9th Retrovirus Overview

The 9th annual Conference on Retroviruses and Opportunistic Infections was held in Seattle, Washington, February 24-28, 2002. While there were no major breakthroughs, there was some good news in the following areas:

New Drugs

Researchers are continuing to develop a variety of new drugs in the following classes: non-nukes (NNRTIs), protease inhibitors and chemokine receptor blockers. Some of these drugs should become more widely available in North America in 2003. Other new drugs continue to be studied.

Simplifying Treatment

While highly active antiretroviral therapy (HAART) is beneficial, users must often take a handful of pills several times daily. Now, new once-a-day formulations of drugs (such as Zerit XR) are being actively pursued. Doctors are also testing whether existing combination-therapy regimens can be safely and effectively taken once daily.

Hepatitis C Virus (HCV)

Long-term infection with HCV can cause liver damage. While treatment for HCV infection is available, it is unpleasant and does not work for a large proportion of people. In the time before HAART, liver transplants for people with HIV/AIDS (PHAs) who were co-infected with HCV were not encouraged. Now, because PHAs are living longer, researchers have found that liver transplants for some co-infected PHAs who have severe liver damage may be feasible.

Reversing Body Shape Changes

HAART-users often develop changes in body shape as fat gets redistributed around the body. For years researchers have been experimenting with changing PHAs' treatment regimens (called switching treatment) in an attempt to stop or reverse the changes in body shape. Several teams reported small but positive results in so-called "switch" studies.

In other areas the news was not as promising:

Drug Holidays

There has been a great deal of interest by PHAs in STIs (strategic treatment interruptions) or drug holidays. Unfortunately, the results from studies on drug holidays have not been encouraging.

Side Effects

Warnings about new and strange side effects (such as severe muscle weakness) with commonly used AIDS drugs were reported. As well, warnings about existing side effects were strengthened by American regulatory authorities to remind doctors and their patients that AIDS drugs can cause severe side effects.

Although combination therapy has clearly saved many lives, more PHAs appear to be dying from complications related to liver and kidney damage. Whether or not this is a related side effect from treatment remains to be seen.

Vaccines

The scale of two vaccine trials has been reduced due to disappointing preliminary results. However, this has not dampened enthusiasm for vaccine research, which continues to forge ahead.

Look for these and other topics to appear in upcoming CATIE News coverage of the 9th Retrovirus conference.