<<<"We left Geneva with more optimism than much of the mainstream press, which noted the lack of major treatment advances such as
the protease inhibitors at Vancouver, some setbacks in
treatments and vaccines, and the conclusion of many experts
that in fighting the AIDS epidemic, the focus must still be on
prevention, which is known to work but often held back by
politics.>>>>
<<<< And most of the bad news was already known,
and has been widely reported in AIDS TREATMENT NEWS and
elsewhere.">>>>
(ATN) Geneva Conference Treatment Highlights
John S. James
AIDS TREATMENT NEWS Issue #298, July 10, 1998
aegis.com
About 12,000 people attended the 12th World AIDS Conference
(Geneva, Switzerland, June 28 - July 3), the major
international conference which takes place every two years.
Unlike the previous meeting (Vancouver, July 7-12, 1996), where
the big news was protease inhibitors, Geneva did not have one
major story but was characterized by solid scientific
advances--most of them good news. We are now in a period of
incremental more than revolutionary treatment
developments--although some of the reports in Geneva could be
revolutionary if they are confirmed.
Perhaps the most important single change in atmosphere at this
conference is that immunology is at last being taken more
seriously than before. Of course it has always been known that
the immune system is central to this disease, but it has been
easier to find clear targets for treatment development against
the HIV virus--and easier to identify indicators of
antiretroviral activity (since clearly less virus is better
than more) than to know which immune responses are beneficial.
As a result, virology has dominated AIDS medical research,
leaving AIDS immunology underfunded; the great majority of
immunologists in the U.S. and the world today have never done
any work in AIDS. Now there is widespread consensus that this
disconnect between immunology and AIDS research must end.
We left Geneva with more optimism than much of the mainstream
press, which noted the lack of major treatment advances such as
the protease inhibitors at Vancouver, some setbacks in
treatments and vaccines, and the conclusion of many experts
that in fighting the AIDS epidemic, the focus must still be on
prevention, which is known to work but often held back by
politics. This difference in outlook is not because either view
is wrong, but because we are reporting different news. AIDS
TREATMENT NEWS is written primarily for persons who know they
have HIV and who have at least some access to modern medical
care (unfortunately the large majority of people in the world
do not). There are many promising developments likely to result
in important new treatment options during the next several
months or years. And most of the bad news was already known,
and has been widely reported in AIDS TREATMENT NEWS and
elsewhere.
Certainly we agree on the importance of prevention; no one
expects the epidemic to be stopped by finding and treating
everybody, and no proven safe and effective vaccine is
available today. But even though prevention is far more cost-
effective than treatment in saving lives overall, this is no
reason to give up on anybody. People need hope if they are to
mobilize for effective policies; millions of lives may be saved
by low-cost treatments; and research focusing on far less
costly antiretrovirals can benefit everybody, even those with
no financial constraints on their care.
Some of the treatment highlights of the Geneva conference--
which we plan to cover in separate articles--are:
* Restoration of patients' HIV-specific immune responses (in
this issue);
* New antiretroviral combinations now supported by data from
major clinical trials;
* More interest in hydroxyurea in antiretroviral
combinations;
* New information on combining approved drugs, such as
indinavir and ritonavir;
* A report of successful growth-hormone treatment of body-
shape changes which may be caused by protease inhibitors in
some patients (in this issue);
* New results on nerve growth factor for treating peripheral
neuropathy;
* Reduction of mother-infant HIV transmission to under one
percent;
* Concerns on the safety of combination antiretroviral
treatment during pregnancy;
* Progress in diagnostics, including an experimental test for
immune function, and one for viral load inside cells.
We will also look at what is being done on the conference
theme of "bridging the gap"--providing treatment for the 90
percent of people with HIV who do not have access today.
P.O. Box 411256 San Francisco, CA 94141 800/TREAT-1-2 toll-free
U.S. and Canada 415/255-0588 regular office number fax:
415/255-4659 Internet: aidsnews@aidsnews.org
Copyright 1998 by John S. James. Permission granted for
noncommercial reproduction, provided that our address and phone
number are included if more than short quotations are used.
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