15 th International Symposium on HIV

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1 Toulon, France May 2008 Challenges Without Borders 5 th International Symposium on HIV and Emerging Infectious Diseases Final programme HOT TOPICS IN HIV & HEPATITIS INFECTIONS

2 Sponsors Sponsors Table of Contents Addresses Table DES MatiEres Adresses We would like to thank the following sponsors for their support of the 5th ISHEID: Gold Sponsor Sponsor d Or UNE DIVISION DE Silver Sponsors Sponsors d Argent Nous remercions les partenaires de l industrie pour leur support au 5ème ISHEID: Addresses Adresses Welcome Message Message de bienvenue Committees Comités About the ISHEID A propos d ISHEID The City of Toulon Ville de Toulon The Symposium Venue Lieu du Symposium Schedule at a Glance Programme récapitulatif Symposium Programme Programme du Symposium Exhibitors / Exhibition Plan Exposants / Plan de l exposition General Information Informations générales Sponsors / Exhibitors Partenaires / Exposants Invited Speaker Abstracts Abstracts des orateurs invités General Sponsors Sponsors Généraux Special partner Associé spécial Symposium Organiser Organisateur du Symposium Symposium Venue Lieu du Symposium K.I.T. GmbH Association & Conference Management Group & Co. KG Kurfürstendamm Berlin Germany Phone: Fax: Website: Palais des Congrès Neptune Place de Besagne Centre Commercial Mayol BP Toulon Cedex France Phone: Fax: Website: Official carriers Transporteurs Officiels 2 3

3 WelcomE Message Message de Bienvenue Dear Colleague, Cher collègue, I am delighted to invite you to take part in the 5th ISHEID, to be held at the Palais des Congrès convention centre in Toulon, France from May J ai le plaisir de vous inviter à prendre part au 5ème ISHEID qui se tiendra au Palais des Congrès de Toulon du 28 au 30 Mai The theme for the coming edition will be Challenges Without Borders, in reference to our Symposium s continually-expanding international reach and adamantly global approach to today s pathologies. Since its launch, ISHEID has focused primarily on the state-of-the-art of HIV / AIDS research, but has gradually opened up to other emerging infectious diseases challenging the future of our societies. Among the multitude of scientific events covering these issues, ISHEID has its own specificities: first and foremost it is the only French stage regularly welcoming the world s leading experts in infectious diseases. It also offers a unique mix of talks by international celebrities and presentations of unpublished data by young researchers. Lastly, it fosters extensive scientific exchanges in a friendly atmosphere and its human scale facilitates direct contact with top personalities. Our motto is quality: we endeavour to cater for every detail, from the programme which is designed to differ from that of other conventions to the pertinent content of the pharmaceutical industry satellite symposia, and the expertise of our interpreters. As we want this ISHEID to stand out from other meetings, we have decided to limit the issues in the HIV and viral hepatitis fields to 0 5 Hot Topics. This will allow us to publish after the meeting a summary of the statements made during the sessions. 4 WelcomE Message Message de Bienvenue Le thème choisi pour cette édition est «défis sans frontières», mettant en avant l ouverture internationale toujours croissante de notre congrès qui s intéresse, lui-même, à des pathologies de préoccupation planétaire. En effet, depuis sa création l ISHEID est avant tout consacré aux actualités sur l infection à VIH / SIDA, mais il s est peu à peu ouvert aux autres pathologies infectieuses émergentes qui constituent les défis de demain de nos communautés. Dans la multitude des manifestations scientifiques couvrant ces problématiques, il apporte ses particularités. Tout d abord, il est la seule scène en France qui accueille régulièrement les plus hautes personnalités scientifiques internationales dans le domaine des maladies infectieuses. Ensuite, il est l endroit où vous trouverez aussi bien des mises au point réalisées par des «stars» mondialement reconnues, que des présentations, par de jeunes chercheurs, de données non encore publiées. Enfin, il permet de larges échanges scientifiques dans une atmosphère conviviale qui préserve «l échelle humaine» et permet une rencontre directe avec les plus grandes personnalités. To pursue these objectives, I will once again be backed by talented Steering and Scientific Committees. I am very much looking forward to seeing you again in Toulon in May 2008, and to writing this new page of ISHEID with you. Afin de distinguer l ISHEID des autres congrès existants, nous avons décidé de ne traiter dans le domaine du VIH et des hépatites virales que 0 à 5 «Questions d Actualité». Cela nous permettra par la suite de publier un consensus autour de ces points tel qu il sera obtenu lors des sessions. Pour relever et assurer ces objectifs, je me suis à nouveau entouré d un Comité d Organisation et d un Comité Scientifique talentueux. J ai hâte de vous retrouver à Toulon en Mai 2008 pour écrire ensemble cette nouvelle page de l ISHEID! Warmest wishes, Amicalement, Dr. Alain Lafeuillade Symposium Chairman Président Notre maître mot est la qualité. Pour cela, vous constaterez que chaque détail a été mûrement réfléchi, du choix des thèmes du programme -qui ne veut pas être redondant avec d autres congrès- au contenu des symposia satellites de l industrie -qui doivent apporter un réel savoir- en passant par la qualité de la traduction simultanée. 5

4 Committees COMITES About the ISHEID A propos d ISHEID Symposium Chairman Président Scientific Committee Comité scientifique About the ISHEID A propos d ISHEID Alain Lafeuillade Chalucet Hospital Toulon, France Steering Committee Comité d organisation Jean-François Delfraissy CHU Kremlin Bicêtre Kremlin, France José Gatell Hospital Clinic Provincial Barcelona, Spain Milos Opravil University Hospital Zurich, Switzerland Guido Poli San Raffaele Scientific Institute Milan, Italy Christine Rouzioux Laboratory of Virology CHU Necker-Enfants Malades Paris, France Vicente Soriano Hospital Carlos III Instituto de Salud Madrid, Spain Hans-Jürgen Stellbrink IPM Study Center Hamburg, Germany Stefano Vella Instituto Superiore di Sanità Rome, Italy Dominique Blanc Marseille, France Antoine Chéret Toulon, France Jean-Albert Gastaut Marseille, France Robert Gallo Baltimore, USA Gilles Hittinger Toulon, France Leondios Kostrikis Nicosia, Cyprus Jean-Pierre de Jaureguiberry Toulon, France John Kaldor Sydney, Australia Denis Lacoste Bordeaux, France Jean-Marie Lang Strasbourg, France Yves Mouton Tourcoing, France Mark Nelson London, UK Cécile Poggi Toulon, France Jacques Reynes Montpellier, France Paolo Rizzardi Milan, Italy Jürgen Rockstroh Hamburg, Germany Alain Rieu Toulon, France Catherine Tamalet Marseille, France Giuseppe Tambussi Milan, Italy Jean-Claude Tardy Lyon, France The event started out in the mid 980 s as a regional meeting on HIV infection and AIDS led by local practitioners, at the time when the epidemic first struck the Provence-Alpes-Côte d Azur causing many deaths. The first annual meetings focused on epidemiologic and clinical aspects of this new disease, and management of the associated opportunistic infections. Staged at Toulon General Hospital s conference hall, they attracted around 00 participants. 992 saw the simultaneous launch of Toulon s new Palais des Congrès Convention Centre and a special Medical Unit at the hospital, led by Dr. Alain Lafeuillade. At that time, the regional meeting was upgraded to a Mediterranean Symposium and welcomed its first overseas speakers. The Symposium audience changed radically in 993: until then, it had mostly attracted doctors and consultants who were not directly involved in the management of AIDS patients, but the programme s increasingly technical content now particularly targeted hospital personnel in daily contact with patients. From its formative years as a post-graduate training tool, the event had evolved to a specialist HIV / AIDS Symposium in its own right. In recognition of its pioneering spirit, the 995 edition attracted nearly 500 participants and included the first pharmaceutical industry satellite symposia plus parallel sessions. The team of Toulon practitioners in charge of logistics decided to reschedule the Symposium every two years, and call on the services of a professional events organiser. Between 995 and 2006, ISHEID welcomed most of the world s leading AIDS specialists, such as Professors Robert Gallo, Anthony Fauci, David Ho, Douglas Richman, David Back, Roger Pomerantz, Brian Gazzard, Giuseppe Pantaleo, Brigitte Autran, Françoise Brun-Vezinet, Julio Montaner and Pedro Cahn. The Steering and Scientific Committees were joined by dynamic European personalities such as Professors Stefano Vella, José Gatell and Jean-François Delfraissy. Au commencement l événement était une «réunion régionale d information sur l infection à VIH et le SIDA» organisée par des praticiens locaux. C était au milieu des années 80, alors que l épidémie touchait de plein fouet la région Provence Alpes Côte d Azur et causait de nombreux décès. Les premières éditions, annuelles, permirent de décrire les aspects épidémiologiques et cliniques de cette nouvelle maladie, et de préciser la gestion des infections opportunistes. Réalisées dans la salle de conférence du Centre Hospitalier de Toulon, elles accueillaient une centaine de participants. En 992, avec l ouverture simultanée du Palais des Congrès de Toulon et d une Unité Médicale spécialisée au Centre Hospitalier de Toulon dont la gestion est confiée au Dr Alain Lafeuillade, la «réunion régionale» devient «congrès méditerranéen» et accueille ses premiers orateurs étrangers. C est en 993 que s effectue un changement radical de l audience du Symposium : jusque là fréquenté essentiellement par des médecins libéraux non directement impliqués dans la prise en charge des malades du SIDA, la technicité des sujets abordés fait qu il s adressera désormais aux acteurs hospitaliers qui ont en charge les malades. La manifestation passe ainsi du statut de formation post universitaire à un congrès à part entière de la spécialité. L édition de 995 consacre cette évolution avec près de 500 participants, les premiers symposia satellites de l industrie et l aménagement de sessions en parallèle. Le groupe de praticiens toulonnais qui assurait jusqu alors seul la logistique du congrès décide de le renouveler désormais tous les 2 ans et de faire appel à une agence spécialisée dans l organisation. Entre 995 et 2006, l ISHEID aura accueilli la plupart des sommités internationales ayant marqué l histoire du SIDA, tels les Professeurs Robert Gallo, Anthony Fauci, David Ho, Douglas Richman, David Back, Roger Pomerantz, Brian Gazzard, Giuseppe Pantaleo, Brigitte Autran, Françoise Brun-Vezinet, Julio Montaner, Pedro Cahn. Ses Comités d Organisation et Scientifique auront été rejoints par des personnalités européennes dynamiques, tels les Professeurs Stéfano Vella, José Gatell, Jean-François Delfraissy

