2nd International AIDS Society Conference on HIV Pathogenesis and Treatment


Paris, France - July 13-16, 2003


| July 2003 | Sunday 13th . 18:00-19:30
Session 1OS - Opening Session
Opening Session
Chair persons
Michel Kazatchkine, ANRS, Paris, France
Joep Lange, University of Amsterdam, Amsterdam, The Netherlands
1* KEYNOTE LECTURE: EXPANDING ACCESS TO ANTIRETROVIRAL TREATMENT IN THE DEVELOPING WORLD: THE ECONOMIC RATIONALE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 1)
Jean-Paul Moatti, University of the Mediterranean, Marseille, France
Abstract not available
2* COMMUNITY ADDRESS: WHERE IS THE WAR CHEST AGAINST AIDS?
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 2)
Marie-Josée Mbuzenakamwe, Association Nationale de Soutien aux Séropositifs et Sidéens (ANSS), Bujumbura, Burundi
Abstract not available
| July 2003 | Monday 14th . 8:30-9:30
Session 2PL - Plenary
Chair persons
Françoise Barré-Sinoussi, Institut Pasteur, Paris, France
Souleymane Mboup, University Cheikh Anta Diop, Dakar, Senegal
3* CHALLENGES AND LESSONS LEARNED IN IMPLEMENTING ANTIRETROVIRAL THERAPY IN THE DEVELOPING WORLD
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 3)
Ernest Darkoh, Ministry of Health, Gaborone, Botswana
Abstract not available
4* HOST/VIRUS MECHANISMS IN THE MOLECULAR PATHOGENESIS OF HIV
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 4)
Nathaniel R. Landau The Salk Institute for Biological Studies, San Diego, USA
Abstract not available
| July 2003 | Monday 14th . 10:00-12:00
Session 3FO - Forum
HIV Drug Resistance
Conveners
François Clavel, Hospital Bichat-Claude Bernard, Paris, France
Daniel Kuritzkes, Partners AIDS Research Center, Harvard Medical School, Charlestown, USA
5* STATE-OF-THE ART TALK: MECHANISMS OF HIV DRUG RESISTANCE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 5)
François Clavel, Hospital Bichat-Claude Bernard, Paris, France
Abstract not available
6* STATE-OF-THE-ART TALK: USE AND CLINICAL IMPACTS OF DRUG RESISTANCE TESTING IN HIV INFECTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 6)
Daniel Kuritzkes, Partners AIDS Research Center, Harvard Medical School, Charlestown, USA
Abstract not available
7 COMBINING TENOFOVIR TO OTHER NRTIs: IMPACT ON RESISTANCE AND VIRAL FITNESS AT THE MOLECULAR LEVEL
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 7)
B Canard1, J Deval1, KL White2, MD Miller2, J Courcambeck3, B Selmi1 and J Boretto1
Our data describe at the molecular level both how a resistant virus is unable to resist to two drugs simultaneously, and for the first time, how viral fitness of a resistant virus is directly linked to its decreased ability to use natural nucleotide substrates. All together, these data predict a benefit for the combination of tenofovir DF with 3TC, as well as open new avenues in how to drive resistant virus to reduced viral fitness.
8 POLYMORPHISM OF HIV-2 PROTEASE GENE AND SELECTION OF DRUG RESISTANCE MUTATIONS IN HIV-2 INFECTED PATIENTS INCLUDED IN THE FRENCH ANRS COHORT AND TREATED WITH PROTEASE INHIBITORS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 8)
D Descamps1, S Matheron1, F Damond1, G Peytavin1, P Campa1, S Pueyo2, F Mammano1, S Lastere1, I Farfara1, F Simon3, G Chene2 and F Brun-Vezinet1 for the French HIV-2 ANRS cohort
Mutations associated with HIV-1 PI resistance were detected in HIV-2 treated pts. Substitutions of amino acids of currently unknown impact need to be evaluated by in vitro experiments.
9 THE INHIBITORY QUOTIENT (IQ) OF TIPRANAVIR/RITONAVIR (TPV/r) in TRIPLE CLASS EXPERIENCED HIV + PATIENTS; RESULTS FROM BI 1182.52.
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 9)
DL Mayers1, VM Kohlbrenner1, C Dohnanyi1, JP Sabo1, TR MacGregor1, W Verbiest2, P McKenna2, S McCallister1
The IQ of TPV observed in this trial of HTE triple class experienced pts compares favorably IQ data for other PIs obtained from treatment-naïve pts. This high IQ, coupled with the need for multiple protease gene mutations in most HIV isolates that show decreased susceptibility to TPV, suggests that TPV/r may provide antiviral activity in the majority of HTE HIV + patients.
10 A RANDOMIZED CONTROLLED TRIAL OF PHENOTYPIC RESISTANCE TESTING IN ADDITION TO GENOTYPIC RESISTANCE TESTING: THE ERA TRIAL
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 10)
C Loveday1, DT Dunn2, H Green2, A Rinehart3 and P McKenna4 on behalf of the ERA Steering Committee
The ERA trial found no clear evidence of added value (in terms of virological response) of phenotypic resistance testing against a background of genotypic resistance testing in patients with limited therapeutic options.
| July 2003 | Monday 14th . 10:00-12:00
Session 4FO - Forum
Immunopathogenesis and Immune Restoration
Conveners
Brigitte Autran, University Hospital Pitié-Salpêtrière, Paris, France
Bruce D. Walker, Partners AIDS Research Center, Harvard Medical School, Charlestown, USA
11* STATE-OF-THE ART TALK: RATIONALE FOR HIV-SPECIFIC IMMUNOTHERAPY: LESSONS FROM CHRONIC HIV INFECTION AND IMMUNE RESTORATION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 11)
Brigitte Autran, University Hospital Pitié-Salpêtrière, Paris, France
Abstract not available
12* STATE-OF-THE-ART TALK: PROSPECTS FOR IMMUNOTHERAPY OF HIV INFECTION: LESSONS FROM ACUTE INFECTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 12)
Bruce D. Walker, Partners AIDS Research Center, Harvard Medical School, Charlestown, USA
Abstract not available
13 PRELIMINARY RESULTS OF ESPRIT (EVALUATION OF SUBCUTANEOUS PROLEUKIN IN A RANDOMISED INTERNATIONAL TRIAL): BASELINE PREDICTORS OF CD4 T-CELL RESPONSE TO INTERLEUKIN-2
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 13)
L Weiss1, J Aboulhab2, GA Babiker2, JD Bebchuk3, J Darbyshire2, D Newberry2, C Capitant1 and JP Aboulker1 for the ESPRIT research group
CD4 cell count response after the first 3 cycles of IL-2 at Month 8 is associated with a higher nadir and baseline CD4 and younger age.
14 INTERLEUKIN-7 STIMULATES T-CELL RENEWAL WITHOUT INCREASING VIRAL REPLICATION IN SIV-INFECTED MACAQUES
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 14)
MT Nugeyre1, V Monceaux2, S Beq1, MC Cumont2, R Ho Tsong Fang2, L Chêne1, M Morre3, F Barré-Sinoussi1, B Hurtrel2, N Israël1
We show here that IL-7 induces both a central renewal and a peripheral expansion of T lymphocytes associated with cell activation. No increase in the viral load was shown in blood or lymph nodes. Furthermore no alarming side effect was observed. These data strengthen the rationale for the use of IL-7 as an efficient immunotherapy in AIDS.
15 IMMUNOLOGICAL IMPROVEMENT FOLLOWING HAART COINCIDES WITH RESTORED THYMIC FUNCTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 15)
R Cheynier1, R Bordi2, ML Dion2, R Woods3, J Montaner3, F Harris4, M Lederman5 and RP Sékaly2
The positive correlation between CD4 counts and intrathymic proliferation in HAART treated patients suggests the important role of thymic function in immune reconstitution following HAART.
16 THYMIC VOLUME IS INDEPENDENTLY ASSOCIATED WITH THE MAGNITUDE OF CD4+ T-CELL RECOVERY AFTER SHORT AND LONG TERM ON HAART
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 16)
E Ruiz-Mateos1, A Vallejo1, A Rubio1, N Soriano1, R de la Rosa2, S Molina1, A Sánchez-Quijano2, E Lissen2 and M Leal2 for the Viral Hepatitis and AIDS study Group
In conclusion, thymic volume is the main and only factor independently associated with the magnitude of CD4+ T-cell recovery either after short or long term on HAART. Thymic volume is not associated with the magnitude of TREC-bearing cells recovery, suggesting that other alternative mechanisms for TREC production such as redistribution and/or extrathymic synthesis might be involved.
| July 2003 | Monday 14th . 10:00-12:00
Session 5FO - Forum
Opportunistic Infections in
Resource-limited Settings
Conveners
Kevin De Cock, CDC, Nairobi, Kenya
Peter Mugyenyi, Joint Clinical Research Centre, Kampala, Uganda
17* STATE-OF-THE ART TALK: PATTERN OF OPPORTUNISTIC INFECTIONS IN AIDS PATIENTS IN AFRICA: THE UGANDAN EXPERIENCE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 17)
Peter Mugyenyi, Joint Clinical Research Centre, Kampala, Uganda
Abstract not available
18* STATE-OF-THE-ART TALK: TUBERCULOSIS IN THE CONTEXT OF HIV/AIDS IN 2003
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 18)
Kevin De Cock, CDC, Nairobi, Kenya
Abstract not available
19 BCG-INDUCED DISEASE IN HIV-INFECTED CHILDREN
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 19)
AC Hesseling1, HS Schaaf1, N Beyers1, MF Cotton1, RP Gie1, BJ Marais1, P van Helden2, WA Hanekom3 and R Warren1,3
The clinical picture was similar to tuberculosis, although right axillary adenitis is more common. Young symptomatic HIV-infected infants are at risk for BCG-related complications. Clinical features do not adequately distinguish between BCG and M. tuberculosis. Coinfection with M. tuberculosis can occur. Due to study limitations, we are unable to recommend a change in current vaccination policy. Population-based controlled studies are necessary to assess the risk of BCG in HIV-infected children.
