Call for Increased Access to HIV Prevention and Treatment, Careful Monitoring of Viral Evolution

By Henry Neondo, Rio de Janeiro

The international leaders in HIV and AIDS research and policy called for expanded reach of AIDS treatment, care and prevention services in the context of changing dynamics in the global HIV/AIDS epidemic.

The first plenary session of the International AIDS Society (IAS) Conference on HIV Pathogenesis and Treatment -- organized by IAS and currently taking place in Rio de Janeiro, Brazil-- featured new analysis of HIV viral subtypes, information about emerging HIV epidemics and unique experiences with treatment and prevention delivery.

In her plenary address, Dr. Francine McCutchan discussed the importance of developing a fuller understanding of the impact of recombinant viruses on HIV prevention and treatment.

HIV recombinants result when two or more HIV subtypes genetically combine. McCutchan is head of the Global Molecular Epidemiology Programme for the US Military HIV Research Program and Adjunct Professor at the Bloomberg School of Public Health, Johns Hopkins University in Baltimore, USA.

Some local HIV epidemics have a large presence of dually infected individuals (people who have been infected with HIV two or more times).

In her research mostly in East Africa, McCutchan found a relationship between rates of dual infection and presence of viruses that have a unique genetic structure and have been isolated in only one individual.

In the four East African cohorts McCutchan studied, presence of these unique viruses increased in parallel with dual infections, suggesting that repeated infection with HIV drives increasing genetic diversity of the virus.

She also found a higher proportion of unique viruses and dual infections in urban and high-risk settings as compared to rural and agricultural settings.

McCutchan's research underscores the need for effective HIV prevention interventions, especially in high risk populations.

Reducing the incidence of dual infection may improve the success of AIDS treatment and limit the emerging genetic diversity of HIV-1 strains in the pandemic.

"Today's presentations give us a window into an evolving epidemic that is growing steadily more severe,"said Conference Co-Chair Dr. Celso Ramos, Former President of the Sociedade Brasileira de Infectologia (SBI).

"The global response must be as dynamic as the epidemic itself. It is critical that researchers and policy makers apply what we are learning to saving lives and preventing new infections."

"The new scientific findings presented at this conference highlight the urgency of applying what we learn on the ground in countries most affected by the epidemic" said Craig McClure, Executive Director of the International AIDS Society.
"We must narrow the gap between scientific discovery and practice by quickly modifying our responses in line with new research findings. This is a rapidly evolving virus and epidemic and we need to stay ahead of it."