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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.

Guidelines on PrEP

Today, the US Centers for Disease Control and Prevention (CDC) published interim guidelines for US healthcare providers on the use of pre-exposure prophylaxis (PrEP), the administration of antiretrovirals (ARVs) to prevent HIV infection. For now, the CDC recommends that PrEP be considered only for adult men who have sex with men (MSM) at high risk of HIV infection through sex (see complete guidelines). Ken Mayer, medical research director of Fenway Health in Boston, says the CDC’s interim guidelines represent the first "statement about the use of chemoprophylaxis" for HIV.  

We're quite enamored with finding beauty in science, whether it's some of the striking images created using electron microscopy or artistic renderings like the one of a dendritic cell that graced IAVI Report cover last year (Looks like a flower, no?).

Two years ago, we ran this headline on the front cover of IAVI Report: Will a Pill a Day Keep HIV at Bay? Well, today, that question was answered. And the answer is, yes it will.

If you are interested in reading more about many of the topics discussed at the recent Keystone Symposium on Immunological Mechanisms of Vaccination in Seattle, check out the current issue of Immunity. 

In the new issue of IAVI Report we wrote about how researchers at the AIDS Vaccine 2010 conference in Atlanta discussed the limited window of opportunity for conducting clinical trials to test partially effective HIV prevention strategies, including HIV vaccine candidates and oral or topical antiretroviral pre-exposure prophylaxis (PrEP), in combination.

Several speakers today discussed the development of new adjuvants, and Norman Baylor of the US Food and Drug Administration (FDA) gave an overview of the FDA’s safety and other regulatory requirements for adjuvants to be licensed for use in humans. “The biggest concern is safety,” he said. “That’s what we really need to demonstrate with these new adjuvants.” 

Today I had the chance to talk to Rino Rappuoli, one of the three scientific organizers of the Keystone Symposium on Immunological Mechanisms of Vaccination. Rappuoli, a vaccinologist, is the head of research at Novartis Vaccines and Diagnostics in Siena, Italy. Here is some of what he said. 

Systems biology was on the agenda today, and speakers described many projects that use this more holistic approach to study vaccination and infections. While there is a lot of promise in the approach, it also presents challenges. One challenge came up repeatedly today;  when researchers use microarrays to measure the expression of thousands of genes, the data of gene expression changes might just reflect changes in the abundance of certain cell types and not changes in gene expression in the same cell type. “This comes up again and again and again [that] you are getting these gene changes and much of what you are getting is simply the change in populations,” said Ron Germain of the National Institute of Allergy and Infectious Diseases, who mentioned the problem in his talk. 

Adjuvants were a much discussed topic on this second day of the conference, and it became clear that we are still far from understanding how they work. Take Alum, for example, which consists of insoluble aluminum salts. It is used in three quarters of all our childhood vaccines, according to Stephanie Eisenbarth of Yale University, one of the speakers today who studies Alum. 

"It does not rain in Seattle.” That’s what Shiu-Lok Hu of the Washington National Primate Research Center said just a few days ago in New Orleans when he announced that the next Annual Symposium on Nonhuman Primate Models for AIDS will be in Seattle next year. 

Genetics and genomics was the topic of most talks today, the last day of the conference. Jessica Satkoski Trask from the University of California, Davis said in her talk that when it comes to the availability of genetic tools, nonhuman primates (NHPs) have a long way to go compared with mice or fruit flies. “If you want a knock out mouse, you call the knock out mouse store and they send you the mice,” she said, referring to mice that have a gene knocked out. In contrast, “rhesus macaques and primates are not set up as a genetic model yet. There is going to be a need for a more and more diverse set of genetic tools.” 

Speakers today continued to discuss the development of nonhuman primate (NHP) models that can mimic different aspects of HIV infection and pathogenesis. Cristian Apetrei from the University of Pittsburgh described the development of an NHP model of elite controllers, HIV-infected individuals who control virus replication below detectable levels without treatment. Apetrei and colleagues infected rhesus macaques with simian immunodeficiency virus (SIV)agm, the SIV that naturally infects African green monkeys without causing disease. The rhesus macaques infected this way showed symptoms resembling human elite controllers. Apetrei said that having such a model is important because it makes it possible to study how elite control develops early after infection. 

“Food in New Orleans is more of a religion,” Andrew Lackner, director of the Tulane National Primate Research Center (TNPRC), said in the opening remarks at this year’s 28th Annual Symposium on Nonhuman Primate Models for AIDS, which is taking place from October 19-22 in New Orleans. It was therefore quite appropriate that the almost 200 conference participants were given a New Orleans cookbook, which features “fifty-seven classic Creole recipes that will enable everyone to enjoy the special cuisine of New Orleans.” 

Earlier today, AIDS Vaccine 2010 came to a close in Atlanta. The feeling of optimism that has been palpable in the field over the past year was sustained through the four-day meeting and many new, incremental scientific advances were reported.

Although researchers at AIDS Vaccine 2010 in Atlanta gathered at the Georgia Aquarium last night, it seems they've been on a fishing expedition for quite some time. Fishing for antibodies, that is.

Last night the more than 1,000 delegates attending AIDS Vaccine 2010 in Atlanta piled into the city’s aquarium, reportedly the world’s largest, for dinner, drinks, and yes, even dancing. I’m happy to report they didn’t serve fish.

Although researchers at AIDS Vaccine 2010 in Atlanta gathered at the Georgia Aquarium last night, it seems they've been on a fishing expedition for quite some time. Fishing for antibodies, that is.