20 PASSIVE VERSUS ACTIVE TUBERCULOSIS CASE FINDING AND ISONIAZID PREVENTIVE THERAPY AMONG HOUSEHOLD CONTACTS IN A RURAL DISTRICT OF MALAWI
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 20)
R Zachariah1, MP Spielmann1, AD Harries2, P Gomani3, SM Graham4-5, E Bakali3 and P Humblet6
Where the majority of TB patients are HIV positive, active case finding among household contacts yields 9 times more TB cases and is an opportunity for reducing TB morbidity and mortality. The need for a CXR is an obstacle for the uptake of INH prophylaxis.
21 DETECTION OF HIV, CHLAMYDIA, GONORRHEA, AND HERPES SIMPLEX BY DNA PCR IN CERVICOVAGINAL FLUIDS: CORRELATES OF MALE TO FEMALE AND FEMALE TO MALE TRANSMISSION OF HIV-1 INFECTION IN ZAMBIA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 21)
R Chavuma1 for the the Rwanda/Zambia HIV Research Group2,5
HIV is detectable in most CVF samples from HIV+ and some seroconverting women. Most HIV transmissions occurred without chlamydia, gonorrhoea, or HSV. Male-to-female transmission was associated with chlamydia and gonorrhoea, but female-to-male transmission was not. HSV shedding in CVF was associated with both acquiring and transmitting HIV.
22 INCREASING IN VITRO RESISTANCE TO FLUCONAZOLE IN CRYPTOCOCCUS NEOFORMANS ISOLATED IN CAMBODIA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 22)
B Sar1, D Monchy1, N Prak2, C Keo1 and JL Sarthou1
By contrast, FLC showed a big MIC change over time. In addition for 402 isolates the serotypes of C. neoformans were determined. 98.5% of isolate were serotype A and 1.5% were serotype B. Correlation between in vitro resistance to antifungal agents and clinical efficacy of treatment are not significantly established. Our study indicates that the resistance in vitro of C. neoformans to FLC appears to be linked to extended maintenance treatments under strictly controlled clinical prescription. C. neoformans var. neoformans is the isolate predominance of opportunistic infection in Cambodia.
| July 2003 | Monday 14th . 10:00-12:00
Session 6FO - Forum
Molecular Epidemiology of HIV and
Implications of Viral Diversity
Conveners
Francine McCutchan, US Military HIV Research Program, Rockville, USA
Martine Peeters, Institut de Recherche pour le Développement (IRD), Montpellier, France
23* STATE-OF-THE-ART TALK: OVERVIEW OF GLOBAL HIV-1 DIVERSITY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 23)
Francine McCutchan, US Military HIV Research Program, Rockville, USA
Abstract not available
24* STATE-OF-THE-ART TALK: GENETIC DIVERSITY OF HIV IN AFRICA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 24)
Martine Peeters, Institut de Recherche pour le Développement (IRD), Montpellier, France
Abstract not available
25 VIRAL LOAD (VL) AND CD4 RESPONSE TO PI CONTAINING REGIMEN IN B VERSUS NON-B TREATMENT-NAÏVE HIV-1 PATIENTS (P)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 25)
S De Wit1, R Boulmé2, B Poll1, JC Schmit2 and N Clumeck1
The HIV population starting therapy in Belgium shows a high heterogeneity of sub-types. No difference in VL response at m24 to a PI-containing regimen was found between B and non-B sub-types whereas CD4 response was lower in the non-B p., particularly those with A sub-type. Whether this is due to viral or immune factors warrants further investigation.
26 HIV-1 ENVELOPE GENE EVOLUTION IS DRIVEN BY STRONG NEUTRALIZING ANTIBODY SELECTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 26)
EE Paxinos1, T Wrin1, J Galovich1, J Beauchaine1, S Little2, DD Richman2 and CJ Petropoulos1
These findings support our hypothesis that rapid evolution of the HIV env gene following primary infection occurs in response to strong NA selective pressure and that env sequence divergence over time reflects the continual emergence of NA resistant escape variants.
27 LONG TERMINAL REPEAT SEQUENCE ANALYSIS OF THE HIV-1C EPIDEMIC IN ETHIOPIA DEMONSTRATING ASYMMETRIC PREVALENCE OF THE TWO CO-CIRCULATING GENOTYPES C AND C’: INDICATION FOR BIOLOGICAL ADVANTAGE OF THE C GENOTYPE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 27)
G Pollakis, T van Opijnen, A Kliphuis, A Abebe, J Goudsmit and MP de Baar
The surveillance of the HIV-1 circulating strains, especially in areas of high prevalence such as Ethiopia is crucial for future vaccine studies. We have identified that in Ethiopia two strains of subtype C (C and C') are co-circulating and demonstrated that recombinant progeny exist, possibly through unidirectional recombination and evolutionary pressure on the respective biological functions of the LTR promoter and the envelope protein. There is indication that one group may have a biological advantage over the other.
| July 2003 | Monday 14th . 12:30-13:30
Session 7FO - Forum
Treatment Issues in Pediatric HIV Infection
Conveners
Stéphane Blanche,, Hospital Necker-Enfants Malades, Paris, France
Katherine Luzuriaga, University of Massachussetts Medical School, Worcester, USA
28* STATE-OF-THE ART TALK: EARLY COMBINATION THERAPY: DETERMINANTS OF VIRAL SUPPRESSION AND LONG-TERM FOLLOW-UP
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 28)
Katherine Luzuriaga, University of Massachussetts Medical School, Worcester, USA
Abstract not available
29* STATE-OF-THE-ART TALK: MANAGEMENT OF PEDIATRIC ANTIRETROVIRAL TREATMENT
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 29)
Stéphane Blanche, Hospital Necker-Enfants Malades, Paris, France
Abstract not available
30 PATTERN AND CORRELATES OF VIRAL LOAD IN KENYAN HIV-1 INFECTED CHILDREN
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 30)
E Obimbo1, D Mbori-Ngacha1, P Otieno2, A Isavwa1, D Wamalwa1, C Farquhar3, R Bosire1, B Lohman1,3, B Richardson3 and G John-Stewart1,3
High peak VL is associated with high maternal VL, premature birth, high VL set point and with rapid disease progression among Kenyan HIV-1 infected infants.
31 HIGHLY ACTIVE ANTIRETROVIRAL THERAPIES AMONG HIV-1-INFECTED CHILDREN IN ABIDJAN, CÔTE D'IVOIRE (ANRS 1244)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 31)
P Msellati5, P Fassinou1, N Elenga2, F Rouet3, R Laguide2, KA Kouakoussui2, M Timite1 and S Blanche4
Globally adherence to treatment was good. 72 children were tested for HIV-1 RNA VL and CD4 before HAART initiation (median 52 days): median VL 5.41 log, median number of CD4 182/mm3, median percentage 7.9%. After 335 days with HAART, 48% under 2.4 log and 10.7% are between 2.4 and 3.0 log cp/ml, median VL 2.53 log cp/ml, median number of CD4 479 and median percentage 18.4. HAART treatment of children in Africa is feasible and as effective as in developed countries.
32 PREDICTORS OF IMMUNOLOGIC LONG-TERM NON-PROGRESSION IN HIV-INFECTED CHILDREN IN A PROSPECTIVE BIRTH COHORT
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 32)
K McIntosh1, C Mao1, M Paul2, M Charurat3 and W Shearer2 for the Women and Infants Transmission Study (WITS)
The levels of L phenotypic markers, particularly activation markers, in the first 4 months of life may predict rapid progression in infants and allow identification of slow immunologic progressors who may not need immediate ART.
33 MORTALITY AND MORBIDITY IN HIV-INFECTED INFANTS TREATED BEFORE 6 MONTHS OF AGE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 33)
A Faye
Children given early multitherapy do not suffer the early-onset, severe form of childhood HIV infection.
| July 2003 | Monday 14th . 12:30-13:30
Session 8PL - Plenary
Extraordinary Plenary Session
20 Years of HIV Science
Chair persons
Robert C. Gallo, Institute of Human Virology, University of Maryland, Baltimore, USA
Luc Montagnier, Fondation Mondiale Recherche et Prévention Sida, Paris, France
34* KEYNOTE LECTURE: 20 YEARS OF HIV SCIENCE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 34)
Anthony S. Fauci, Director, NIAID, National Institutes of Health, Bethesda, USA
Abstract not available
35* KEYNOTE ADDRESS: FROM SCIENCE TO ACTION: CHALLENGES IN MANAGING AIDS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 35)
Nelson Mandela, Former President of the Republic of South Africa, Founder, Nelson Mandela Foundation
Abstract not available
| July 2003 | Monday 14th . 14:30-16:30
Session 9OA - Oral Abstracts
Antiretroviral Therapy
Chair persons
Mauro Schechter, Federal University of Rio de Janeiro, Brazil
Stefano Vella, Istituto Superiore della Sanità, Rome, Italy
36 BIKS STUDY (LOPINAVIR/RITONAVIR-EFAVIRENZ COMBINATION): COMPLETE 24-WEEK RESULTS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 36)
V. Ferré1, C. Allavena1, I. Poizot-Martin2, G. Beck-Wirth3, I. Cohen Codar5, P. Perré4, F. Raffi1, and the BIKS study group
The dual combination of LPV/r-EFV shows a similar immuno-virological efficacy to a NRTI-based HAART regimen with an acceptable tolerability. Durability of antiviral effect will be assessed at W48 of follow-up.
