Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Introduction to CROI 2017
Day 1 CROI 2017:
An overview of CROI this year for those may not have attended previously:
Today we were reminded that The Conference on Retroviruses and Opportunistic Infections (CROI) commenced in 1993 to provide a forum for basic scientists and clinical investigators to present their latest data, and to interact. The Conference has grown in size over the past 24 years and is currently capped at about 4,000 attendees. This year the 4,200 participants are from 90 countries, and 40% of abstracts were from outside the USA. One in five attendees are new to CROI, so if you have not attended before, try to get there next year (Boston 4-7 March 2018). The opening sessions traditionally consist of: the Bernard Fields Lecture, named in tribute to the exemplary work of esteemed microbiologist and virologist Bernard Fields, and the N’Galy-Mann Lecture, named in honour of Drs Bosenge N’Galy and Jonathan Mann for their crucial pioneering work in HIV science in Africa. It is always a sad time to reflect on the untimely deaths of these two great men working in HIV/AIDS in the very early days of the epidemic. I will always remember Dr Mann’s extraordinary speeches in those early days – he was a great orator.
This year the Bernard Fields Lecture was delivered by Jeffrey D. Lifson, from the Frederick National Laboratory for Cancer Research and focussed on the work done in HIV prevention and pathogenesis using nonhuman primate(NHP) models. Dr Lifson made the case that, with limitations, nonhuman primate models eg in macaque and sootey mangabey monkeys with SIV models, ‘have been able to recapitulate all the key aspects of human HIV infection in research systems that could provide important experimental advantages’ but that the viruses used in in NHP were not HIV. He also discussed the issue of gut pathogenesis in HIV/SIV infection with the sequence of events:
· Loss of CD4+ t-cells
· Epithelial disruption
· Microbial translocation (microbiome shifts)
· Local and systemic immune activation/inflammation
· Responses to inflammation Treg, TGF-B, LT fibrosis,
· Not fully restored/reversed by cART.
A number of presentations at the conference will be on the changes in human gut microbiome with acute HIV infection, ARV therapy and elite controllers.
The N’Galy-Mann Lecture was delivered by James G. Hakim, University of Zimbabwe on the HIV/AIDS research in Zimbabwe which has included collaborative research with the ACTG in USA and the Kirby Institute in Australia. The opening session concluded with a special CROI Foundation award to Oliver Mtukudzi, a wonderful musician and human rights activist from Zimbabwe.