5 About the ISHEID A propos d ISHEID The City of Toulon Ville de Toulon The City of Toulon Ville de Toulon The pooled work of these eminent personalities reinforced the Symposium s international stature and won the loyalty of a continually expanding core of industrial partners. Although ISHEID still focuses essentially on HIV infection, it now encompasses the sphere of emerging infectious diseases, such as Creutzfeldt-Jacob s disease, avian influenza and viral hepatitis. The Symposium currently welcomes the world s foremost experts on these topics. ISHEID offers clinicians and biologists highly technical, state-of-the-art presentations by THE leading authorities in their fields. It is also the stage for hands-on, thematic workshops and gives young researchers and practitioners a chance to kick off with their first presentations. The programme is enhanced with quality-certified satellite symposia by its industrial partners, scientific posters and a richly varied, informative exhibition. Over the years, ISHEID has won the loyalty of numerous participants from many different horizons and countries. Thanks to their feedback, we know they particularly appreciate the easy communication facilitated by ISHEID s human scale, its relaxed and warm atmosphere, and original content. In 2008, we hope to take ISHEID one step further in its quest to become an unrivalled international benchmark. Le travail conjugué de ces personnes aura permis au congrès d asseoir sa place internationale tout en fidélisant ses partenaires industriels chaque année plus nombreux. L ISHEID est ainsi un congrès toujours essentiellement centré sur l infection à VIH mais également ouvert aux maladies infectieuses émergentes qui défient notre avenir. De la maladie de Creutzfeldt-Jacob à la grippe aviaire, en passant par les hépatites virales, ces thèmes ont aussi permis d accueillir les personnalités scientifiques mondiales qui faisaient l actualité. L ISHEID est donc la scène sur laquelle cliniciens et biologistes vont trouver les mises à jour -les «State of the Art»- les plus élaborées, sous forme de «lectures» données par LA personne qui fait autorité sur le sujet. C est également le lieu d ateliers de travail pratiques et thématiques, et l occasion pour de jeunes chercheurs ou de jeunes praticiens de se «lancer» en effectuant leurs premières présentations. Le programme est agrémenté de symposia satellites proposés par les partenaires industriels, dont la qualité est vérifiée par les Comités, de posters scientifiques et d une exposition riche et variée. Au fil des années, de nombreux participants ont ainsi été fidélisés, venus d horizons et pays variés. En discutant avec eux, on s aperçoit qu ils apprécient avant tout la taille humaine du congrès, permettant des échanges directs, son ambiance conviviale qui facilite aussi la communication, l originalité des thèmes abordés. Avec l édition de 2008, notre souhait est de faire franchir à l ISHEID un pas de plus vers son caractère incontournable. The historical maritime city of Toulon, the capital of France s Var region, welcomes the ISHEID every second year. The city is situated in Southern France, between Marseilles and Nice, on the French Riviera. Toulon is well known to have the most beautiful harbour in Europe, Roman remains, and the traditional charm of Provence. The city offers many points of interest, including the Provencial food market one of the Provence s biggest held every morning on the Cours Lafayette. Discover the historic quarter, ancient cathedral, shady squares and moss-covered fountains as well as the more recent upper city quarters, where monuments from Napoleon III s era abound. All at a few minutes walking distance, Toulon s port and marina, pedestrian streets, malls and typical cafés welcome visitors the whole year round. The sea front with its numerous terraces overlooking the Marina is a favourite spot for lunch. The coast and inland mountains, with their characteristic Mediterranean flora and fauna, are fully developed for sports, nature and leisure activities. Cable car rides to the Mount Faron provide a panoramic view over the city and bay. As an economic, academic and cultural hub, Toulon offers complete business and tourism facilities coupled with a sophisticated communications network and more than 300 days of sun every year. La ville maritime historique de Toulon est la capitale de la région française du Var et accueille ISHEID tous les deux ans. La ville est située au sud de la France, entre Marseille et Nice, sur la French Riviera. Toulon est bien connue pour abriter le plus beau port d Europe, des vestiges romains, et pour son charme traditionnel de Provence. La ville offre de nombreux centres d intérêts, notamment le marché provençal un des plus grands de Provence qui se tient tous les matins sur le Cours Lafayette. Découvrez le quartier historique, l ancienne cathédrale, les places ombragées et les fontaines couvertes de mousse, de même que les quartiers chics les plus récents et les nombreux monuments datant de l ère de Napoléon III. Tout se trouve à quelques minutes de distance à pied, le port de Toulon et la marina, les rues pédestres, les rues commerçantes et les cafés typiques qui accueillent les visiteurs tout au long de l année. Le front de mer avec ses nombreuses terrasses donnant sur la marina est un des points de rencontre favoris pour le déjeuner. La côte et les montagnes intérieures avec leur faune et leur flore méditerranéenne caractéristique sont très appropriées pour les activités sportives, de découverte de la nature et de détente. Un téléphérique jusqu au Mont Faron offre une vue panoramique sur la ville et la rade de Toulon. En tant que plateforme économique, universitaire et culturelle, Toulon offre des dispositifs pour les affaires et le tourisme associés à un réseau de communication sophistiqué et plus de 300 jours de soleil par an