37 EMTRICITABINE, DIDANOSINE AND EFAVIRENZ ONCE-DAILY(OD) VERSUS CONTINUED PI-BASED HAART (C) IN HIV-INFECTED ADULTS WITH UNDETECTABLE PLASMA HIV-RNA: 48-WEEK RESULTS OF A PROSPECTIVE RANDOMIZED MULTICENTER TRIAL (ALIZE-ANRS99)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 37)
J. Molina1, F. Ferchal1, V. Journot2, P Yéni3, W. Rozenbaum3, C. Rancinan2, L. Morand-Joubert3, S. Fournier1, P. Morlat2, B. Dupont3, J. Delfraissy3, P. Dellamonica4, I. Poizot-Martin5, E. Rosenthal4, G. Chêne2, and the Alize study group
The substitution of a PI-based regiment by a simple once-daily combination of emtricitabine, didanozine and efavirenz mainted full control of plasma HIV-RNA levels for 48 weeks and was well tolerated.
38 A RANDOMIZED, DOUBLE-BLIND, MULTICENTER COMPARISON OF EMTRICITABINE QD TO STAVUDINE BID IN TREATMENT-NAÏVE HIV-INFECTED PATIENTS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 38)
F. Raffi1, M. Saag2, P. Cahn3, M. Wolff4, D. Pearce5, J. Molina6, J. Hinkle7, A. Shaw7, E. Mondou7, J. Quinn7 and F. Rousseau7 for the FTC301 Study Team
Once-daily FTC demonstrated durable and superior virologic efficacy and tolerability through 60 weeks of follow-up compared to twice-daily d4T when used with once-daily ddI and EFV.
39 COMPARISON OF PI-BOOSTED INDINAVIR WITH EFAVIRENZ PLUS STAVUDINE REGIMENS IN EASIER (EUROPEAN AND SOUTH AMERICAN STUDY OF INDINAVIR, EFAVIRENZ, AND RITONAVIR)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 39)
M Stek Jr1, B Hirschel2, J Benetucci3, G Reboredo4, D Duiculescu5, J Begovac6, K Brinkman7, D Banhegyi8, M Shivaprakash1 and J Menten1 for the EASIER study team
At 48 weeks, the compact, IDV/RTV+EFV nucleosidesparing regimen yielded similar promising efficacy and safety data as compared with results achieved using the PI+NNRTI foundation plus D4T.
40 DIRECTLY OBSERVED THERAPY (DOT) FOR HIV+ DRUG USERS (IDUs)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 40)
FL Altice, J Mezger, J Hodges, D Bruce, S Springer and GH Friedland
Active IDUs with HIV have significant social and medical co-morbidity and disenfranchisement from the health care system. Despite these obstacles, they have improved health outcomes while on DOT. HIV+ IDUs with baseline viral suppression do not need DOT and such resource-consuming efforts should be reserved for those who might benefit most.
41 ACTG 5095: A COMPARATIVE STUDY OF 3 PROTEASE INHIBITOR-SPARING ANTIRETROVIRAL REGIMENS FOR THE INITIAL TREATMENT OF HIV INFECTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 41)
RM Gulick1, HJ Ribaudo2, CM Shikuma3, S Lustgarten2, WA Meyer4, K Klingman5, KE Squires6, S Snyder7 and DR Kuritzkes8
In treatment-naïve pts, ZDV/3TC/ABC was inferior to EFV-containing treatment in terms of rates and time to virologic failure.
42 INDUCTION OF ANTIRETROVIRAL-NAÏVE HIV-INFECTED SUBJECTS WITH TRIZIVIR (TZV) AND SUSTIVA (EFV) FOR 48 WEEKS (ESS40013)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 42)
M Markowitz1, J Lang2, E DeJesus3, C Hill-Zabala4, ER Lanier4, Q Liao4, K Pappa4 and M Shaefer4
TZV+EFV is a compact potent 4-drug regimen that can effectively reduce vRNA in patients with broad ranges of vRNA and CD4 cell counts. Full data from M will be presented in the future.
43 EARLY VIROLOGIC FAILURE IN A PILOT STUDY EVALUATING THE EFFICACY OF ABACAVIR, LAMIVUDINE AND TENOFOVIR IN THE TREATMENT NAÏVE HIV-INFECTED PATIENTS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 43)
C Farthing, H Khanlou and V Yeh
Although preliminary, these results raise the concern about potency and efficacy of this regimen administered once-daily in HIV treatment naïve pts, particularly those with initial VL >100,000.
| July 2003 | Monday 14th . 14:30-16:30
Session 10SY - Special Symposium
Symposium on Cellular Immunity
Chair persons
Patrice Debré, University Hospital Pitié-Salpêtrière, Paris, France
Joseph M. McCune, Gladstone Institute of Virology and Immunology, San Francisco, USA
44* SKEWED REPRESENTATION OF FUNCTIONALLY DISTINCT POPULATIONS OF VIRUS-SPECIFIC CD4 T-CELLS IN HIV-1-INFECTED SUBJETS WITH PROGRESSIVE DISEASE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 44)
Alexandre Harari, Lausanne University Hospital, Switzerland
Abstract not available
45* IMPACT OF HIV-1 SPECIFIC T-CELL RESPONSES ON VIRAL SEQUENCE VARIATIONS AND CONTROL OF VIRAL REPLICATION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 45)
Marcus Altfeld, Partners AIDS Research Center, Massachusetts General Hospital, Charlestown, USA
Abstract not available
46* FAILING IMMUNE CONTROL IN HIV INFECTION: LESSONS FROM THE NATURAL COURSE OF INFECTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 46)
Debbie van Baarle, Clinical Viro-Immunology, Sanquin Research at CLB, Amsterdam, The Netherlands
Abstract not available
47* GENERATION OF DYSFUNCTIONAL CD8 LOW SINGLE POSITIVE 8 THYMOCYTES IN THE HIV-INFECTED THYMUS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 47)
David Favre, Gladstone Institute of Virology and Immunology, The J. David Gladstone Institutes, University of California, San Francisco, USA
Abstract not available
48* CD8+ T-CELL DIFFERENTIATION TOWARDS SENESCENCE FOLLOWING ABERRANT CD8+ ACTIVATION IN HIV-1 INFECTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 48)
Victor Appay, MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK
Abstract not available
49* THE POTENTIAL OF VACCINE-ELICITED CELLULAR IMMUNE RESPONSES
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 49)
Emilio A. Emini, Merck Research Laboratories, West Point, USA
Abstract not available
| July 2003 | Monday 14th . 14:30-16:30
Session 11OA - Oral Abstract
Complications of Antiretroviral Therapy
Chair persons
Andrew Carr, St.Vincent’s Hospital Sydney, Australia
Jose Gatell, University of Barcelona, Spain
50 A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF ROSIGLITAZONE FOR PATIENTS WITH HIV LIPODYSTROPHY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 50)
C Hadigan1, S Yawetz2, A Thomas3, F Havers1, PE Sax2 and S Grinspoon1
With open label extension, insulin sensitivity remained improved and SAT increased further for a net change of ±15% from baseline after 6 months. These data demonstrate positive effects of rosiglitazone on insulin sensitivity and fat in HIV-infected patients with lipodystrophy and insulin resistance. Thiazolidinediones may provide an important therapeutic benefit. Studies are needed to identify optimal dose, duration of treatment, subpopulations most likely to benefit and choice of specific thiazolidinedione to minimize effects on cholesterol.
51 BASELINE (BL) LACTATE LEVELS AND CT SCAN VALUES PREDICT THE REGRESSION OF LIPOATROPHY (LA) IN CT SCAN 48 WEEKS AFTER A SWITCH FROM STAVUDINE (D4T) TO ABACAVIR (ABC) OR ZIDOVUDINE (ZDV)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 51)
J Hernandez1, D Ward2, V Williams1, G McComsey3, T File4, T Lonergan5, S Hessenthaler1 and R Fisher1
Subjects with LA showed progressive gains in body fat through wk 48 when d4T was replaced with either ABC or ZDV. BL lactate levels and BL CT scan values were predictive of a decrease in VAT at 48 weeks.
52 RISKS OF CARDIOVASCULAR DISEASE ASSOCIATED WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY AMONG PERSONS TREATED FOR HIV/AIDS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 52)
AR Levy1, B Sobolev1, RS Hogg1,2, U Iloeje3, J Mukherjee3, B Yip2, M Harris2, MV O’Shaughnessy2 and JS Montaner2
This population-based analysis showed that the risk of cardiovascular disease may be increased when HIV-infected subjects were using PIs. The true association is likely to be stronger than shown here because misclassification of exposure likely reduced in magnitude of the association.
53 SHORT-TERM TOLERANCE OF EFAVIRENZ IN HIV-INFECTED AFRICAN ADULTS PARTICIPATING IN THE TRIVACAN ANRS 1269 TRIAL, ABIDJAN, CÔTE D’IVOIRE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 53)
C Danel1, R Moh1, E Messou1, A Minga1, C Seyler1, D Sauvageot1, X Anglaret3, E Bissagnene2 and R Salamon3 for the ANRS 1269 Study Group
In these preliminary data from adult patients receiving efavirenz in trial conditions (counselling on compliance), subjective symptoms were frequently self-reported, but no severe adverse event was notified and no treatment modification decided. Data available on June 2003 (350 patients) will be presented at the conference.
54 ACTG 5097s: IMPACT OF EFAVIRENZ (EFV) ON NEUROPSYCHOLOGICAL PERFORMANCE, MOOD, AND SLEEP BEHAVIOUR IN HIV-POSITIVE INDIVIDUALS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 54)
DB Clifford1, S Evans2, Y Yang2, E Acosta3, K Goodkin4 and RM Gulick5
In a large active-controlled trial, early neurologic symptoms distinct from depression or anxiety were associated with EFV use, and resolved by week 4. Improvement in neuropsychologic performance was comparable in EFV and non-EFVtreated subjects.
