Clinicians debate antiretroviral tactics and toxicities, resistance testing, and hepatitis virus coinfection

First-time visitors to the University of Chicago’s Gleacher Center, Room 200, may get the vague sense that they’ve seen this place before – perhaps in certain circa-1600 oil paintings.

More than anything, Room 200 looks like a 21st century reimagining of a 17th century surgery, those steeply banked semicircles where medicine’s initiates, and the merely curious, gathered to watch the day’s deans dissect cadavers – or less fortunate live specimens – for their edification.

Something very much like that happened on May 16-17, 2002, in Chicago, when the International Association of Physicians in AIDS Care (IAPAC) gathered some of this era’s top HIV thinkers and asked them to anatomise four specimens before an eager crowd. And the specimens were very much alive, and expertly vivisected though not human, mammalian, or even Drosophilian, but rather conceptual.

In anatomy lessons led by Christine Wanke (Tufts University, Boston), Diane Havlir (University of California, San Diego), Daniel Kuritzkes (Brigham and Women’s Hospital, Boston), and Maurizio Bonacini (California Pacific Medical Center, San Francisco), a faculty of eight pared away superficial tissue and probed the tendons of four topics: antiretroviral tactics, their metabolic and morphologic side effects, resistance testing, and the confluence of HIV with hepatitis B and C viruses.

The IAPAC Sessions 2002 differed from classically limned anatomy lessons in another important way: although the audience included a sprinkling of the merely curious, most attendees were anything but acolytes in HIV medicine. They were carefully selected clinicians seeing large quotas of people with HIV, and imbued with a matching commitment to the corpus of complication and contingency that defines the art in this science.