3rd IAS Conference on HIV Pathogenesis and Treatment, 24-27 July 2005, Rio de Janeiro, Brasil
As we went to press the 3rd IAS Conference in Rio had just drawn to a close. We will include full reports from the meeting in our next issue but a few presentations deserve mentioning briefly here:
- The first large prospective randomised trial looking at male circumcision as an intervention to reduce female to male HIV transmission reported protection equivalent to a vaccine with 66% efficacy.  This association had previously only be reported from retrospective analysis. The mechanism for increased risk in uncircumcised men is thought to be due to HIV susceptible Langerhans cells in the inner foreskin, that are closer to the epithelial surface, and that have little, if any, protective covering of keratin (See report in HTB August/September 2004).
- Further analyses from the TOPS study evaluating single dose nevirapine tail coverage with 4- or 7-days of AZT/3TC (which gave significant reduction in detectable nevirapine associated resistance). This analysis included maternal viral load data showing the percentage of women with viral load <400 copies/mL in both the 4- and 7-day arms. It was suggested that this may answer the question Why is short cover working? The strategy (7 days cover) was included for consideration in appropriate circumstances in the new WHO draft MTCT guidelines. 
- Reducing resistance may also explain the findings from a study evaluating immunolgical response to nevirapine containing HAART in a group of women who had previously received nevirapine MTCT prophylaxis. Although the study discussed exposure to single dose nevirapine 60% of women had received AZT/3TC in addition. There was a similar response in exposed and unexposed women at six months of therapy. 
- Medicins Sans Frontieres presented encouraging results from a group of 1840 children in resource-limited settings in Africa. 97% of children were treated with WHO recommended first line therapy and 65% with cut up fixed dose combination Triomune. Over six-month follow up data was available for 54% of children and over one-year data for 29% of the children. The median CD4 percentage increase was +9% at six months, +11% at 12 months and +13% at 24 months. 
Conference coverage has been archived and is available for viewing on kaisernetwork.org with links to this site from the IAS conference website. Daily conference coverage includes webcasts and transcripts of plenary sessions, select other sessions, and the opening and closing ceremonies.
Abstracts from the meeting are also availble to search online.
Rapid conference reports are already available on many sites including:
- The Body
- HIV InSite
- National AIDS Treatment Advocacy Project
- Clinical Care Options for HIV
- Auvert B, Puren A, Taljaard D et al. Impact of male circumcision on the female-to-male transmission of HIV. 3rd IAS Conference on HIV Pathogenesis and Treatment, Rio de Janeiro, July 2005. Abstract TuOa0402.
- McIntyre JA, Martinson N, Gray GE et al. Addition of short course Combivir to single dose Viramune for the prevention of mother to child transmission of HIV-1 can significantly decrease the subsequent development of maternal and paediatric NNRTI-resistant virus. 3rd IAS Conference on HIV Pathogenesis and Treatment, Rio de Janeiro, July 2005. Abstract TuFoO2O4.
- Bedikou G, Viho I, Towne-Gold B et al. Six month immunological response with HAART containing nevirapine in HIV-infected women post exposure to single dose of nevirapine for PMTCT. The MTCT Plus Initiative in Abidjan, cote Divoire (2003-2005). 3rd IAS Conference on HIV Pathogenesis and Treatment, Rio de Janeiro, July 2005. Abstract MoOa0203.
- AIDS Working Group, Epicentre, Medicins Sans Frontieres. Very satisfactory outcomes can be achieved in children treated with highly active antiretroviral treatment under programme conditions in resource-limited settings: the experience of Medicins Sans Frontieres. 3rd IAS Conference on HIV Pathogenesis and Treatment, Rio de Janeiro, July 2005. Abstract WeOaLB0201.