6 The Symposium Venue Lieu du Symposium Schedule at a Glance Programme recapitulatif The Symposium Venue Lieu du Symposium Wednesday 28 May 2008 Thursday 29 May 2008 Friday 30 May 2008 The Palais des Congrès Toulon Neptune is located in the heart of the city and close to the port. The Convention Centre has accommodated more than,300 events since its opening in 99. The new airport Toulon-Hyères lies within a twenty minute distance from the Toulon Neptune and the SNCF train station can be reached in a fifteen minute walk. A car park with a capacity of,400 vehicles is located beneath the Convention Centre. Palais des Congrès Neptune Place de Besagne Centre Commercial Mayol BP Toulon Cedex France Phone: Fax: Website: Site internet: Le «Palais des Congrès Neptune» de Toulon est situé au coeur de la ville et près du port. Le centre des congrès a accueilli plus de 300 événements depuis son ouverture en 99. Le nouvel aéroport de Toulon-Hyères est à 20 minutes de distance du Palais des Congrès Neptune et la gare SNCF peut être atteinte en 5 minutes à pied. Un parking pour voitures avec une capacité de 400 places est situé au sous-sol du centre des congrès. 08:00 MTE (unrestricted grant 08:30 from MSD-Chibret) 09:00 09:30 0:00 0:30 Coffee Break :00 :30 2:00 2:30 Lunch MTE 2 MTE 3 MTE 4 (unrestricted grant from Boehringer Ingelheim) Plenary Session 2 Plenary Session 3 Coffee Break Panel Panel 2 Panel 3 Panel 4 (unrestricted grant from Boehringer Ingelheim) Symposium GlaxoSmithKline Lunch Symposium Schering-Plough Lunch Poster Symposium Discussion Bristol-Myers Squibb 3:00 3:30 Lunch Break / Exhibition Lunch Break / Exhibition 4:00 Plenary Session Satellite Symposium Opening Ceremony Gilead 4:30 Parallel Parallel Session 3 Session 4 5:00 5:30 Coffee Break Rapporteur 6:00 Point / Point / Closing Ceremony 6:30 Satellite Symposium Counterpoint Counterpoint 2 Tibotec, a division of Janssen-Cilag 7:00 7:30 8:00 Welcoming Cocktail Courtesy of Tibotec, 8:30 a division of Janssen-Cilag 9:00 9:30 Parallel Session Parallel Session 2 0

7 Symposium Programme Programme du symposium Symposium Programme Programme du symposium Wednesday 28 May 2008 Thursday 29 May :00 6:00 Room Vauban Plenary Session / Opening Ceremony Challenges in HIV Infection Chairs: Alain Lafeuillade (Toulon, France) Stefano Vella (Rome, Italy) Introductory Remarks: Alain Lafeuillade, Symposium Chairman Stefano Vella, on behalf of the Steering Committee Managing HIV Drug Interactions David Back (Liverpool, UK) The Challenges of HIV Reservoirs & Persistence Tae-Wook Chun (Bethesda, USA) Anti-HIV Vaccine Development Robert Gallo (Baltimore, USA) 6:30 8:00 Room Colbert Satellite Symposium Tibotec, a division of Janssen-Cilag Combating and Preventing Antiviral Drug Resistance: From Drug Discovery to Clinical Evidences Drug Discovery and Investigational Compounds in Development at Tibotec Brian Woodfall (Mechelen, Belgium) A Next-Generation NNRTI for Managing Treatment- Experienced HIV--Infected Patients Giovanni Di Perri (Turin, Italy) Darunavir: Virological Features Vincent Calvez (Paris, France) 08:00 09:00 Room Vauban Meet The Experts Including Resistance Testing in Clinical Practice Mark Wainberg (Montreal, Canada) Anna Maria Geretti (London, UK) Supported by an Unrestricted Educational Grant from MSD-Chibret Meet The Experts 2 Room Colbert Managing HIV HCV Coinfection in Practice Jürgen Rockstroh (Bonn, Germany) José M. Miró (Barcelona, Spain) 09:5 0:45 Room Vauban Plenary Session 2 HAART from Today to Tomorrow Chairs: Alain Lafeuillade (Toulon, France) Caroline Solas (Marseille, France) When May we Use HIV- Integrase Inhibitors in our Strategies? David Cooper (Sydney, Australia) New Antiretroviral Drugs in the Pipeline Roy Gulick (New York, USA) HAART Tomorrow: Considering Difficulties Ahead Mark Wainberg (Montreal, Canada) :5 2:5 Panel Room Vauban Which is the Best Treatment for Antiretroviral Naive Patients? Stefano Vella (Rome, Italy) Jose Gatell (Barcelona, Spain) Richard Haubrich (San Diego, USA) Panel 2 Room Colbert Renal Dysfunction and Antiretroviral Therapy Christoph Fux (Bern, Switzerland) Bruce Hendry (London, UK) Pablo Labarga (Madrid, Spain) Corinne Bagnis (Paris, France) 2:30 3:30 Room Colbert Lunch Symposium GlaxoSmithKline First Line Therapy in 2008 Chair: Alain Lafeuillade (Toulon, France) Isabelle Poizot-Martin (Marseille, France) Jean-Claude Tardy (Lyon, France) This Symposium will be held in French with simultaneous translation into English. Lunch Symposium Room Vauban Schering-Plough Vicriviroc: A Next Generation CCR5 Antagonist for HIV Treatment Lisa M. Dunkle (Kenilworth, USA) 4:00 5:30 Room Vauban Satellite Symposium Gilead HIV Infection Complications Which role for HIV infection in complications? Cécile Goujard (Le Kremlin Bicêtre, France) Which role for HAART complications and how to manage them? Thierry Prazuck (Orléans, France) Focus on cardiovascular risk and lipid disorders; Stéphane de Wit (Brussels, Belgium) This Symposium will be partly held in French with simultaneous translation into English. 6:00 7:00 Room Vauban Point / Counterpoint A Pivotal Role for HIV Entry Inhibitors? Animator: Richard Haubrich (San Diego, USA) Pros: Eva Poveda (Madrid, Spain) Cons: Stéphane de Wit (Brussels, Belgium) Point / Counterpoint 2 Room Colbert A Future for Immune-based Therapy in HIV? Pros: Guido Poli (Milan, Italy) Cons: Jade Ghosn (Paris, France) 7:5 8:45 Room Vauban Parallel Session Chairs: Patricia Enel (Marseille, France) Alain Lafeuillade (Toulon, France) Parallel Session 2 Room Colbert Chairs: Alain Rieu (Toulon, France) Gilles Hittinger (Toulon, France) 2 3

8 Exhibitors Exhibition Plan Exposants Plan de l exposition Friday 30 May :00 09:00 Room Vauban Meet The Experts 3 Including TDM in Clinical Practice Rodolphe Garraffo (Nice, France) Giovanni Di Perri (Turin, Italy) Meet The Experts 4 Room Colbert Practical Management of Metabolic Complications in HIV + Patients William Powderly (Dublin, Ireland) Graeme Moyle (London, UK) tbc Supported by an Unrestricted Educational Grant from Boehringer Ingelheim 09:5 0:45 Room Vauban Plenary Session 3 Hepatitis Viruses & Coinfection Chairs: Pierre Pellegrino (London, UK) Antoine Chéret (Toulon, France) New Paradigms in the Treatment of Hepatitis C in HIV Vicente Soriano (Madrid, Spain) Acute HCV Infection Mark Nelson (London, UK) Treatment of HBV Infection: How Do the New Agents Fit? Yves Benhamou (Paris, France) :5 2:5 Room Vauban Panel 3 Pre-exposure Prophylaxis for HIV Infection? Eric De Clercq (Leuven, Belgium) Lynn A. Paxton (Atlanta, USA) Panel 4 Room Colbert Liver Toxicity of Antiretroviral Drugs Pablo Barreiro (Madrid, Spain) Stanislas Pol (Paris, France) Vicente Soriano (Madrid, Spain) Supported by an Unrestricted Educational Grant from Boehringer Ingelheim 2:30 3:30 Room Colbert Lunch Symposium Bristol-Myers Squibb What is the Definition of an Active Antiretroviral in 2008? Chairs: Alain Lafeuillade (Toulon, France) Jacques Izopet (Toulouse, France) When HIV Infection is Diagnosed at a Late Stage Graeme Moyle (London, UK) Which Role for Virology in Early-Treatement Lines? Jonathan Shapiro (Israel) Q&A Poster Discussion Room Vauban 4:30 5:30 Room Vauban Parallel Session 3 Chairs: Christophe Renou (Hyères, France) Bruno Lacarelle (Marseille, France) Parallel Session 4 Room Colbert Chairs: Eric Jullian (Toulon, France) Leondios G. Kostrikis (Nicosia, Cyprus) 5:45 7:00 Room Vauban Rapporteur Session / Closing Ceremony Chairs: Alain Lafeuillade (Toulon, France) Jean-Claude Tardy (Lyon, France) Rapporteurs: Rodolphe Garraffo (Nice, France) Marie-Lise Gougeon (Paris, France) Christine Rouzioux (Paris, France) Vicente Soriano (Madrid, Spain) Hans-Jürgen Stellbrink (Hamburg, Germany) Symposium participants are invited to visit the exhibition located on the first floor of the Symposium venue. A large area of prime location gives both commercial and non-commercial organisations a unique opportunity to showcase their products, programmes and services to a targeted audience. Opening times: Wednesday 28 May 2008: 3:30 9:30 Thursday 29 May 2008: 08:00 8:00 Friday 30 May 2008: 08:00 7:30 Exhibition Plan Level Plan de l exposition Niveau 0 GlaxoSmithKline 02 Pfizer 03 MSD-Chibret 04 Bristol-Myers Squibb 05 Gilead 06 Abbott 07 Boehringer Ingelheim 08 Partec 09 Tibotec, a division of Janssen-Cilag 0 Siemens Diagnostics Thomas Land Publishers 2 Wisepress.com 3 Stemcell Technologies Internet Café courtesy of Abbott Les participants au Symposium sont invités à visiter l exposition située au premier étage du Palais Neptune. Un vaste espace d exposition est réservé aux organisations commerciales et non commerciales pour leur donner l opportunité de présenter leurs produits, programmes et services au public ciblé du symposium. L exposition sera ouverte aux heures suivantes: Mercredi 28 mai 2008: 3:30 9:30 Jeudi 29 mai 2008: 08:00 8:00 Vendredi 30 mai 2008: 08:00 7:30 05 Internet Café 0 Entrance Poster Exhibition Poster Exhibition 09 Room Colbert 4 5