55 INCREASES IN CREATININE DURING THERAPY WITH TENOFOVIR DF
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 55)
M Harris1, B Yip1, N Zalunardo2, R Werb2, M Valyi1, R Hogg1 and J Montaner1
In summary, clinically significant Cr increases were observed in 7% of patients taking TDF for 6 months, resulting in at least 1% of patients discontinuing TDF during the first year. Among patients with normal renal function at baseline, those with more advanced HIV disease are at higher risk of developing elevated Cr levels while taking TDF.
56 INCIDENCE AND RISK FACTORS FOR SEVERE ADVERSE EVENTS IN A PROSPECTIVE COHORT OF HIV-INFECTED ADULTS STARTED ON A PROTEASE INHIBITOR-CONTAINING THERAPY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 56)
X Duval1, V Journot2, T May3, C Charlois1, A Waldner4, C Merle de Boever6, C Barennes2, JM Ragnaud5, G Chêne2, C Leport1 and the APROCO Study Group
SAE after the initiation of HAART are frequent and related both to host (renal, hepatic tests and hepatitis co-infections) and treatments characteristics. Early occurrence of SAE in the course of therapy could involve for some of them a toxic mechanism, with decreasing risk over time.
57 GENDER AND RACE SUBGROUP ANALYSES IN A PROSPECTIVE STUDY OF HYPERLIPIDAEMIA IN ART-NAÏVE SUBJECTS TAKING TRIZIVIR (TZV), COMBIVIR (COM)/NELFINAVIR (NFV), OR STAVUDINE (D4T)/LAMIVUDINE (3TC)/NFV
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 57)
K Tashima1, P Kumar2, A Rodriguez-French3, M Thompson4, P Wannamaker5, V Williams5 and K Pappa5
Virologic and metabolic responses to the different regimens appear to vary by gender and race and further study is justified.
| July 2003 | Monday 14th . 14:30-16:30
Session 12OA - Oral Abstract
Mother-to-Child Transmission
Chair persons
Gunnel Biberfeld, Karolinska Institute, Stockholm, Sweden
Nicolas Meda, Centre MURAZ/OCCGE, Bobo-Dioulasso, Burkina Faso
58 TIMING OF MOTHER-TO-CHILD TRANSMISSION OF HIV-1 (MTCT) AND INFANT MORTALITY IN THE FIRST SIX MONTHS OF LIFE IN HARARE, ZIMBABWE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 58)
LS Zijenah1, LH Moulton2, P Iliff3, K Nathoo3, MW Munjoma4, K Mutasa3, L Malaba5, P Zvandasara4, BJ Ward6 and J Humphrey2–3 for the ZVITAMBO Study Group
In the first 6 months of life, IU and IP/ePP transmission contributed about 25% of the 30.7% MTCT. This is the first study with a large cohort, in the absence of antiretroviral intervention, to define contributions of the three modes of MTCT. Our data, in addition to serving as a historical comparison, may be useful in the designing and evaluating the efficacy of short course antiretroviral trials aimed at reducing MTCT in developing countries.
59 MATERNAL VIRAL LOAD AND CCR5 CO-RECEPTOR UTILIZATION: CRITICAL DETERMINANTS IN MOTHER-TO-CHILD HIV-1 TRANSMISSION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 59)
A Gormley1, B Weiser1, H Burger1, C Kitchen2, A Uppal1, R Moore1, C Brunner1 and S Philpott1
Although total viral load correctly predicted transmission in 94.3% of cases (OR=45.15, 95% CI=3.144-649.0), R5 viral load correctly predicted 98% (OR=496.77, 95% CI=3.044-999.0). One non-transmitting mother, whose total viral load exceeded one million copies, had an R5 load of only ∼100,000. Our results suggest that CCR5 plays an essential role in vertical transmission. Blockade of this receptor may provide an additional strategy to prevent motherto- child transmission.
60 FACTORS ASSOCIATED WITH PERINATAL HIV-1 TRANSMISSION IN MOTHERS AND NON-BREASTFED INFANTS RECEIVING ZIDOVUDINE (ZDV) PROPHYLAXIS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 60)
G Jourdain1,2, JY Mary3, S Le Coeur2,4, N Ngo-Giang-Huong1,2, K McIntosh5, K Kengsakul6, K Boonrod7 and M Lallemant1,2 for the perinatal HIV prevention trial group (PHPT)
Factors independently associated with early and late transmission despite ZDV may give insight on the mechanisms of transmission or of ZDV prophylaxis failure. The pathogenesis significance of elevated creatinine in relation to transmission needs to be investigated. Support: NIH R01 HD33326, IRD, Roche Diagnostics, GlaxoWellcome.
61 EFFECT OF PERINATAL ZIDOVUDINE TREATMENT ON THE EVOLUTION OF CELL-FREE HIV-1 IN BREAST MILK ON POSTNATAL TRANSMISSION, ANRS 049 DITRAME-VIRO STUDY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 61)
O Manigart1, M Crépin2, V Leroy3, N Meda1, D Valéa1, EN Janoff4, F Rouet2, L Dequae-Merchadoux3, F Dabis3, C Rouzioux5 and P Van de Perre1 for the ANRS 049 DITRAME Study Group
In a multivariate analysis performed on data from 80 women with complete information, increase of HIV-1 RNA in milk from day 45 to day 90 was significantly associated with postnatal transmission and with previous ZDV prophylaxis. The substantial risk of postnatal transmission of HIV-1 are significantly associated with HIV-1 RNA levels in milk. The rebound of HIV-1 RNA levels in milk after discontinuation of maternal ZDV, but before cessation of breasfeeding may introduce additional risk of postnatal transmission.
62 MULTICENTRE, RANDOMIZED CONTROLLED TRIAL, ASSESSING THE SAFETY AND EFFICACY OF NEVIRAPINE IN ADDITION TO ZIDOVUDINE FOR THE PREVENTION OF PERINATAL HIV IN THAILAND: PHPT-2 UPDATE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 62)
M Lallemant1,2, G Jourdain2, S Le Coeur2,3, JY Mary4, K McIntosh5, N Ngo-Giang Huong2, E Guerrin-Tran6, S Koetsawang6 and V Thaineua7
While adding NVP during labour and in the neonate to oral ZDV prophylaxis significantly decreases HIV transmission, the need for the infant NVP dose still needs to be established. Sponsors: NIH R01 HD39615, USA; ANRS 1208 and IRD, France; Ministry of Public Health, Thailand; Boehringer-Ingelheim (study treatment), Glaxo-Smith-Kline (ZDV), Roche Diagnostics (DNAPCR).
63 MORTALITY IN BREAST-FED AND FORMULA-FED CHILDREN BORN TO HIVINFECTED WOMEN IN A PMTCT PROJECT IN ABIDJAN (CÔTE D'IVOIRE): DITRAME PLUS ANRS 1202
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 63)
R Becquet1, L Becquet2, DK Ekouevi1,2, I Viho2, H Toure2, F Dabis1, M Timite-Konan3 and V Leroy1
In this context of an intensive counselling from birth, there is no evidence of a higher mortality in formula-fed HIV-uninfected children compared to those breast-fed. Further follow-up will allow us to compare these mortality rates with those in the general population in Abidjan.
64 INFANT FEEDING COUNSELLING IN THE REDUCTION OF MOTHER TO CHILD TRANSMISSION OF HIV IN MATERNAL AND CHILD HEALTH SETTINGS, NDOLA, ZAMBIA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 64)
E Muyunda2, N Ntombela2, J Tshiula2, F Munkonze2, N Dondi2, T Nyirenda2, M Mzumara2, M Barrett2, N Franklin2, C Kruger2, H Chiyota2, W Siasulwe3, M Lembalemba1, E Sakala1, A Banda1, S Kalibala3, N Rutenberg3 and S Geibel3
There is need to seriously consider realistic ways of incorporating replacement feeding in this community. If replacement feeding is unrealistic even in an urban area, it may not be different in the rural areas.
65 HIV-2 MOTHER-TO-CHILD TRANSMISSION RISK ASSESSED BY REAL TIME DNA PCR TECHNOLOGY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 65)
M Burgard1, S Blanche1, MJ Mayaux2, C Allisy3, N Ciraru4, G Firtion5, JM Retbi6 and C Rouzioux1 for the the ANRS Paediatric Cohort Study Group
HIV-2 rate of transmission was 0.5% (1/204; 95%CI:0-1.5%). Real time PCR is an easy and convenient method for HIV-2 diagnosis in neonates.
| July 2003 | Monday 14th . 14:30-16:30
Session 13OA - Oral Abstract
Reservoirs and Superinfections
Chair persons
Christine Rouzioux, Hospital Necker-Enfants Malades, Paris, France
Luc Perrin, Geneva University Hospital, Switzerland
66 PERSISTENCE OF HIV-1 MULTIDRUG RESISTANCE WITHOUT ANY ANTIRETROVIRAL TREATMENT 2 YEARS AFTER SEXUAL TRANSMISSION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 66)
C Delaugerre1, L Morand-Joubert2, O Picard2, ML Chaix3, AG Marcelin1, V Schneider4, A Krivine5, A Compagnucci6, C Katlama1, PM Girard2 and V Calvez1
Only multidrug resistant viruses, present in the source patients and well-adapted to the environment, were transmitted. In the index patients, an expansion of predominant MDR quasispecies and the ‘archival’ of all mutations were observed. These results explain the persistence of mutations and suggest the high difficulty to return to a wild-type viral population sensitive to an antiretroviral treatment. The treatment of index patients is limited and the major risk is the transmission of these multidrug resistant viruses.
