PITTSBURGH, May 17 Issues on the forefront of HIV prevention research will be taking center stage at the International Microbicides Conference (M2010) at the David L. Lawrence Convention Center in Pittsburgh May 22-25. M2010 will be a gathering of leading investigators, clinicians, policy makers, community advocates and experts in global health who are working in all facets of HIV prevention and in all parts of the world. Nearly 1,000 participants from 47 countries will be attending.
The meeting includes discussions of new research developments on a number of different HIV prevention strategies, including microbicides and pre-exposure prophylaxis (PrEP). Microbicides are substances designed to be applied topically on the inside of the rectum or vagina to prevent the acquisition of HIV, whereas oral PrEP is an approach involving the use of antiretroviral drugs by HIV-negative people to reduce their risk of acquiring HIV.
An on-site press room for registered media will be located in Room 309 of the Convention Center. Hours of operation will be 7 a.m. to 7 p.m. (ET), Saturday, May 22 through Tuesday, May 25. Press room staff can be reached during this time at +1 (412) 325-6063/6064. Press briefings will be held each day (please the schedule below). Journalists unable to attend in-person may participate via domestic and international teleconference.
The schedule of press briefings and topics to be discussed are listed below:
SUNDAY, May 23
A Time of Greater Risk: Protecting Against HIV During Pregnancy
Young women of reproductive-age are among those at greatest risk of acquiring HIV. Several studies have suggested that during pregnancy women are even more susceptible to infection. Women need a method to protect themselves all the time, including when they are pregnant. Researchers will report results of the first clinical trial to evaluate the safety of a vaginal microbicide in pregnant women. The study, which involved applying a single dose of tenofovir gel hours before women gave birth by caesarean delivery, represents an important first step to determine whether use of a vaginal microbicide to protect against HIV during pregnancy is safe for women and their babies. If pregnancy represents a time when women are at greater risk of HIV, what about men? Findings from a large prospective study involving 3,321 couples in which one partner was HIV-infected and the other not, sought to understand what effect pregnancy has on HIV risks in both women and men.
Participants: Nelly Mugo, M.D., M.P.H., University of Nairobi & Kenyatta National Hospital, Nairboi, Kenya, and University of Washington, Seattle; Richard Beigi, M.D., University of Pittsburgh School of Medicine and Magee-Womens Hospital of UPMC. Moderator: Sharon Hillier, Ph.D., University of Pittsburgh School of Medicine and Magee-Womens Research Institute.
Anticipating the Next Clinical Trials: New Molecules and Compounds for HIV Prevention
Clinical trials of PrEP are focused on two antiretrovirals (ARVs) tenofovir and Truvada® from one class of ARVs called nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs). The roster of ongoing microbicide trials are of gels that contain either tenofovir, dapivirine or UC781. Dapivirine and UC781 are non-nucleoside reverse transcriptase inhibitors, a close cousin to the NRTI class of ARVs. While the hope is that at least one of these trials will arrive at a safe and effective prevention approach, scientific advances are constantly presenting new leads to pursue. There are more than 50 compounds and drug combinations in various stages of preclinical development as potential oral or topical microbicides for preventing HIV. These include different types of ARVs, such as protease inhibitors, entry inhibitors and fusion inhibitors, and new combinations of these and other drugs. Researchers are taking aim at HIV from all possible angles. Results of new studies could indicate the direction of future clinical trials, including results from the first primate study evaluating an integrase inhibitor as a topical microbicide.
Participants: Walid Heneine, Ph.D., U.S. Centers for Disease Control and Prevention; Robin Shattock, Ph.D., St. George's, University of London, U.K. Moderator: Jim Turpin, Ph.D., Division of AIDS, National Institute of Allergy and Infectious Diseases, U.S. National Institutes of Health
MONDAY, May 24
Microbicides that Do More than Gel: Vaginal Rings, Tablets and Films
As alternatives to microbicide gels that must be used every day or at the time of sex, researchers are looking at other types of formulations that may be more acceptable for women to use, and for certain drugs or drug combinations, may be more optimal vehicles for their delivery. Unlike a gel, an intravaginal ring, for example, feasibly could provide protection for a month at a time. In fact, one research group has developed an intravaginal ring formulated with two anti-HIV drugs dapivirine and maraviroc that it found can deliver therapeutic levels of both drugs for up to 30 days. Other researchers have developed a vaginal film smaller than a stick of gum and as thin as a sheet of paper. The idea is that as the film would melt away drug would be dispersed to cells to protect against HIV. Laboratory tests of a similar approach an almond-shaped vaginal tablet found it can dissolve quickly yet still deliver sustained levels of anti-HIV drugs over several hours.