9 General Information Informations GEnErales General Information Informations GEnErales General Information Informations Générales Abstract Book All accepted abstracts will be published in the abstract book, which will be part of the Symposium bag. Badge A badge is required for admission to all official Symposium sessions, the exhibition and poster area, the Opening Ceremony and Closing Ceremony. Each participant is asked to present the badge in order to gain access to the Symposium. The badge must be clearly displayed at all times. A handling fee of EUR will be charged to every name change to an existing congress registration or for a lost badge. Catering There is a Snack Bar located on the second floor at the Palais des Congrès Neptune, offering light snacks and beverages on a cash basis. Certificate of Attendance There will be a CME questionnaire in your Symposium bag. Please complete the questionnaire and exchange it for a Certificate of Attendance at the registration area. Climate Sunny Mediterranean climate: In May, the weather is always warm with temperatures reaching 25 C. Livre d abstracts Tous les abstracts retenus sont publiés dans le livre d abstracts, placé dans la mallette du Symposium. Badge Le badge doit être présenté à l entrée des sessions scientifiques, de l exposition, des zones de posters, ainsi que pour les cérémonies d ouverture et de clôture. Le badge doit être porté à tout moment durant le Symposium et n est pas transférable. Un forfait de 30 EUR sera facturé pour le remplacement de tout badge perdu ou pour tout changement de nom. Snack bar Un snack bar est situé au 2ème étage du Palais Neptune, offrant différentes boissons et snacks. Seuls les paiements en espèce sont acceptés. Certificat de participation Un questionnaire CME est placé dans les mallettes du Symposium. Veuillez compléter ce questionnaire et le remettre au comptoir d inscription en échange de votre certificat de participation. Climat Climat méditerranéen ensoleillé: en mai le temps est toujours chaud avec des températures atteignant les 25 C. CME Credits The 5th International Symposium on HIV and Emerging Infectious Diseases is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to provide the following CME activity for medical specialists. The EACCME is an institution of the European Union of Medical Specialists (UEMS), The 5th International Symposium on HIV and Emerging Infectious Diseases is designated for a maximum of 0 (ten) hours of European external CME credits. Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity. EACCME credits are recognized by the American Medical Association towards the Physician s Recognition Award (PRA). To convert EACCME credit to AMA PRA category credit, contact the AMA. There will be a CME questionnaire in your Symposium bag. Please complete the questionnaire and exchange it for a Certificate of Attendance at the registration area. Coat check, Luggage and Poster Storage There is a coat check located in the basement of the Palais des Congrès Neptune. Palais des Congrès Neptune charges a nominal fee for the use of this service. Crédits CME Le 5ème ISHEID est accrédité par l EACCME (European Accreditation Council for Continuing Medical Education) concernant les activités de CME (Continuing Medical Education) pour les médecins spécialistes. L EACCME est une institution de l UEMS (European Union of Medical Specialists) Le 5ème ISHEID est prévu pour un maximum de 0 (dix) heures de crédits CME externes européens. Les médecins spécialistes ne peuvent se prévaloir que des heures qu ils ont effectivement passées dans une activité éducative. Les crédits EACCME sont reconnus par l AMA (American Medical Association towards the Physician s Recognition Award). Afin de convertir un crédit EACCME en AMA PRA catégorie, prière de contacter l AMA. Un questionnaire CME est placé dans les mallettes du Symposium. Veuillez compléter ce questionnaire et le remettre au comptoir d inscription en échange de votre certificat de participation. Vestiaire, bagages et dépôt des posters Un vestiaire est situé au rez-de-chaussée du Palais des Congrès Neptune. L utilisation du vestiaire est payante

10 General Information Informations GEnErales General Information Informations GEnErales Currency The national currency in France is the EURO ( Euro= 00 Cents). Coins of, 2 and 5 Cents are copper-coloured; coins of 0, 20 and 50 Cents are gold-coloured; and 2 Euro coins are gold-and-silver coloured. Euro notes come in denominations of 5, 0, 20, 50, 00, 200 and 500. Credit cards as well as most major currencies are widely accepted. For currency exchange, please ask your hotel for further information. Electricity The electrical supply in most areas of France is 220 V, 50 Hz. Plug sockets are European continental standard (two round pins). Internet Facilities There will be internet facilities in the exhibition area, courtesy of Abbott. Same opening hours as the exhibition. Insurance and Liability The Symposium Organiser can not accept liability for personal injury, loss of or damage to belongings of Symposium participants, either during or as a result of the Symposium. Please check the validity of your own insurance. Language The official Symposium language is English. Simultaneous translation into French will be provided for each session. Monnaie La monnaie nationale en France est l EURO ( Euro= 00 centimes d Euro). Les pièces de, 2 et 5 Centimes sont cuivrées ; les pièces de 0, 20 et 50 Centimes sont dorées ; les pièces de et 2 Euro sont dorées et argentées. Les billets en Euro comportent des coupures de 5, 0, 20, 50, 00, 200 et 500. Les cartes de crédit de même que la plupart des monnaies principales sont largement acceptées. Pour changer de l argent, merci de vous adresser à votre hôtel. Electricité La charge électrique dans la plupart des régions de France est 220 V, 50 Hz. Les prises électriques sont au standard européen continental (prise ronde bipolaire). Internet Un cyber café est situé dans l exposition, avec l aimable soutien d Abbott. Mêmes horaires d ouverture que l exposition. Assurance et responsabilité L organisateur du Symposium ne peut être rendu responsable en cas de dommages aux personnes, de pertes ou de dommages aux effets des participants du Symposium, ni pendant, ni après celui-ci. Merci de vérifier la validité de votre propre assurance. Langues La langue officielle du Symposium est l anglais. Une traduction simultanée en français sera proposée pour toutes les sessions. Les symposia tenus en français seront traduits en anglais. Opening Ceremony The Opening Ceremony, as part of Plenary Session, on Wednesday 28 May 2008 will take place from 4:00 to 6:00 in the Auditorium Vauban. Poster Area / Best Poster Prize The Poster Area is located on the first floor of the Palais Neptune. The best poster will be awarded during the Symposium. Programme Changes The organisers cannot assume liability for any changes in the programme due to external or unforeseen circumstances. Registration Hours Wednesday 28 May :00 8:00 Thursday 29 May :30 8:00 Friday 30 May :30 6:00 Smoking Policy It is forbidden to smoke anywhere in the Palais des Congrès Neptune. Speaker Preview Room The Speaker Preview Room is located in the Jules Verne room on the second floor at the Palais des Congrès Neptune. Opening Hours Wednesday 28 May :00 9:30 Thursday 29 May :00 9:00 Friday 30 May :00 6:00 Cérémonie d ouverture La cérémonie d ouverture aura lieu le mercredi 28 mai 2008 de 4:00 à 6:00 à l auditorium Vauban dans le cadre de la session plénière. Espace Poster / Prix du Meilleur Poster L espace poster est situé au premier étage du Palais Neptune. Le prix du meilleur poster sera remis pendant le Symposium. Changements dans le programme Les organisateurs n assument aucune responsabilité pour des changements dans le programme qui seraient dus à des circonstances extérieures ou imprévisibles. Horaires d inscription Mercredi 28 mai :00 8:00 Jeudi 29 mai :30 8:00 Vendredi 30 mai :30 6:00 Tabac Il est interdit de fumer dans l ensemble des espaces du Palais des Congrès Neptune. Salle des orateurs La salle des orateurs est située dans la salle Jules Verne au 2ème étage du Palais des Congrès Neptune. Horaires d ouverture Mercredi 28 mai :00 9:30 Jeudi 29 mai :00 9:00 Vendredi 30 mai :00 6:00 Symposium Bag The Symposium bag, containing the Symposium material, will be handed out at the registration counter on-site. Mallette du Symposium La mallette contenant le matériel du Symposium est disponible sur place au comptoir des inscriptions