67 THE LYMPHOCYTE HIV RESERVOIR IN PATIENTS ON PROLONGED HAART IS A MEMORY OF VIRUS EVOLUTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 67)
O Lambotte1, ML Chaix2, B Gubler3, N Nasreddine1, C Wallon1, C Goujard4, C Rouzioux2, Y Taoufik1,3 and JF Delfraissy1,4
The HIV lymphocyte reservoir is dynamic with a diversity mainly resulting from the successive archiving of plasma viruses circulating during the HIV infection course. The archiving of resistant virus must be taken into account in therapeutic decisions.
68 ENUMERATION OF LATENTLY INFECTED CD4+ T-CELLS FROM HIV-1 INFECTED PATIENTS USING AN HIV-1 ELISPOT ASSAY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 68)
V Baillat1, JM Fondere2, G Petit Jean2, V Perez2, J Reynes1 and JP Vendrell2,3
As each immunospot represents one HIV-1-secreting cell, the HIV-1 ELISPOT assay is an eligible assay to enumerate HIV-1 latently infected CD4+ T lymphocytes from peripheral blood. This sensitive assay could become a useful tool for precisely evaluating latently infected CD4+ T cell frequencies.
69 DEACETYLASE INHIBITORS AS CANDIDATE DRUGS TO PURGE LATENTLY HIV-1-INFECTED RESERVOIRS IN HAART PATIENTS? MECHANISTIC INSIGHTS INTO REGULATION OF VIRAL REPLICATION BY DEACETYLASE INHIBITORS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 69)
Y Collette1, V Quivy2, E Adam2, B Vire1, D Demonte2, V Bours3, J Piette3, D Olive1, A Burny2 and C Van Lint2
We identify a new regulatory link between DACi and NF-κB-dependent gene expression, which is not at the level of NF- κB/DAC interactions but at the level of IκBα cytoplasmic content. The physiological relevance of this TNFα-DACi synergism was shown on HIV-1 replication in both acutely and latently HIV-infected cells.
70 DUAL ROLE OF PROSTATIN IN INHIBITION OF INFECTION AND REACTIVATION OF LATENCY OF HUMAN IMMUNODEFICIENCY VIRUS IN PRIMARY BLOOD LYMPHOCYTES AND IN LYMPHOID TISSUE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 70)
A Biancotto1, JC Grivel2, M Pion1, F Gondois-Rey1, R Vigne1, S Brown3, LB Margolis2 and I Hirsch1
While prostratin stimulation restricts susceptibility of primary resting CD4 T cells to HIV at the virus cellentry and the reverse transcription levels, it efficiently reactivates expression of pre-integrated and integrated latent HIV-1. This dual role makes of prostratin an excellent candidate for the elimination of persistent HIV infection from latent reservoirs in HAART-treated patients.
71 RECOMBINATION FOLLOWING SUPER-INFECTION BY HIV-1
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 71)
G Fang1, B Weiser1,2, C Kuiken3, S Philpott1, S Rowland-Jones4, F Plummer5, J Kimani6, CH Chen1, B Shi1, R Kaul5,6, J Bwayo6, O Anzala6 and H Burger1,2
It illustrates that chronic infection with one strain may not provide protection against challenge from another. Recombination resulting from superinfection with diverse strains may pose problems for eliciting broad immune responses necessary for an effective vaccine.
72 HIV-1 SUPERINFECTIONS IN A COHORT OF COMMERCIAL SEX WORKERS IN BURKINA FASO AS ASSESSED BY A NOVEL AUTOLOGOUS HETERODUPLEX MOBILITY PROCEDURE, ANRS 1245 STUDY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 72)
O Manigart1,2, V Courgnaud2, O Sanou1, D Valéa1,2, N Nagot1,2, N Meda1,2, E Delaporte2, M Peeters2 and P Van de Perre2
In both women, retrospective analyses of stored samples showed acquisition of a second virus concomitant with an increasing plasma HIV RNA. Autologous HMA procedure, followed by acrylamide extraction of heteroduplexes, allowed identifying HIV-1 co- and super-infections in a large cohort study. HIV-1 super-infection is not an uncommon phenomenon.
73 PREVALENCE OF CO AND SUPER-INFECTION IN IVDUs
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 73)
S Yerly1, S Jost1, M Monnat2, A Telenti3, J-P Chave4, L Kaiser1, P Burgisser3 and L Perrin1
In recently infected IVDUs, the prevalence of co-infection is high (6%). In chronically infected IVDUs super-infection is not rare and has been observed in patients previously able to control HIV-1 infection due to another subtype.
| July 2003 | Monday 14th . 14:30-16:30
Session 14OA - Oral Abstract
AIDS-Related Diseases
Chair persons
Alaka Deshpande, JJ Hospital, Mumbai, India
Pierre-Marie Girard, Hospital Saint-Antoine, Paris, France
74 MULTICENTRIC CASTLEMAN’S DISEASE IN 70 HIV-INFECTED PATIENTS: A PROSPECTIVE COHORT STUDY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 74)
E Oksenhendler1, L Galicier1, L Gérard1, F Agbalika2 and V Meignin3
HIV/HHV8-associated MCD is a multiclonal virus-induced B cell lymphoproliferative disorder with plasmacytic differentiation. Evolution towards HHV8+NHL is unpredictable, although frequent if not constant.
75 RISK FACTORS FOR NON-HODGKIN LYMPHOMA IN HIV-INFECTED PATIENTS IN THE HAART ERA: A CASE CONTROL STUDY IN THE AQUITAINE COHORT (1996–2002)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 75)
E Balestre1, F Bonnet1,2, R Thiébaut1,3, D Neau2, JL Pellegrin2 and F Dabis1 for the Groupe d’Epidémiologie Clinique du SIDA en Aquitaine (GECSA)
We have confirmed the protective effect of HAART but also of antiherpetic drugs on the risk of developing NHL. The role of HIV RNA need to be better assessed because it could represent a chronic simulating factor of B cells at the origin of monoclonal proliferation.
76 ELEVATED LEVELS OF SOLUBLE CD30 (sCD30) AND CD44 (sCD44) PRECEDE THE DEVELOPMENT OF AIDS-ASSOCIATED NON-HODGKIN’S B-CELL LYMPHOMA (AIDS-NHL)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 76)
E Crabb Breen, M Epeldegui, S Fatahi, WJ Boscardin, R Detels and O Martínez-Maza
Serum levels of sCD30 and sCD44, molecules associated with B cell activation, were significantly increased preceding the clinical diagnosis of AIDS-NHL. A multifactorial analysis is underway to determine if sCD30 and/or sCD44 may be acting in concert with other B cell stimulatory molecules that have been shown to be elevated preceding the development of AIDS-NHL, to promote/reflect lymphomagenesis.
77 EBV SPECIFIC CTLs ARE CONSERVED IN MOST PATIENTS WITH EBV+ AIDS-ASSOCIATED LYMPHOMA DESPITE HIGH EBV VIRAL LOAD AND LOW CD8 COUNT
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 77)
L Galicier1, G Carcelain2, Y BenHadj Hmida2, J Gabarre3, JC Nicolas4, B Autran2 and E Oksenhendler1
The association of EBV+ NHL with high EBV viral load and low CD8 count suggests that loss of EBV control may play a direct role in the pathogenesis of AIDS lymphoma. However, although 30% of the patients had no detectable EBV-CTLs, more than 50% had normal T cell responses to both latent and lytic EBV peptides, whatever the EBV status of the tumour, suggesting that the loss of functional CTLs is not pivotal in the genesis of the majority of AIDS lymphomas.
78 PROGNOSTIC FACTORS OF KAPOSI’S SARCOMA IN THE ERA OF HAART
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 78)
V Martinez1–2, E Caumes1,I Gorin2, D Salmon-Ceron3, C Katlama1, F Bricaire1 and N Dupin2
Patients naïve of antiretroviral therapy or with progression of KS at months 6 and 12 have an additional risk of progression of KS. Moreover, our results shown a relationship between remission of KS and supressed viral load under HAART.
79 SYPHILIS AND THE CENTRAL NERVOUS SYSTEM (CNS) IN HIV INFECTED PATIENTS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 79)
S Hopkins, H McDermott, F Lyons, C Bergin and F Mulcahy
50% of lumbar punctures were not required in this cohort if CS and sTPPA >5120 were utilized for assessment of NS risk. This study provides clinical criteria for evaluating syphilis in HIV-positive individuals.
80 NATURAL HUMAN CYTOMEGALOVIRUS (HCMV) DNA POLYMERASE POLYMORPHISM: CONSEQUENCE ON GENOTYPIC DIAGNOSIS OF ANTIVIRAL DRUG RESISTANCE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 80)
AM Fillet1, L Auray1, S Alain4, K Gourlain1, F Najioullah5, S Gouarin6, J Carquin7, I Garrigues8, N Houhou2, D Thouvenot5, BM Imbert9, MC Mazeron2 and the ANRS Cytomegalovirus Study Group
Both mutations A885T and S655L were frequently observed, as previously published (Chou 1999). In contrast, S633F, T691A and A692S have never been described. All mutations occurred outside of conserved functional domains where resistance mutations have been identified. Results showed no distinctive clustering with geographical origin.
81 FACTOR ASSOCIATED AND PROGNOSTIC DETERMINANTS OF TOXOPLASMIC ENCEPHALITIS IN THE HAART ERA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 81)
D Larussa1, P Lorenzini1, A Cingolani2, S Bossolasco3, MG Finazzi4, M Bongiovanni5, B Vigo6, S Grisetti1, G Guaraldi7, B Gigli, A Mariano8, ER Dallenogare9, A Ammassari2, A d’Arminio Monforte5, P Cinque3 and A Antinori1 for the Italian Registry Investigative Neuro AIDS (IRINA)
TE remains the main neurological disorder even in the HAART era. Occurrence of TE as clinical progression during HAART negatively affects clinical response, even if high rates of survival were observed independently from HAART exposure before diagnosis.
| July 2003 | Monday 14th . 14:30-16:30
Session 15OA - Oral Abstract
Epidemiology, Morbidity and Mortality
Chair persons
Charles Gilks, WHO, Geneva, Switzerland
Harold W. Jaffe, CDC, Atlanta, USA
82 HIV TRANSMISSION DURING PRIMARY VERSUS SECONDARY HIV INFECTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 82)
M Xiridou1, M Kretzschmar2, R Geskus1, J De Wit1,3 and R Coutinho1,4
Therefore, early treatment of PHI has only a limited impact on the spread of HIV. However, during a period with high incidence, primary infections account for a larger fraction of new infections and early treatment may have a major impact.
