Important note: Information in this article was accurate in January 2004. The state of the art may have changed since the publication date. 
Treatment Issues: Newsletter of Current Issues in HIV/AIDS - Volume 18, Number 1 & 2, January / February 2004
Bob Huff
Some of the most important talks at the 11th Annual Retrovirus Conference this year are now available as free webcasts. If you did not attend the conference or were unable to catch every session, you can access over 20 hours of plenary talks, mini-lectures and symposiums offered as video and audio accompanied by synchronized slides. A low-speed connection offers voice and slides without the video. As you work your way through these talks you will be exposed to the latest issues in the science and social reality of HIV and AIDS.
Many of the talks delve deeply into scientific details of their subject and may be incomprehensible to those without some background in the topic. Other talks discuss the science in a clear manner and are worth tackling even if one's scientific literacy is low. A few talks cover issues that everyone should become familiar with, such as the crisis of HIV in the developing world, the state of the epidemic in U.S. prisons and jails, and the potential for developing an effective microbicide. Here is an annotated guide to Retrovirus on the web: www.retrovirus.org
Stephen Lewis
(Sunday, 5:30 pm; Opening Plenary; Click the index button and skip to Lewis' talk)
If you have not heard of Stephen Lewis, or have only read his speeches on the plague in Africa, start here. Listening to him is like witnessing a great orator from the 19th Century. Lewis sounds a clarion call for treatment and action in Africa. He convinces in the language of necessity, compunction and love. This was truly the keynote message for the conference.
Men on the DL
(Tuesday, 12:00 pm; Men on the "Down Low": More Questions than Answers.)
Greg Millet of the CDC discusses the situation of heterosexually-identified black men in the U.S. who have sex with men. He reviews common assumptions about DL men, the history of the term, outlines gaps in the research and makes recommendations for filling those gaps.
HIV Care in Jail
(Tuesday, 12:00 pm; HIV in Jails and Prisons)
Jim McAuley of Chicago's Cook County Jail demonstrates that for many people, jail is the only opportunity they have to access health care services. But the short time spent in jail and the high turnover rate poses limitations to the amount of care that can be delivered.
Psychiatric Issues in Youth
(Monday, 4:00 pm; Symposium on Emerging Long-term Complications)
Sharon Nachman of Stony Brook University in New York discusses what is known and not known about psychiatric disorders in children and adolescents growing up with HIV.
Global HIV / AIDS Issues
(Sunday, 3:00 pm; Symposium: Development in the Global Response to AIDS)
Scaling Up from the Top Down
David Miller of WHO presents a comprehensive, if dry, overview of the challenges of scaling-up treatment, prevention and care efforts to reach millions of people who urgently need them. Many of the issues he discusses are also applicable to the need in the U.S. to reach and treat the large numbers of people with HIV who remain unaware of their status or have not entered care.
Planning Treatment in Uganda
Alex Coutinho of TASO in Uganda discusses the scale-up effort in his country where one million people have already died of AIDS, one million have been orphaned and 25 million need treatment. The goal in Uganda is allow parents to live long enough to raise their children. Coutinho focuses on plans for family-based treatment programs aimed at rural areas. Don't miss the gallery of photos from rural TASO treatment centers at the end of his talk.
Treatment in the Private Sector
Gavin Churchyard gives an interesting and detailed report about the first year of the Anglo American Mining company's program for offering therapy to all HIV-positive employees in their South African operations.
These presentations start with a general overview of the issue and why it is important before veering into deep waters. But stick with it; the presenters all do a great job of making their points clearly with minimal jargon.
Herpes and HIV
(Wednesday, 10:00 am; Mini-lecture on Global AIDS)
Connie Celum, of the University of Washington, Seattle, describes the symptoms of HSV-2 infection, its interactions with HIV disease, then reviews what is known about the increased risk for HIV acquisition and transmission. Studies of acyclovir therapy in discordant couples are proposed. Graphic content!
Tuberculosis and HIV
(Wednesday, 8:30 am; Plenary; Tuberculosis and HIV: Is there a Scientific Basis for Hope?)
Peter Small, of the Bill and Melinda Gates Foundation, gives an overview of TB infection and the history of efforts to vaccinate. He also notes increased interest in the "subtle, ongoing dialog" between the host and the pathogen with a goal of tipping the balance towards the host. His conclusions are worth wading through some dense slides, particularly his recommendation that more cooperation is needed between the TB and HIV research establishments.
Malaria and HIV
(Wednesday, 10:30 am; Interaction of HIV and Malaria)
Richard Steketee, of the CDC, offers viewers a "Malaria 101" talk, then describes what is known about the interaction between these diseases in the developing world.
Microbicides
(Monday, 9:00 am; Plenary; How close are we to a microbicide?)
Robin Shattuck, of St. George's Hospital in London, details the considerable challenges to developing an effective microbicide. One daunting example is the large quantity of product required for current candidates to be effective in animal models. Yet in the end, with the number of candidates and the emerging commitment of resources, the longer-term outlook is promising.
Mother to Child Transmission
(Monday, 11:45 am; Mini-lecture: Treatment strategies for preventing MTCT)
Ten years after the first historic report that mother-to-child transmission of HIV could be prevented with AZT, Elaine Abrams, of Harlem Hospital, reviews the progress and the potential for continued roll-out of effective approaches. Particular attention is paid to the emerging challenge of resistance in women and children previously exposed to nevirapine.
Treatment Complications in Women
(Monday, 4:00 pm; Symposium on Long-term Complications of HIV)
Bone loss, lipid changes, and body shape changes associated with antiretroviral drug therapy in women. Multiple speakers.
Budding and Release
(Sunday, 5:30 pm; Opening Plenary. Cellular Factors and HIV Budding)
Wesley Sundquist, of the University of Utah, Salt Lake. The details are boggling, but the fact of how HIV subverts normal processes to engineer its escape from cells is stunning.
APOBEC3G
(Tuesday, 9:00 am; Plenary, DNA Editing and Host Restriction Factors)
Michael Neuberger, of the Medical Research Council, Cambridge, UK, tells the story of the discovery of APOBEC3G, a potent, innate anti-HIV defense.
For more on APOBEC3G, see:
(Tuesday, 4:00 pm; Symposium, Host Restriction Factors)
Multiple speakers
Future Therapy
(Wednesday, 4:00 pm; Symposium, Antiretroviral Therapy)
Warner Greene, of the Gladstone Institute in San Francisco, reviews potential new drug targets emerging from basic research.
Amalio Telenti, of the University of Lausanne, discusses the challenges and potential of using genetics to guide therapeutic choices.
Lisa Demeter, of the University of Rochester, gives a fascinating and important talk on emerging evidence about NRTI drug resistance.
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