches to prevention amongst MSM, and the challenge of implementing these programmes in areas where resources are restricted and legal barriers remain.
Topics covered also include the unique challenges faced by black MSM around the world; stigma and discrimination affecting MSM; and a look at the global epidemiology of HIV infection in MSM.
The full series can be accessed online at:
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