83 HORMONAL CONTRACEPTION AND RISK OF HIV-1 ACQUISITION: RESULTS OF A 10-YEAR PROSPECTIVE STUDY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 83)
L Lavreys1-2, JM Baeten1, HL Martin Jr3, JK Kreiss1, K Mandaliya4, J Ndinya-Achola2 and J Overbaugh5
Use of hormonal contraception is associated with a significantly increased risk of HIV-1 acquisition. Condoms should be rigorously promoted in women at risk for HIV-1 and who use hormonal contraception.
84 PREVALENCE OF UNDIAGNOSED HIV INFECTION IN FEBRILE PATIENTS PRESENTING TO AN EMERGENCY DEPARTMENT IN SOUTH-EASTERN USA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 84)
AC Weintrob1, AML Anderson1, C Seshadri1, LB Caram1, MG Kerkau2, SA Fiscus2 and CB Hicks1
A significant number of people with undiagnosed HIV infection present to the Duke ED. As many patients use the ED as their primary source of medical care, improved strategies for HIV testing are required in this setting.
85 IMMUNOLOGICAL AND CLINICAL RESPONSES TO HAART OVER 50 YEARS OF AGE, RESULTS FROM THE FRENCH HOSPITAL DATABASE ON HIV
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 85)
S Grabar1,2, I Kousignian2, A Sobel3, P Enel4, C Jung3 and D Costagliola2
Patients over 50 years old exhibited an immune response after HAART. However, their CD4 cells reconstitution was significantly slower than in younger patients. This may explain why older patients have a higher risk of clinical progression.
86 THE IMPACT OF THE EMERGENCE OF ANTIRETROVIRAL RESISTANCE IN THE FIRST YEAR ON SURVIVAL IN SUBSEQUENT YEARS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 86
RS Hogg, CS Alexander, B Yip, W Dong, T Mo, J Woodward, B Wynhoven, L Ting, MV O’Shaughnessy, JSG Montaner and R Harrigan
In conclusion, these results indicate that although the emergence of resistance remains relatively low after the first year on therapy, persons who exhibited reduced sensitivity to NNRTIs during this period appear at greater risk of death.
87 MORTALITY DUE TO HEPATITIS C-RELATED LIVER DISEASE IN HIV-INFECTED PATIENTS IN FRANCE IN 2001 (MORTAVIC 2001 STUDY)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 87
E Rosenthal1, M Poirée1, C Pradier2, C Perronne3, D Salmon-Ceron4, L Geffray5, RP Myers6, P Morlat7, G Pialoux8, S Pol9 and P Cacoub10 for the GERMIVIC Joint Study Group
In the post-HAART era, ESLD due to HCV is a growing cause of mortality in HIV-infected patients. Increased longevity attributable to HAART, and a higher prevalence of alcohol consumption, are likely involved in this trend.
88 CAUSES OF DEATH IN HIV-INFECTED ADULTS IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART): THE FRENCH SURVEY MORTALITÉ 2000
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 88)
C Lewden1, S Bévilacqua2, F Bonnet3, L Héripret4, D Salmon5, P Morlat3, T May2, D Costagliola6, E Jougla7, G Chêne1 and the Mortalité 2000 Study Group
In 2000, half of deaths in HIV-infected patients were still AIDS-related. Nevertheless changes in the causes of death in HIV-infected persons leads to a diversification of places and modalities of care at the end of life in this population. This has to be taken into account in surveys describing the distribution of the causes of death.
89 MORTALITY AFTER STARTING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 89)
A van Sighem1, A Ghani2, P Reiss3, I Gyssens4, K Brinkman5, J Lange3, I van Valkengoed1, L Gras1, F de Wolf1,2
The reduction in overall mortality is due to a reduction in HIV-related mortality. Non-HIVrelated mortality remains higher than in the general population. The lack of any change in non-HIV-related mortality suggests that toxicity has not yet become a major risk factor for death.
| July 2003 | Monday 14th . 14:30-16:30
Session 16OA - Oral Abstract
Virus Entry and Early Steps of Virus Cycle
Chair persons
Quentin Sattentau, Oxford University, UK
Fernando Arenzana, Institut Pasteur, Paris, France
90 INTERACTIONS BETWEEN HIV AND THE DUFFY ANTIGEN RECEPTOR FOR CHEMOKINES (DARC)
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 90)
SJD Neil, D Marchant, A McKnight and RA Weiss
Our results indicate that HIV binds to DARC and imply a role for DARC in the sequestration of virus on circulating RBCs, as well as potentially affecting plasma levels of DARC ligands such as RANTES.
91 HIV-1 EXPLOITS AN ENV-INDUCED SYNAPSE IN CD4+ T-CELLS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 91)
CL Jolly and QJ Sattentau
We propose that ‘virological synapse’ formation is an actin-dependent process that facilitates cellto- cell transfer of infectious viral material, and may be an important mechanism of viral dissemination in densely-packed lymphoid tissue.
92 HIV-1 MEDIATED SIGNAL TRANSDUCTION THROUGH CCR5 ALLOWS INFECTION OF RESTING MEMORY T-CELLS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 92)
J Vasudevan1, A Matthews1,2, A Meek1 and D Camerini1,2
Preliminary QPCR results show a decrease in completion of reverse transcription and 2-LTR circle production in RMT infected with R5 or X4 HIV-1. Our data implicate R5 HIV-1 mediated signalling via CCR5 in the establishment of infection in normal, resting memory T cells. In contrast, X4 HIV-1 infection is blocked at a post-entry step in RMT. Signalling through Gái and Gás do not appear to play a role in the establishment of infection, but the downstream signalling molecules PI3K and c-Src may be important mediators of R5-HIV-1 infection of RMT.
93 HIV-1 INFECTIVITY REFLECTS A DYNAMIC BALANCE BETWEEN FUSION AND ENDOCYTOSIS IN HUMAN CD4 T LYMPHOCYTES
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 93)
E Schaeffer1,2 and WC Greene1
In conclusion, these studies reveal an intriguing compensatory link between fusion and endocytosis of HIV-1, which in T cells is governed by the common involvement of CD4 receptors in both entry pathways.
94 EFFICIENCY OF HOST CELL ENTRY IS THE DOMINANT FACTOR MEDIATING EX VIVO HIV-1 FITNESS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 94)
DM Moore, AJ Maroszan, SC Ball, A Abraha, K Demers and EJ Arts
Preliminary data also suggests that increased fitness or efficiency of host cell entry is related to a reduced sensitivity to entry inhibitors such as AOP- or PSC-RANTES, T-20, T-1249 and C34. This study provides evidence that host cell entry is important for pathogenesis and should remain an important target for anti-HIV-1 drugs.
95 POTENT SUPPRESSION OF HIV-1 INFECTIVITY BY LENTIVIRAL VECTORS INTERFERING WITH THE VIRUS-INDUCED CD4 DOWN-MODULATION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 95)
J Lama1,2 and B Groschel1
Lentiviral vectors expressing CD4Δcyt were efficient at blocking HIV infectivity in a variety of cells expressing different ranges of surface- CD4, and also in CD4-positive primary lymphocytes. These results provide proof-of-principle that selective inhibition of the virusinduced CD4 down-modulation may constitute a suitable strategy to halt HIV replication.
96 EXISTENCE OF TWO DISTINCT MECHANISMS FOR THE BINDING OF HIV-1 ENVELOPE GLYCOPROTEINS TO DC-SIGN
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 96)
L Vachot, Y Ataman-Onal and B Verrier
This result indicates that DC-SIGN binding to HIV-1 envelope glycoproteins could occur by two mechanisms through the recognition of glycans or through interaction with protein core. Those results provide new insight for the design of Env immunogens able to induce neutralizing antibodies for DC-SIGN/gp120 interaction.
97 SENSITIVITY OF HIV-1 SUBTYPE C ISOLATES TO THE FUSION INHIBITOR T-20
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 97)
T Cilliers, T Patience, MA Papathanasopolous, L Morris
These data suggest that T-20 appears to be effective against HIV-1 subtype C isolates and may be useful for treating patients infected with this subtype.
| July 2003 | Monday 14th . 17:00-18:00
Session 17CO - Controversy
Is There a Prospect for Therapeutic Vaccination?
Moderator
Michael Lederman, Case Western Reserve University/University Hospitals of Cleveland, USA
98* PRO SPEAKER
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 98)
Yves Lévy, Hospital Henri-Mondor, Créteil, France
Abstract not available
99* CON SPEAKER
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 99)
Jonathan Weber, Imperial College of Science, Technology and Medicine
Abstract not available
| July 2003 | Monday 14th . 17:00-18:00
Session 18CO - Controversy
Should We Modify Antiretroviral Treatment based on Cardiovascular Risk?
