Prevention a priority at European HIV conference

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Prevention looks set to be the major theme of the 12th European AIDS Conference, which officially opened in Cologne on November 11th.

Launching the conference to the media, Prof. Francoise Barre-Sinoussi said that preventing HIV from establishing infection in individuals was now one of the priorities of basic research into the virus.

Picking up on the prevention theme, Prof. Jurgen Rockstroh of Bonn University highlighted that 50% of HIV infections are undiagnosed in Europe.

Glossary

stigma

Social attitudes that suggest that having a particular illness or being in a particular situation is something to be ashamed of. Stigma can be questioned and challenged.

elite controllers

A small subset of people living with HIV who are able to control HIV replication in the absence of antiretroviral treatment for an unusually long period of time. Definitions vary, but an elite controller is usually defined as a person whose viral load has remained below 50 copies. However, because HIV continues to replicate even in elite controllers, ART is recommended for elite controllers who have declining CD4 counts or who develop HIV-related complications. Elite controllers and viraemic controllers are members of a larger group known as HIV controllers. Around half of HIV controllers can also be described as long-term non-progressors.

Reducing this and providing HIV treatment and care would improve individual outcomes and help prevent new infections, the assembled media were told.

Basic research: better drugs, better prevention

Over 4000 delegates have gathered in Cologne to learn about recent developments in the continent’s HIV epidemic.

Current HIV treatment is highly effective and doctors are increasingly hopeful that patients in Europe have the chance to live a near-normal lifespan. Prof. Barre-Sinoussi told the assembled media, however, that one of the main objectives of basic research into HIV was to find new targets for antiretroviral drugs, and even ways of eradicating HIV infection.

She suggested that research into so-called “elite controllers” – HIV-positive individuals who remain free of symptoms of the infection and have a very low viral load – could not only improve HIV treatment, but could also benefit prevention.

HIV in Europe

The importance of timely diagnosis of HIV was clear during Prof. Rockstroh’s summary of the clinical highlights of the conference.

Approximately half of all HIV infections in Europe are undiagnosed, this figure increasing to 79% in some Eastern European countries.

Increasing HIV testing was essential to control of the epidemic on the continent, said Prof. Rockstroh. However, laws criminalising HIV transmission and exposure and the high levels of stigma that surround the virus in some countries were targeted as obstacles preventing individuals from testing.

Several other key themes of the conference were also highlighted at the press conference:

  • HIV and aging. It has become increasingly clear that HIV can cause diseases of aging, such as heart, kidney and liver disease. Appropriate use of antiretroviral therapy can help reduce the risk of such illnesses, but this is only possible if an individual knows his or her status. Research will also be presented highlighting the possible complications of HIV treatment and the importance of the provision of patient care by multi-disciplinary teams of experts.
  • Access to treatment. Around 80% of diagnosed patients in richer European countries are taking anti-HIV drugs, compared to only 5% in Eastern European countries with the worst epidemics. The 2010 International AIDS Conference in Vienna will focus on the epidemic in Eastern Europe, and the scene will be set at the Cologne conference.
  • Co-infections. A third of patients in western Europe are co-infected with hepatitis C virus, a figure that increases to 70% in Eastern Europe where injecting drug use is fuelling the epidemic. This means that liver disease is an importance cause of illness and death in this population and there is an urgent need for new anti-hepatitis C therapies. Despite this, there has been little research involving new drugs in co-infected patients. Possible ways forward will be the subject of a special session of the conference.
  • Providing the best possible care. New European HIV guidelines will be presented to the conference. These will cover antiretroviral treatment, medical monitoring and the treatment of hepatitis co-infections.

Regular news on key developments will be published at aidsmap.com.