11 General Information Informations GEnErales Sponsors Exhibitors Partenaires Exposants Symposium Courtesies and Code of Conduct In consideration of all Symposium participants, mobile phones should be switched off in all session rooms. Symposium participants are expected to refrain from the following: ) Inflicting personal threat or harm to any Symposium participant, exhibitor or staff, 2) Inflicting damage to any property, 3) Preventing speakers from giving their speeches. Welcome Reception The Welcome Reception on Wednesday 28 May 2008 will take place from 8:00 to 9:30 in the exhibition area, courtesy of Tibotec, a division of Janssen-Cilag. Civilités du symposium et code de conduite Par égard à l ensemble des participants, les téléphones portables doivent être éteints dans toutes les salles de session. Les participants au Symposium sont priés de s abstenir des choses suivantes: ) Infliger une menace personnelle ou un dommage à tout participant, exposant ou organisateur du Symposium, 2) Infliger des dommages à la propriété, 3) Empêcher les orateurs de tenir leur discours. Cocktail de bienvenue Le cocktail de bienvenue a lieu le mercredi 28 mai 2008 de 8:00 à 9:30 dans l exposition, avec l aimable soutien de Tibotec, une division de Janssen-Cilag. Abbott Abbott is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs more than 68,000 people and markets its products in more than 30 countries. Abbott s news releases and other information is available on the company s Website at: Abott est un groupe international travaillant au service de la Santé, qui se consacre à la recherche, au développement, à la fabrication et à la commercialisation de produits pharmaceutiques et médicaux, y compris de nutrition, de dispositifs chirurgicaux et de diagnostic. Le groupe emploie personnes et commercialise ses produits dans plus de 30 pays. Les communiqués de presse ainsi que d autres renseignements sur Abbott sont disponibles sur le site internet: Boehringer Ingelheim The Boehringer Ingelheim group is one of the world s 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 43 affiliates in 47 countries and almost 37,500 employees. Since it was founded in 885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel products of high therapeutic value for human and veterinary medicine. In 2005, Boehringer Ingelheim posted net sales of 9,5 billion Euro while spending almost one fifth of net sales in its largest business segment Prescription Medicines on research and development. For more information please visit: Le groupe pharmaceutique Boehringer Ingelheim, dont le siège se situe à Ingelheim en Allemagne, figure parmi les 20 premières entreprises du médicament au monde. Le groupe compte 43 filiales dans 47 pays et près de employés. Cette entreprise indépendante à capitaux privés est engagée depuis 885 dans la recherche et le développement, la fabrication et la commercialisation de produits d intérêt thérapeutique majeur a usage humain et vétérinaire. En 2005, Boehringer Ingelheim a enregistré un chiffre d affaires de 9,5 milliards d euros et a consacre a la recherché et au développement, près de 20% du chiffre d affaires de produits de prescription Si vous souhaitez en savoir davantage sur Boehringer Ingelheim, n hésitez pas consulter notre site internet a l adresse suivante: Bristol-Myers Squibb Bristol-Myers Squibb est une entreprise du médicament qui fait de la recherche de médicaments à fort potentiel d innovation sa priorité. Bristol-Myers Squibb concentre aujourd hui ses efforts sur des maladies graves pour lesquelles subsiste un vrai besoin médical encore insatisfait : le cancer, les maladies cardiovasculaires, le VIH et le sida, les hépatites, les troubles psychiatriques, la douleur et la polyarthrite rhumatoïde. Bristol-Myers Squibb a réalisé en 2007 un chiffre d affaires mondial de 9.3 milliards de dollars, dont 5.6 milliards pour l activité Pharmacie et a investi 3.2 milliards de dollars dans ses activités de Recherche & Développement. En France, Bristol-Myers Squibb occupe le 8ème rang des entreprises du médicament avec un chiffre d affaires de milliard d euros. Pour plus d information, consultez le site Internet :

12 Sponsors Exhibitors Partenaires Exposants Sponsors Exhibitors Partenaires Exposants Gilead Sciences Gilead Sciences est une société biopharmaceutique qui découvre, met au point et commercialise des produits thérapeutiques innovants dans des secteurs où les besoins en médecine restent sans réponse. La mission de Gilead est de faire progresser, dans le monde entier, les soins chez les patients atteints d affections mettant leur vie en danger. La société Gilead, dont le siège est installé à Foster City, en Californie, est présente en Amérique du Nord, en Europe et en Australie. GlaxoSmithKline GlaxoSmithKline s commitment to hospitals is primarily a story built around numerous therapeutic innovations. GSK has been present for many years in vital areas such as HIV, antibiotherapy, oncology, anaesthesia and, more recently, thrombosis and cardiology. In each of these areas, GSK plays a key role in the development of therapeutic strategies. With the HIV infection, for example, which is no longer an emergency pathology but a chronic pathology, it is now essential to consider new requirements and support the health care teams in order to combine for each patient the best therapeutic strategy and optimised quality of life. A multidisciplinary player at the service of the hospital L engagement de GlaxoSmithKline à l hôpital est d abord une histoire construite autour d un grand nombre d innovations thérapeutiques. GSK est présent de longue date dans les domaines essentiels comme le VIH, l antibiothérapie, l oncologie, l anesthésie, et plus récemment la thrombose et la cardiologie. Dans chacun de ces domaines, GSK est un acteur à part entière de l évolution des stratégies thérapeutiques. A titre d exemple, pour l infection à VIH qui n est plus une pathologie d urgence mais une pathologie chronique, il est aujourd hui indispensable de prendre en compte de nouveaux besoins, d accompagner les équipes soignantes afin de concilier pour chaque patient la meilleure stratégie thérapeutique et une qualité de vie optimisée. Un acteur multidisciplinaire à l écoute de l hôpital MSD MSD, un leader de l industrie pharmaceutique. Filiale de Merck & Co., MSD est un laboratoire pharmaceutique fondé sur la recherche et dédié aux patients. Créé en 89, Merck & Co. découvre, développe, fabrique et met sur le marché des vaccins et des médicaments pour répondre à des besoins médicaux non satisfaits. L entreprise consacre de larges efforts à élargir l accès à ses médicaments, à travers des initiatives de grande ampleur. Ces initiatives incluent non seulement la donation de médicaments mais aussi des programmes pour en faciliter l accès aux plus démunis. Partec, Excellence in Flow Cytometry (FCM) Partec provides complete solutions covering flow cytometers, fluorescence microscopes, software, reagents, applications and after sales service. With the innovative generation of Partec FCM, we are addressing the increasing demand for reliable results in research and clinical routine: Dedicated accurate and highly affordable HIV monitoring systems First mobile/portable FCM instruments Cost-reduced immunophenotyping High-end multi-color analysis Decentralized research applications in cell biology and microbiology Partec fournit des solutions complètes couvrant cytomètrie en flux, microscopie à fluorescence, logiciels, réactifs, applications et service après-vente. Avec la génération innovante de CFM, nous répondons à la demande toujours croissante de résultats fiables en recherche et routine clinique: Cytomètres en flux précis et au meilleur prix pour le suivi HIV Instruments mobiles/portables Immunophénotypage à coût réduit Analyse multi-couleur de haute technologie Applications décentralisées de recherche en biologie cellulaire Pfizer Pfizer, the world s leading pharmaceutical company and top investor in private biomedical research across the world, has been mobilising its teams and resources (more than researchers and 7,6 billion Euro R&D Budget in 2006) to invent, develop and provide medicines to patients and healthcare professionals, in order to treat the pathologies affecting millions of patients across the world: cardiovascular diseases, cancer, rheumatology, central nervous system disorders, HIV/ aids infectious diseases, respiratory illnesses, ophthalmologic afflictions, endocrinal diseases, transplants, urological and gynaecological disorders and orphan diseases. Pfizer, première entreprise du médicament et premier investisseur en recherche biomédicale privée dans le monde, mobilise ses équipes et ses ressources (plus de chercheurs et un budget de Recherche et Développement de 7,6 milliards d euros en 2006) pour inventer, développer et mettre à la disposition des patients et des professionnels de santé des médicaments en vue de traiter des pathologies affectant des millions de patients dans le monde: maladies cardiovasculaires, cancers, rhumatologie, troubles du système nerveux central, maladies infectieuses VIH/sida, pathologies respiratoires, affections ophtalmologiques, maladies endocriniennes, greffes, troubles urologiques-gynécologiques et maladies orphelines. Siemens Medical Solutions Diagnostics Siemens Medical Solutions Diagnostics is the leading clinical diagnostics company in the world. We are committed to providing clinicians with the vital information they need for the accurate diagnosis, treatment and monitoring of patients. Our comprehensive portfolio of performance-driven systems, unmatched menu offering, and IT solutions, in conjunction with highly responsive service, is designed to streamline workflow, enhance operational efficiency and support improved patient care. The depth and breadth of our diagnostic solutions chemistry, immunoassay, automation, hematology, hemostasis, microbiology, diabetes, urinalysis, blood gas and molecular testing are designed to meet the growing demands of our customers, today and tomorrow. Through Siemens extensive expertise in medical imaging and leading-edge information technology, we are also uniquely positioned as the world s first fully integrated diagnostics company to deliver more personalized care to patients around the globe. To learn more about Siemens Medical Solutions Diagnostics, please visit our Website at: STEMCELL Technologies The Cell Experts offers a complete spectrum of products and services for immunology research. RoboSep, the fully automated cell separator, is a self-contained instrument for isolating the immune system cells involved in HIV pathogenesis. RoboSep reagents are based on the EasySep immunomagnetic technology and are available for the isolation of highly purified T cells, CD4+ T cells, CD8+ T cells, Regulatory T cells, dendritic cells, and monocytes among others. It is also possible to isolate cells directly from whole blood by a negative selection immunodensity procedure with RosetteSep. Specialized cell culture media and reagents formulated for a variety of cell types are also available