Moderator
David Cooper, University of New South Wales, Sydney, Australia
100* PRO SPEAKER
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 100)
Marc van der Valk, Academic Medical Center, University of Amsterdam, The Netherlands
Abstract not available
101* CON SPEAKER
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 101)
Sam Bozzette, University of California, San Diego, USA
Abstract not available
| July 2003 | Monday 14th . 17:00-18:00
Session 19CO - Controversy
The Non-Public Sector Is More Important Than Governments for Expanding Access to Treatment in the Developing World
Moderator
ElHadj Sy, Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
102* PRO SPEAKER
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 102)
Alex G. Coutinho, The AIDS Support Organisation (TASO), Kampala, Uganda
Abstract not available
103* CON SPEAKER
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 103)
Daniel Berman, Médecins Sans Frontières, Geneva, Switzerland
Abstract not available
| July 2003 | Monday 14th . 17:00-18:00
Session 20CO - Controversy
Viral Subtypes Are of Major Relevance for HIV Vaccines
Moderator
William Malegapuru Makgoba, University of Natal, Durban, South Africa
104* PRO SPEAKER
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 104)
Max Essex, Harvard AIDS Institute, Boston, USA
Abstract not available
105* CON SPEAKER
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 105)
Sarah Rowland-Jones, Weatherall Institute of Molecular Medicine, Oxford University, UK
Abstract not available
| July 2003 | Monday 14th . 18:00 - 19:30
Session 21PL - Plenary
Chair persons
Christine Katlama, University Hospital Pitié-Salpêtrière, Paris, France
Giuseppe Pantaleo, Lausanne University Hospital, Switzerland
106* NEW ANTIRETROVIRAL DRUGS AND THERAPEUTIC STATEGIES
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 106)
Patrick Yéni, Hospital Bichat, Paris, France
Abstract not available
107* HIV VACCINE RESEARCH: THE STATE OF THE SCIENCE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no.
Lawrence Corey, University of Washington, Seattle, USA
Abstract not available
| July 2003 | Tuesday 15th . 10:00-12:00
Session 22FO - Forum
The Scaling-Up of Antiretroviral Therapy in Developing Countries
Chair persons
Papa Salif Sow, Dakar University Teaching Hospital, Dakar, Senegal
Paulo Teixeira, Brazilian STD/AIDS Program, Ministry of Health, Brasilia, Brazil
108* UPDATE ON THE USE OF ANTIRETROVIRALS IN COUNTRIES WITH LIMITED RESOURCES: FROM PILOT STUDIES TO PUBLIC HEALTH REALITIES
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 108)
Papa Salif Sow, Dakar University Teaching Hospital, Senegal
Abstract not available
109* THE CHALLENGES OF EXPANDING ACCESS TO ANTIRETROVIRALS WORLDWIDE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 109)
Paulo Teixeira, Brazilian STD/AIDS Program, Ministry of Health, Brasilia, Brazil
Abstract not available
110 SAFETY AND IMMUNOLOGICAL EFFECTIVENESS OF SIMPLIFIED FIXED-DOSE COMBINATION OF NEVIRAPINE-BASED HAART AMONGST INDIAN PATIENTS: EXTENDED FOLLOW-UP DATA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 110)
S Pujari1, A Patel2, E Naik3, J Patel2, K Patel2, A Mane1, S Bhagat1 and A Vashsihtha1
The fixed dose combination of NVPbased HAART showed good safety and durable immunological improvement in this largest observational study till date from India. Simplifying therapy may be one of the reasons explaining this remarkable success.
111 WHAT HAPPENS WHEN A RESEARCH PROJECT CLOSES: HIV INCIDENCE, MORTALITY, AND PERCEPTIONS IN A COUPLES’ COHORT IN LUSAKA, ZAMBIA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 111)
E Shutes1,3 and the Rwanda/Zambia HIV Research Group1,3
Self-reported and objective data confirmed that risk reduction was maintained in the absence of regular follow-up. The most negative perceived impact on study participants was the loss of health care, which coincided with an increase in mortality rates. HIV research projects should make transition plans and establish functional health referral mechanisms for study participants when research funding ends.
112 TREATMENT OF HIV DISEASE WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN CHIRADZULU DISTRICT, MALAWI
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 112)
N Durier
Results are showing the feasibility of large-scale HAART in under-privileged areas. Our experience is also being incorporated into the design of the national HIV/ARV programme.
113 COST IMPLICATIONS OF PROVIDING SCALED-UP HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN A MIDDLE INCOME MICROSTATE: THE BARBADOS EXPERIENCE IV
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 113)
SA Adomakoh1, NKP Adomakoh2, A Gaskin1, TC Roach3, A Abayomi3 and HS Fraser1
The results indicate a cost shift from inpatient to outpatient care in the first year of HAART. However projections showed with planned increases in support staff and VCT uptake, earlier diagnosis of AIDS patients and increased provision of HAART, net cost is likely to increase to $388 per month. To optimize beneficial returns in terms of health gains and increased productivity, follow-up support programmes that encourage return to work and skills training of PWHA must operate in tandem with HAART treatment services.
| July 2003 | Tuesday 15th . 10:00-12:00
Session 23FO - Forum
Salvage Therapy
Conveners
Robert L. Murphy, Northwestern University Medical School, Chicago, USA
Schlomo Staszewski, J.W. Goethe University, Frankfurt am Main, Germany
114* STATE-OF-THE-ART TALK: NOVEL STRATEGIES FOR SALVAGE THERAPY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 114)
Schlomo Staszewski, J.W. Goethe University, Frankfurt am Main, Germany
Abstract not available.
115* STATE-OF-THE-ART TALK: NEW ANTIRETROVIRAL AGENTS AND THEIR OPTIMAL USE IN SALVAGE THERAPY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 115)
Robert L. Murphy, Northwestern University Medical School, Chicago, USA
Abstract not available.
116 ANALYSIS OF VIROLOGICAL RESPONSE OF ENFUVIRTIDE IN TORO: IMPLICATIONS FOR PATIENT MANAGEMENT
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 116)
J Montaner1, R DeMasi2, J Delehanty2, J Chung3, Z Gafoor2 and M Salgo3 on behalf of the TORO 1 and TORO 2 Study Groups
While the comparative efficacy of ENF+OB over OB alone has previously been established, these results suggest that the virological response to ENF+OB therapy is directly related to the activity of the background regimen and improved responses were observed in less advanced and less-experienced patients.
117 ANTIVIRAL EFFICACY, METABOLIC CHANGES AND SAFETY OF ATAZANAVIR (ATV) VERSUS LOPINAVIR/RITONAVIR (LPV/RTV) IN COMBINATION WITH TWO NRTIs IN PATIENTS WHO HAVE EXPERIENCED VIROLOGICAL FAILURE WITH PRIOR PI-CONTAINING REGIMEN(S): 24-WEEK RESULTS FROM BMS AI424-043
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 117)
L Nieto-Cisneros1, C Zala2, WJ Fessel3, J Gonzalez-Garcia4, C Cohen5, R McGovern6, E Adler7 and C McLaren6
Significant reductions in HIV RNA and robust increases in CD4 cell counts were observed in this PI-failing, ARV-experienced population. While non-boosted ATV demonstrated less antiviral efficacy than the boosted LPV/RTV regimen, ATV had a more favourable lipid profile. ATV may be an option for some ARV-experienced patients, e.g., where lipid management is a priority.
118 EFFICACY AND SAFETY OF ATAZANAVIR (ATV) WITH RITONAVIR (RTV) OR SAQUINAVIR (SQV) VS LOPINAVIR/RITONAIR (LPV/RTV) IN COMBINATION WITH TENOFOVIR (TFV) AND ONE NRTI IN PATIENTS WHO HAVE EXPERIENCED VIROLOGIC FAILURE TO MULTIPLE HAART REGIMENS: 16-WEEK RESULTS FROM BMS AI424-045
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 118)
R. Badaro1, E. DeJesus2, A. Lazzarin3, J. Jemsek4, B. Clotet5, R. Wilber6, A. Thiry6, A. Rightmire6
In this highly ARV-experienced population, the efficacy of ATV/RTV QD is similar to LPV/RTV BID through 16 weeks. ATV, when boosted with RTV or combined with SQV is safe, well tolerated and with a more favorable lipid profile than LPV/RTV.
119 FAILURE OF STRUCTURED TREATMENT INTERRUPTION (STI) TO CONFER BENEFIT IN THE SETTING OF TREATMENT FAILURE: CPCRA 064 RESULTS BY BASELINE CD4 COUNT AND PHENOTYPIC SENSITIVITY SCORE (PSS) SUBGROUPS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 119)
J Lawrence1, K Huppler Hullsiek2, D Mayers3, D Abrams1, R Reisler4, L Crane5, B Schmetter6, T Dionne7, J Saldanha8, M Jones1 and J Baxter9 for the CPCRA 064 Study Team for the Terry Beirn Community Programs for Clinical Research on AIDS
Subgroup analyses by baseline CD4 count and PSS show similar results to the full cohort, suggesting that STI in these subpopulations does not confer immunological or virological benefit.
| July 2003 | Tuesday 15th . 10:00-12:00
Session 24FO - Forum
Viral Molecular Pathogenesis
Conveners
Olivier Schwartz, Institut Pasteur, Paris, France
Didier Trono, Geneva University Hospital, Switzerland
120* STATE-OF-THE-ART TALK: HIV AND DENDRITIC CELLS: VIRUS SPREAD AND ANTIGEN PRESENTATION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 120)
Olivier Schwartz, Institut Pasteur, Paris, France
Abstract not available.
121* STATE-OF-THE-ART TALK: INNATE INTRACELLULAR ANTIRETROVIRAL DEFENSES
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 121)
Didier Trono, Geneva University Hospital, Switzerland
Abstract not available.
122 IDENTIFICATION OF TIP47 AS THE FIRST CELLULAR CO-FACTOR INVOLVED IN THE RETROGRADE TRANSPORT OF THE HIV-1 ENVELOPE TO THE TRANS-GOLGI NETWORK: EFFECT ON THE ENV INCORPORATION AND ON HIV-1 INFECTIVITY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 122)
G Blot1, K Janvier1, S Le Panse2, R Benarous1 and C Berlioz-Torrent1
Mutation of the Y802W803 di-aromatic motif abolished both targetting to the TGN as well as interaction with TIP47 and decreased Env cell surface expression. These data support the view that binding of TIP47 to HIV-1 Env facilitates its delivery to the TGN. Lastly, we show that virus mutated in the Y802W803 motif is poorly infectious and presents a defect in Env incorporation, supporting a model in which retrograde transport of Env is implicated in optimization of fully infectious HIV-1 production.
