It's fair to say that this year's 18th Conference on Retroviruses and Opportunistic Infections (CROI) was dominated by discussion about pre-exposure prophylaxis (PrEP), the use of antiretrovirals (ARVs) to prevent HIV infection. This is not all that surprising given that last year two trials demonstrated the first efficacy of PrEP using ARVs in either a pill or topical gel format.

Today's opening plenary presentation by Rochelle Walensky of Harvard Medical School focused on the cost effectiveness of HIV treatment and prevention. She started by defining cost effectiveness as "value for money," which means that a cost-effective strategy does not necessarily imply a cost savings.

At the 18th Conference on Retroviruses and Opportunistic Infections (CROI) that is taking place this week in Boston, researchers reported results from a Phase I trial of a gene therapy approach that disrupts expression of the CCR5 receptor on human T cells, one of two receptors used by HIV to gain entry into cells, in an attempt to make the cells resistant to HIV infection.

PrEP Rally

Last year marked a promising new chapter in the field of oral and
topical antiretroviral (ARV)-based prevention. Results of the Centre for the AIDS
Programme of Research in South Africa (CAPRISA) 004 trial showed that
a microbicide candidate consisting of a 1% tenofovir gel was able to
reduce HIV incidence in a group of South African women by 39%.
Several months later, a study (known as iPrEx) of nearly 2,500 men and transgendered women who
have sex with men at 11 clinical sites in the US, South Africa, Brazil, Thailand, and Ecuador showed that daily administration of the ARVs
emtricitabine (FTC) and tenofovir (TDF) was 44% effective in
protecting against HIV infection.

Forget the Oscars, the real show is in Boston. Tonight, the 18th Conference on Retroviruses and Opportunistic Infections, a three-day meeting that will highlight scientific advances in treating and preventing HIV, kicked off with a discussion of the small stuff, microRNAs. Bryan Cullen of the Duke University Medical Center delivered the Bernard Fields memorial lecture on the role these small RNAs play in some viral infections.