13 Sponsors Exhibitors Partenaires Exposants Invited Speaker Abstracts Thomas Land Publishers HIV Clinical Trials, a leading international journal devoted exclusively to HIV/AIDS clinical therapeutics. Combines thorough peer review with rapid time to publication. MEDLINE; EMBASE and Elsevier BIOBASE; Science Index Expanded, ISI Alerting Services and Current Contents /Clinical Medicine. Impact Factor.704. Subscriptions include online access to full-text of all published articles. TIBOTEC Commitment in innovation TIBOTEC Pharmaceuticals Ltd, a subsidiary of Johnson & Johnson group, is a global leader in the discovery and development of innovative drugs. Tibotec R&D developed innovative drugs in HIV/AIDS, Hepatitis C and infectious diseases, that fulfill an high medical demand. TIBOTEC, a division of JANSSEN-CILAG, provides patient access to compounds developed by TIBOTEC Pharmaceuticals Ltd research. Among those drugs, three antiretroviral compounds: a protease inhibitor (PI), two non-nucleoside reverse transcriptase inhibitors (NNRTI). TIBOTEC Pharmaceuticals Ltd, filiale du groupe Johnson & Johnson, est une société internationale de recherche et de développement pharmaceutique dont les axes de recherche concernent des médicaments innovants dans le VIH/SIDA, l hépatite C et d autres pathologies infectieuses pour lesquelles il existe un besoin médical important. TIBOTEC, une division de JANSSEN-CILAG, a pour vocation de mettre à disposition des patients des molécules issues de la recherche de TIBOTEC Pharmaceuticals Ltd. Parmi ces molécules, trois anti rétroviraux : un inhibiteur de protéase, deux inhibiteurs non nucléosidiques de la transcriptase inverse. Wisepress.com Wisepress.com, Europe s leading conference bookseller, has a complete range of books and journals relevant to the themes of the meeting. Books can be purchased at the stand or, if you would rather not carry them, posted to you Wisepress will deliver worldwide. In addition to attending 250 conferences per year, Wisepress has a comprehensive medical and scientific bookshop online with great offers, some up to 40% off the publisher list prices. Plenary, 28 May 2008 Challenges in HIV Infection Managing HIV Drug Interactions D. Back University of Liverpool, Pharmacology, Liverpool, United Kingdom The objectives of this review are: To discuss pharmacologic principles underpinning the optimisation of antiretroviral therapy. To outline new data on clinically important drug-drug interactions between antiretrovirals and between antiretrovirals and other drugs. To discuss how to predict, manage and avoid drug-drug interactions including an outline of on-line resources available for this purpose. As access to highly active antiretroviral therapy (HAART) widens and the number of licensed antiretroviral agents (ARV) increases, there is an ongoing need to better understand how to optimise therapy and reduce adverse events. Environment, diet, state of health, co-infections, co-medications all influence a person s response to a drug. In addition, understanding genetic makeup is an important key to creating a more personalised approach to prescribing ( i. e. to ensure greater efficacy and safety). Pharmacokinetic drug interaction studies performed during the drug development process, as a post-licensing commitment provide the substantive data base from which recommendations regarding the use of certain drug combinations are made. However extrapolation on the basis of mechanism of interaction is also important given the sheer number of potential interactions. Thus it is important to have foundational knowledge of drug disposition (enzymes, transporters involved) so that in vitro data (is drug a substrate; is drug an inhibitor of a particular protein) can be used to drive either the key clinical studies or make an informed decision re the potential for an interaction. However, unexpected interactions continue to emerge (e.g. statins and protease inhibitors) which may be clinically relevant. The key to management of patients on multiple drugs is clinical vigilance, access to adequate resources to help inform (eg web based resources), access to therapeutic drug monitoring and close follow up of patients. Recommended reading: Pau AK. Clinical management of drug interactions with antiretroviral agents. Current Opinion HIV & AIDS 2008; 3:

14 Invited Speaker Abstracts Invited Speaker Abstracts Plenary, 28 May 2008 Challenges in HIV Infection The Challenges of HIV Reservoirs and Persistence T.-W. Chun National Institutes of Health, Bethesda, United States of America Plenary, 28 May 2008 Challenges in HIV Infection Toward an HIV Preventive Vaccine: Problems and Prospects Robert C. Gallo, M.D. Director and Professor, Institute of Human Virology of the University of Maryland School of Medicine Effective antiviral therapy has led to rapid and sustained suppression of HIV replication and has dramatically improved the clinical outcome in a majority of infected individuals. However, it has not been possible to eradicate HIV in infected individuals receiving effective antiviral therapy, likely the result of persisting viral reservoirs. In particular, the persistence of latently infected, resting CD4+ T cells has long been considered a major obstacle to the eradication of HIV even in individuals who have received effective antiviral therapy for extended periods of time. However, recent studies have suggested that low levels of on-going viral replication persists and consequently prolongs the overall half-life of HIV in individuals having initiated antiviral drug therapy during the chronic phase of infection. Our recent findings demonstrated that, contrary to current dogma, it is the activated CD4+ T cell compartment that harbors the majority of persisting HIV in infected individuals who have had no detectable viremia for extended periods of time as a result of effective antiretroviral therapy. Our findings also suggested that the frequency of infected CD4+ T cells in gut-associated lymphoid tissue issignificantly higher than that of cells in blood despite years of effective antiretroviral therapy. Although, the eradication of HIV in infected individuals in whom antiretroviral therapy was initiated during the chronic phase of infection continues to remain elusive, our recent data also suggest that early initiation of antiviral therapy followed by the maintenance of undetectable levels of plasma viremia for prolonged periods of time may allow accelerated decay of viral reservoirs in a highly selected group of individuals. These distinctions between early and delayed initiation of antiviral therapy and the prospect of complete eradication of HIV in certain individuals need to be more fully explored as they may shed light on the immunologic and virologic factors involved inefficient clearance of HIV. Three major practical advances in HIV/AIDS have occurred since the epidemic was first recognized: () the blood test of 984 enabling a safe blood supply and allowing the epidemic to be followed; (2) the first authentic antiviral therapy, beginning with AZT in 986 and culminating in the multi-drug approaches of the mid-990s, enabling marked improvement of life for HIV infected persons; and (3) block of mother to child transmission of HIV enabling a remarkable decline in pediatric AIDS in the industrial countries. Three major practical problems remain: () getting therapy to developing countries in a comprehensive and sophisticated manner which has recently been markedly improved by the PEPFAR program but still needs more emphasis; (2) continuing needs for new therapeutic approaches because of the need for life-long treatment with its frequent ultimate toxicity or HIV drug resistance, or alternatively developing a curative therapy which ends drug dependence; and (3) getting rid of HIV by a successful preventive vaccine. In this presentation I will critically review recent vaccine efforts and describe a personal view of the required characteristics for a successful vaccine. To summarize: the special challenge for a successful HIV vaccine is due to HIV DNA integration, HIV variation, and its early harm to the immune system. Though easy to describe, the challenge is uniquely difficult compared to past successful vaccines. However, most if not all current and past vaccine candidates have not taken these features of HIV into account. What is needed and has been needed for over two decades are: () far more availability of primates and to a broader number of scientists; (2) an immune response which is sustained; (3) an immune response which is broad and results in sterilizing immunity or close to sterilizing immunity. Finally, I will describe the characteristics and progress, and remaining problems with a candidate vaccine developed at the Institute of Human Virology. Gallo, R. (2005). The end or the beginning of the drive to an HIV-preventive vaccine: a view from over 20 years. The Lancet, 366,