123 MECHANISM OF ACTION OF THE HIV-1 VIF ACCESSORY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 123)
BR Cullen1,2, HP Bogerd1 and B Doehle2
The mouse homologue of APOBEC3G also specifically blocks HIV-1 replication but in this case the inhibitory effect is not relieved by co-expression of HIV-1 Vif. This result strongly suggests that APOBEC3G-mediated inhibition of HIV-1 replication may play a key role in determining the species tropism of HIV-1. We are currently examining the biological activity of a range of human and simian proteins related to APOBEC3G and are examining the importance of these factors in determining HIV-1 tissue and species tropism.
124 LEDGF/p75 A CELLULAR CO-FACTOR OF HIV-1 INTEGRASE ESSENTIAL FOR HIV-1 REPLICATION: A NOVEL TARGET FOR ANTI-HIV-1 DRUG DISCOVERY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 124)
S Emiliani1, JC Rain2, M Maroun1, F Martin2, E Segeral1, L Selig2, P Legrain2 and R Benarous1
We have isolated several Integrase mutants that have lost interaction with LEDGF/p75. The effects of these mutants on viral replication are presently under investigation. LEDGF/p75, as a key cellular factor for HIV-1 replication, represents a potential target for the development of novel anti HIV-1 drugs.
125 TAT STIMULATES COTRANSCRIPTIONAL CAPPING OF HIV mRNA
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 125)
TM Rana and YL Chiu
Cotranscriptional capping of HIV mRNA is strongly stimulated by Tat and this stimulation requires the C-terminal segment of Tat that mediates its direct binding to Mce1. Our findings implicate cap formation as a component of an elongation checkpoint critical to HIV gene expression.
| July 2003 | Tuesday 15th . 10:00-12:00
Session 25FO - Forum
Pharmacology of Antiretroviral Agents for Managing Treatment
Conveners
Charles W. Flexner, Johns Hopkins University School of Medicine, Baltimore, USA
David Back, University of Liverpool, UK
126* STATE-OF-THE-ART TALK: THE NEW BIOLOGY OF DRUG TRANSPORTERS AND DRUG METABOLIZING ENZYMES: IMPLICATIONS FOR CLINICAL PRACTICE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 126)
Charles W. Flexner, Johns Hopkins University School of Medicine, Baltimore, USA
Abstract not available
127* STATE-OF-THE-ART TALK: THE IMPACT OF GENDER, ETHNICITY AND CO-INFECTIONS ON ANTIRETROVIRAL PHARMACOKINETICS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 127)
David Back, University of Liverpool, Liverpool, UK
Abstract not available
128 SEX DIFFERENCES IN VIROLOGICAL RESPONSE AND SAQUINAVIR (SQV) PHARMACOLOGY IN ACTG 359
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 128)
CV Fletcher1, H Jiang2, RC Brundage3, EP Acosta4, R Haubrich5, D Katzenstein6, S Snyder7 and R Gulick8
A significantly greater proportion of females had VL ≤500 c/ml at wk 16 than males. This finding may be attributed to a sex difference in SQV conc, as females had higher AUCs than males.
129 PLASMA NELFINAVIR CONCENTRATIONS ARE SIGNIFICANTLY LOWER IN PREGNANCY
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 129)
F Wit2, J Nellen1, A Bergshoeff3, D Burger3, M Godfried1, K Boer1, J Lange1 and J Prins1
Non-pregnant females have similar NFV CRs as the male white reference population. Race did not influence the NFV CR in women. Pregnancy is associated with markedly decreased NFV concentrations. Drug levels in pregnant women should be carefully monitored.
130 EXPRESSION AND LOCALISATION OF THE MULTIDRUG RESISTANCE TRANSPORTER IN PLACENTAS FROM HIV-INFECTED MOTHERS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 130)
M Camus1, S Gil1,C Deloménie2, A Devocelle1, I Perrot3, MC Dauge3 and R Farinotti1
P-glycoprotein (P-gp), encoded by mdr1 gene, is a transmembrane protein involved in multidrug resistance (MDR) phenomenon by expulsing drugs out of cells. HIV protease inhibitors which are substrates of P-gp are now more frequently administered to HIVinfected women during pregnancy.
131 PREPARING FOR HIV-1 THERAPY IN SOUTH AFRICA: WILL HOST POLYMORPHISMS IN MDR1 AND CYP3A4 INFLUENCE THERAPEUTIC OUTCOME?
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 131)
PK Chelule1, A Mosam2, M Gordon1, T Palanee1, T Page1, HM Coovadia3 and S Cassol1,4
Recent studies have reported substantial differences in the frequency and distribution of MDR1 and CYP3A4 polymorphisms among different racial groups and suggested that these differences may contribute to HIV-1 treatment failure.
| July 2003 | Tuesday 15th . 10:00-12:00
Session 26FO - Forum
Host Genetic Determinants of HIV Disease
Conveners
Mary Carrington, NCI-FCRDC, Frederick, USA
Amalio Telenti, University Hospital of Lausanne, Switzerland
132* STATE-OF-THE-ART TALK: DISSECTING THE EFFECTS OF HLA AND KIR GENETIC POLYMORPHISM ON HIV DISEASE
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 132)
Mary Carrington, NCI-FCRDC, Frederick, USA
Abstract not available
133* INVITED TALK: HIV MUTATIONAL ESCAPE FROM CTL RESPONSES AND ANTIRETROVIRALS: PARALLELS AND DIFFERENCES
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 133)
Simon Mallal, Royal Perth Hospital, Australia
Abstract not available
133A* STATE-OF-THE-ART TALK: GENETIC PREDICTION OF HIV DISEASE PROGRESSION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 133A)
Amalio Telenti, University Hospital of Lausanne, Switzerland
Abstract not available
134 A-B-O BLOOD GROUPS AND HIV-1 INFECTION
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 134)
SJD Neil, S Magre, Á McKnight and RA Weiss
Incorporation of ABO antigens by HIV-1 may affect transmission of virus between individuals of discordant blood groups by interaction with host natural antibody and complement.
135 INFLUENCE OF CHROMOSOME 3p21-22 CHEMOKINE RECEPTOR VARIANTS AND HAPLOTYPES ON HIV-1/AIDS PATHOGENESIS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 135)
P An1, GW Nelson1, SJ O'Brien2 and CA Winkler1
The gene encoding CCR5, required for cell entry by the R5 strains of HIV-1, occurs in a cluster of five chemokine receptor genes on C3p21.
136 LARGE SCALE MICROARRAY ANALYSIS REVEALS NEW ASPECTS OF EARLY CD4 RECONSTITUTION AFTER INITIATION OF ANTIRETROVIRAL THERAPY IN NAÏVE HIV-POSITIVE PATIENTS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 136)
D Puthier1, F Boutboul2, O Pelé2, S Pierre-François3, B Loriod1, C NGuyen1 and B Autran2
This CD4 cell gene expression profiling during the first wave of CD4 reconstitution during HAART in naïve HIV-infected patients suggests that the major early increase in CD4 cell count involves extinction in the very early cellular machinery of activation that was overexpressed during the natural course of the disease.
137 MANNOSE-BINDING LECTIN (MBL) ALLELES IN SUB-SAHARAN AFRICANS AND RELATIONSHIP WITH SUSCEPTIBILITY TO INFECTIONS
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 137)
LE Mombo1,2, CY Lu1, S Ossari1, I Bedjabaga1, L Sica1, R Krishnamoorthy2 and C Lapoumeroulie2
Our data plus those in the literature suggest that individuals who are homozygous for the mutant MBL alleles display increased susceptibility to infections. Interestingly, we found that individuals who are heterozygous for MBL mutations are much less susceptible to infections than those who are homozygous for the wild-type MBL allele.
| July 2003 | Tuesday 15th . 14:30-16:30
Session 28OA - Oral Abstract
Clinical Science
Chair persons
Julio S.G. Montaner, University of British Columbia, Vancouver, Canada
Praphan Phanuphak, Chulalongkorn University, Bangkok, Thailand
138 COST-EFFECTIVENESS OF GENOTYPIC RESISTANCE TESTING IN PATIENTS WITH EXTENSIVE PRIOR ANTIRETROVIRAL EXPOSURE: MODELLING RESULTS FROM THE NARVAL TRIAL
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 138)
Y Yazdanpanah1, M Vray2, JL Meynard3, E Losina4, L Morand-Joubert3, SJ Goldie5, C Dalban2, MC Weinstein5, PM Girard3 and KA Freedberg6
In patients with extensive prior antiretroviral exposure failing HAART, genotypic resistance testing appears to be cost-effective when explicitly incorporating the benefits from sparing therapeutic options for future use.
139 IS A TOTAL LYMPHOCYTE COUNT A SURROGATE MARKER FOR ABSOLUTE CD4+ CELLS COUNT AMONG HIV-1 INFECTED PATIENTS IN NAIROBI, KENYA?
IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd:(abstract no. 139)
J Kimani1, E Irungu1, P Thottingal1-2, J Njeri1, A Kariri1, C Wachihi1 and FA Plummer1-2
A total lymphocyte count was found to be a poor surrogate marker for absolute CD4+ cells counts in our settings and should be discouraged. Although a definitive study is ongoing, research on newer and affordable CD4+ cells enumeration technologies should be the major priority. However, these findings and the poor infrastructure for monitoring HIV management in most developing countries should not be viewed as a barrier to the scaling-up initiatives for antiretroviral therapy.