CROI formally opened yesterday evening. The format for the opening session of this conference is reliable and runs to its own format. Very little formality, straight into the science and accessible.
This year the first plenary, dedicated to Bernard Fields, was on Hepatitis C, a tiny bit of co-infection but largely monoinfection. It was given by Charlie Rice from the Rockerfeller. Hepatitis C has increasingly been making inroads into CROI and I think this is a great move. Rice commented on the prominence of HCV in this program. While it is not a retrovirus, it is a common opportunistic infection of HIV and we were told that globally about a third of people with HIV also have hepatitis C.
Like all good plenaries the lecture was general enough to be understood by a wide audience, covered the history, outlined some of the challenges and did some speculating. If you are looking for a comprehensive timeline for HCV science have a look at the earlier slides in this presentation. I found it very informative.
Hearing about the problems scientists have experienced in working with the virus were interesting, but I couldn't help thinking "they can't have been that difficult or you wouldn't have got to a cure so quickly." Charlie then went on to summarise the great leaps in treatment efficacy, which I think most of the Australians are familiar with.
In closing he revisited his comments about the difficulties in not have animal models and the practical issues this causes in looking at things like:
- why some people don't respond to treatment
- why others do or don't have improvement in their liver health, and
- why still other's go on to develop liver disease or cancer even if the virus is cleared.
At that stage I ate my words about cure.
The last few minutes of this talk were very poignant:
- about a trillion visions are produced each day,
- the drugs have the potential for resistance resistance, and
- efforts have been focused on treatment rather than vaccine development.
Lastly, accompanied by a photo of the lab dog, he summarised some of the potential animal models. I recommend that you have a look at the presentation. It is up on the CROI webcast site http://www.croiwebcasts.org