15 Invited Speaker Abstracts Invited Speaker Abstracts Plenary 2, 29 May 2008 HAART from Today to Tomorrow Integrase Inhibitors D. A. Cooper National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia Plenary 2, 29 May 2008 HAART from Today to Tomorrow New Antiretroviral Drugs in the Pipeline R. Gulick Weill Medical College of Cornell University, New York, United States of America Considerable effort has been employed to develop new antiretroviral therapies (ART) with novel modes of action with the aim of overcoming the problems of resistance and toxicity associated with currently available ART classes. The development of new ART classes also has the benefit of increasing the diversity of treatment options available during the long-term management of HIV. Integrase strand transfer inhibitors (InSTI) represent one of these new classes of ARTs with a distinct mechanism of action and great potential for future HIV therapy. Several InSTIs are in development with two drugs in this class, raltegravir (MK-058) which was licensed in 2007 and elvitegravir (JT-303/GS-937), in an advanced stage of clinical development. Both raltegravir and elvitegravir have demonstrated potent in vitro anti-hiv activity, even against multi-drug resistant HIV. In addition, it has been demonstrated that raltegravir is synergistic with all ARTs tested and raltegravir resistant HIV remains sensitive to other ARTs. The clinical development of InSTIs has clearly demonstrated that these drugs have a rapid and potent anti-hiv effect in patients compared with currently used drug combinations. Treatment with raltegravir also results in unique viral decay dynamics compared with currently available ARTs. This is characterised by a marked reduction in second phase viral decay. This distinct pattern of viral decay provides the potential for greater understanding of viral dynamics, especially in relation to latent infection in longlived HIV infected cells. Analysis of HIV mutations that confer resistance to raltegravir, elvitegravir and other InSTIs currently in development, demonstrate that different inhibitors do not select for identical resistance mutations. This suggests that there will be opportunities to develop InSTIs with limited cross-resistance. Although further investigation is required, InSTIs are well tolerated and demonstrate great potential for initial HIV therapy and use in highly treatment experienced patients, especially when drug resistance and toxicities need to be considered. In 2008, there are 25 approved antiretroviral drugs in 6 unique mechanistic classes available. However, despite recent advances, current antiretroviral regimens may be inconvenient, toxic, and/or have suboptimal antiretroviral activity, particularly against drug-resistant viruses. Newer compounds are needed that are more convenient, better tolerated, less toxic, and/or have improved activity, particularly against drug-resistant viral strains. Additionally, new agents may offer improved formulations, better tissue reservoir penetration (e.g. genital tract, central nervous system), or may exploit novel targets. The current antiretroviral drug development pipeline is full, with newer agents in traditional mechanistic classes (reverse transcriptase inhibitors, protease inhibitors), newer approved mechanistic classes (entry inhibitors, integrase inhibitors), and agents with novel mechanisms of action (mutation-inducing nucleoside analogues, CD4 receptor attachment inhibitors, maturation/gag processing inhibitors). Of those in the pipeline, several compounds are in phase III development: the NNRTI, rilpivirine; the chemokine receptor inhibitor, vicriviroc; and the integrase inhibitor, elvitegravir. A number of other compounds are in earlier stages of clinical development, including some with unique mechanisms of action, including KP-46 (a nucleoside analogue that induces viral mutations), ibalizumab (a monoclonal antibody that targets the CD4 receptor), and bevirimat (a maturation/gag processing inhibitor). The greatest needs in the clinic today are new compounds that can improve convenience or tolerability over existing drugs or compounds that have activity against multidrug-resistant viral strains. While recently approved NNRTI and PI demonstrate activity against NNRTI- and PI-resistant viral strains, respectively, additional members of newer classes such as the CCR5 antagonists and integrase inhibitors may well demonstrate cross-resistance to the first approved drugs in these classes. Antiretroviral compounds with novel mechanisms of action should have activity against viral strains with resistance to currently approved drug classes. The clinical use of the newer antiretroviral agents will be defined ultimately by the results of clinical trials

16 Invited Speaker Abstracts Invited Speaker Abstracts Panel 2, 29 May 2008 Renal Dysfunction and Antiretroviral Therapy Studies of Renal Disease in HIV: Effects of HAART B. Hendry, F. Post 2 KCL, London, United Kingdom, 2 Kings College London, HIV Medicine, London, United Kingdom Panel 3, 30 May 2008 Pre-exposure prophylaxis for HIV Infection? Prophylaxis of HIV Infections by Tenofovir E. De Clercq Rega Institute for Medical Research, Leuven, Belgium The incidence and aetiology of acute renal failure have been studied in over 2000 patients attending HIV care in London. During the study period, 30 of 2274 patients (5.7%) developed 44 episodes of ARF. The incidence rates of early-onset (within 3 months) and late-onset ARF were 9.3 and.2 episodes per 00 person years respectively (rate ratio 6., p < 0.00). Despite its widespread use in our clinic (2% of all patients), tenofovir use was infrequent (5.4%) among patients with ARF, and considered a co-factor in the development of 2 (.4%) ARF episodes. Tenofovir-toxicity may present with various renal manifestations, including hypophosphataemia, Fanconi syndrome, acute or chronic renal failure, hypokalaemia or nephrogenic diabetes insipidus 23. Patients previously identified in our clinic as having clinically-defined tenofovir-associated renal toxicity were not ascertained by our ARF case definition (the nadir egfr in these patients was?60 ml/min or < 40% reduced from baseline, or they had a single egfr < 60 ml/min), suggesting that frequent GFR estimations may be of limited use for early detection of tenofovir-associated renal toxicity. ARF occurred within 90 days of commencing HAART in 2 patients (%). In 6, immune reconstitution inflammatory syndrome (IRIS) may have contributed to the development in ARF, by unmasking opportunistic infections (M. avium, 2; P. jerovecii, ), worsening cryptococcal meningitis (2), or inducing a hepatitis B flare (). In the other 5 patients, HAART was administered concurrently with potentially nephrotoxic cancer or antimicrobial chemotherapy to systemically ill patients without IRIS. Renal Dysfunction and Antiretroviral Therapy: Proximal Tubulopathy P. Labarga Hospital Carlos III, Infectious Diseases, Madrid, Spain HAART is able to turn HIV infection into a chronic disease. However, for this to be accomplished, antiretrovirals need to be provided for indefinite periods of time. Concerns regarding long-term side effects of anti-hiv medications arose early, and still remain unsolved. Kidney toxicity of antiretrovirals is probably the last to be incorporated into a long list of already recognized insidious side effects, such as metabolic, cardiovascular, hepatic or bone-mineral abnormalities. Tenofovir, the last reverse transcriptase inhibitor to come into market, is uptaken in the proximal tubular cells, via the basolateral organic anion transporter (OAT), and is extruded by the apical multidrug resistance protein (MRP) transporter; as expected, nephrotoxicity is its main side effect. Initial reports have shown little changes in glomerular function after long exposure to tenofovir; little is known, however, on how tubular function may be affected. Most available data are derived from punctual case reports showing Fanconi-like syndrome and renal failure under tenofovir, what makes prospective studies urgently needed at this time. We prospectively analyzed renal function in 232 HIV infected patients (29% naives, 54% under ART with tenofovir, and 7% under ART without tenofovir). The percentage of patients with significantly altered proximal tubular function was, respectively, of 9, 20 and 5% (p=0,03). The multivariate analysis showed that use of tenofovir and diabetes mellitus were independent factors associated to the appearance of this type of renal damage. It is important to notice that, overall, 8 patients presented with severe hypophosphatemia and only 2, both receiving tenofovir, developed Fanconi-like syndrome. The acyclic nucleoside phosphonate tenofovir [(R)-9-(2-phosphonylmethoxypropyl)adenine, PMPA] represents a separate class of reverse transcriptase (RT) inhibitors, namely that of the nucleotide RT inhibitors (NtRTIs) that should be clearly distinguished from the nucleoside RT inhibitors (NRTIs) and non-nucleoside RT inhibitors (NNRTIs) [De Clercq and Hol_, Nature Rev. Drugs Discov. 4: (2005)]. Tenofovir has since 200 been approved for the treatment of AIDS in its oral prodrug form tenofovir disoproxil fumarate (TDF) (Viread ); TDF in combination with emtricitabine (Truvada ) was approved in 2004, and TDF in combination with emtricitabine and efavirenz (Atripla ) was approved in Experimental evidence points to the effectiveness of tenofovir in the prevention of either HIV, SIV or SHIV infection in macaques, irrespective of the route of infection (parenteral, oral, intravaginal or intrarectal) [Tsai et al. Science 270: (995); Tsai et al. J. Virol. 72: (998); Van Rompay et al. J. Infect. Dis. 84: (200); Subbarao et al. J. Infect. Dis. 94: (2006)]. This experimental evidence, together with the experience acquired on the efficacy and safety of tenofovir over the past 6 years in the treatment of AIDS, should justify the further exploration of tenofovir under any of its oral delivery forms (Viread, Truvada or Atripla ) in the pre- and post-exposure prophylaxis of HIV infections. These studies have already been started [Peterson et al., PloS Clin. Trials 2: e27 (2007)]. Oral TDF preparations, to be taken as one pill daily, offer obvious advantages over the use of topical HIV microbicides in that they override formulation problems, readily fulfill compliance requirements and, moreover, may be expected to afford broad prophylactic protection irrespective of the route of HIV transmission. Lynn A. Paxton Atlanta, USA HIV Pre-exposure prophylaxis (PrEP) is commonly defined as the oral use of antiretroviral agents (ART) to prevent HIV transmission. The use of treatment drugs to prevent disease is already standard practice for several infections such as malaria and tuberculosis. Perinatal and post-occupational HIV exposure studies have shown that ART given during or shortly after an exposure can substantially reduce HIV transmission. Several primate models using simian-adapted viruses and various routes of exposure have shown efficacy of PrEP and lend further credence to the logic of this approach. Even though some of the earliest human PrEP trials were terminated prematurely due to various controversies related to trial conduct, PrEP is still considered to be one of the more promising HIV prevention tools currently being explored. PrEP trials are being conducted among IDU in Thailand, MSM in several countries in Asia, Africa and the US, and among heterosexual men and women in several countries in Africa. If PrEP is shown to be safe and effective in the current clinical trials it may begin to be implemented for one or more risk population within 3 to 5 years. The purpose of this symposium is to review the status of the current trials and to discuss several crucial aspects of PrEP implementation including ) biomedical issues such as the potential for the development of resistance mutations and possible effects on HIV treatment programs, 2) behavioral issues such as risk compensation and 3) programmatic and ethical issues such as the feasibility of a PrEP program in settings where other proven HIV prevention interventions still are not accessed by the majority of the people most at risk