Participants: Andrew Loxley, Ph.D., Particle Sciences, Inc., Bethlehem, Pa.; Sanjay Garg, Ph.D., School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, New Zealand; Anthony Ham, Ph.D., ImQuest BioSciences, Frederick, Md. Moderator: Joseph Romano, Ph.D., International Partnership for Microbicides, Silver Spring, Md.
Using ARVs as Prevention: Promise, Precautions and Potential for Drug Resistance
PrEP is a promising HIV prevention approach that involves use of antiretroviral (ARV) drugs that are normally used for treatment of HIV. But, should clinical trials find the strategy successful and PrEP is then rolled out as a prevention approach in at-risk communities, there is concern that virus resistant to the ARVs potentially would emerge and spread. What exactly is the risk and how can we avoid the consequences of "two trains on a collision course"? Two studies looked for answers. In one, a computer model that simulated the impact of PrEP on HIV prevention and drug resistance identified key factors that would influence the spread of HIV drug resistance. In a different take, laboratory studies suggest under what circumstances ARV-based gels could cause virus to become resistant. The same study tested different ARV gels to determine whether they can protect against strains of resistant virus known to be resistant against these ARVs or drugs in the same class.
Participants: Ume Abbas, M.D., Cleveland Clinic Foundation; Susan M. Schader, Ph.D., McGill University and McGill AIDS Centre, Montreal, Canada; John Mellors, M.D., University of Pittsburgh School of Medicine; Regina Osih, MD, MPH, University of the Witwatersrand, Johannesburg, South Africa. Moderator: Mitchell Warren, AVAC: Global Advocacy for HIV Prevention.
TUESDAY, May 25
Use of Lubricants, Unprotected Anal Sex and the Risk of HIV
The risk of acquiring HIV through unprotected anal sex is at least 20 times greater than with unprotected vaginal sex and increases if other infections are already present in the rectal lining. Could the use of lubricants at least certain kinds be another risk factor among men and women who engage in receptive anal intercourse? A study involving nearly 900 men and women in Baltimore and Los Angeles that looked at whether use of lubricants before and during anal sex was associated with risk of rectal sexually transmitted infections will report its findings. Another study that subjected popular over-the-counter and mail-order lubricants to rigorous laboratory tests will reveal what was learned about their effect on cells and rectal tissue. If rectal microbicides and oral PrEP, approaches being studied for preventing HIV transmitted rectally, are found effective, would they be used? In other research, investigators asked this question of high-risk men who have sex with men (MSM) in a survey that aimed to determine the demographic and behavioral factors that may increase the likelihood that MSM will use a microbicide or oral PrEP.
Participants: Charlene Dezzutti, Ph.D., University of Pittsburgh School of Medicine and Magee-Womens Research Institute; Kenneth Mayer, M.D., Fenway Institute, Boston, and Brown University, Providence, R.I.; Pamina Gorbach, Ph.D., School of Public Health and David Geffen School of Medicine, University of California, Los Angeles. Moderator: Ian McGowan, M.D., Ph.D., University of Pittsburgh School of Medicine and Magee-Womens Research Institute
More than 33 million people are living with HIV, more than two thirds of them in sub-Saharan Africa, according to UNAIDS. The number of new infections continues to outstrip advances in treatment: For every two people who begin treatment, five are newly infected. Globally, women account for half of all HIV infections, and in sub-Saharan Africa, women comprise 60 percent of all infected adults. Young women are especially vulnerable. In southern Africa women aged 15 to 24 are at least three times more likely than their male peers to be infected with HIV. Meanwhile, men who have sex with men (MSM) bear the burden of the epidemic in the United States and in other parts of the world, such as Europe, Latin America, Australia and New Zealand. According to the U.S. Centers for Disease Control and Prevention, MSM of all races is the only risk group in the United States in which new HIV infections are increasing. Black heterosexual women represent the third highest risk group in the United States, after white MSM and black MSM, respectively.
M2010 is the sixth biennial meeting of the International Microbicides Conference and marks the first meeting in the United States since the 2000 inaugural gathering in Washington, D.C. Other previous meetings have been in Antwerp, Belgium; London, England; Cape Town, South Africa; and New Delhi, India. Co-chairs of this year's conference are Sharon Hillier, Ph.D., and Ian McGowan, M.D., Ph.D., both of the University of Pittsburgh; and Gita Ramjee, Ph.D., of the Medical Research Council of South Africa.
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