17 Invited Speaker Abstracts Invited Speaker Abstracts Panel 4, 30 May 2008 Liver Toxicity of Antiretroviral Drug Novel Mechanisms of Antiretroviral Liver Toxicity P. Barreiro Hospital Carlos III, Department of Infectious Diseases, Madrid, Spain Meet the Expert, 29 May 2008 Including Resistance Testing in Clinical Practice Including Resistance Testing in Clinical Practice M. A. Wainberg McGill University AIDS Centre, AIDS, Montreal, Canada Liver impairment is currently common cause of morbidity and mortality among HIV infected individuals. According to different series nearly 0% of HIV infected individuals are currently found at cirrhotic stage. We are very used to chronic hepatitis B or C, or alcohol abuse, causing liver decompensation, or predisposing to antiretroviral hepatotoxicity in this population. Most antiretrovirals have been associated with acute liver events, although relative frequency is fairly variable among drugs. Several mechanism of toxicity have been identified, namely direct injury, oxidative stress, hypersensitivity reactions or immune reconstitution phenomena. More recently, other mechanism of insidious liver injury have been suspected among HIV infected individuals developing liver damage without any identified underlying liver condition. In some of them prolonged metabolic abnormalities, mainly hyperlipemia and insulin resistance, may be responsible for the sequence of steatosis, steatohepatitis and cirrhosis. In other more intriguing instances, otherwise healthy individuals present with episodes of hydropic decompensation or variceal bleeding, that lead to the diagnosis of idiopathic portal hypertension. Some arguments indicate that this picture may reflect long-term nuceloside liver toxicity, which may be framed under the histological findings of nodular regenerative hyperplasia and primary portal hypertension. From soon after the first introduction of antiretroviral drugs, the use of HIV drug resistance testing became a mainstay in clinical management. Proper interpretation by clinicians and virologists of drug resistance mutational patterns has potentiated both the sequencing of drugs within a given drug class, as well as the use of drugs from classes that have not previously been used in the treatment of a given patient. Drug resistance is today widely acknowledged to be both a key cause as well as a result of HIV treatment failure, and, in addition, clinicians must deal with the problem of transmitted drug resistance, in which patients are newly infected with viral strains that contain one or more mutations associated with drug resistance. In recent years, the field of HIV drug resistance testing has been complicated by the fact that different viral subtypes may sometimes express different mutations that are associated with resistance to the same compound. In some cases, this may be due to the redundancy of the genetic code and the fact that different viral subtypes may employ different codons in order to express the same amino acid. An example, of this is the fact that the V06M mutation encodes resistance against NNRTIs in subtype C viruses, whereas the equivalent mutation in subtype B viruses is V06A. In other instances, viral RNA template sequences may vary from one subtype to another, so as to promote the selection of certain mutations over others in response to drug selection. As an example, subtype C viruses seem more prone to develop the K65R mutation that can cause broad cross-resistance to a wide range of nucleoside compounds, whereas this mutation is very rare in viruses of subtype B. This finding may have relevance for both treatment and prevention strategies in countries in which subtype C viruses are predominant

18 Invited Speaker Abstracts Invited Speaker Abstracts Meet the Expert 4, 30 May 2008 Practical Management of Metabolic Complications in HIV + Patients Practical Management of Metabolic Complications in HIV + Patients W. Powderly University College Dublin, Dublin, Ireland Point/Counterpoint 2, 29 May 2008 A Future for Immune-based Therapy in HIV David vs. Goliath: Does immunotherapy Still Deserve Attention in the Era of HAART? G. Poli San Raffaele Scientiifc Institute, Immunology and Infectious Diseases, Milan, Italy In most industrialized countries the number of patients living with HIV has increased dramatically in recent years, with improved antiretroviral efficacy. Significant metabolic effects, especially with regard to dyslipidemia, insulin resistance, body composition and bone disease, have been noted in these patients. Some of these conditions have been linked with HIV infection or with its treatment. Furthermore this extended survival means that many individuals who contracted the disease earlier in the epidemic are getting older. Management of these HIV-infected patients is complicated by the presence of comorbidities that are more common with increasing age, such as diabetes mellitus, cancer, and cardiovascular, renal, hepatic, and bone diseases. Assessment of the presence or risk of comorbidities in HIV+ persons has now become part of routine care. Management of persons with HIV should include baseline evaluation of cardiovascular risk and regular monitoring of fasting lipid and glucose levels, renal function, and markers of bone disease. Furthermore, co-morbidities have an important influence on antiretroviral selection, as avoidance of metabolic and other toxicities or drug drug interactions is a key issue. For patients who have developed metabolic complications, especially those involving lipids and insulin metabolism, clinicians treating HIV-infected patients need to have very practical approaches to manaegement which may involve new therapies or changes to current antiretroviral drugs. The terrific advancement of antiretroviral drug research and discovery, with the advent of entry and integrase inhibitors, as well as with the refinement of well established combinations of RT and protease inhibitors in simplified regimens of administration seem destined to saturate the pharmacological handling of HIV+ individuals. In this optimistic scenario, does is it still make sense to invest in immunological approaches to control virus replication and /or reconstitute the deficient immune system of infected individuals? This non rhetorical question bears relevance for the current and future investments in the clinical application of cytokines and related molecules, as best exemplified by the use of interleukin-2 (IL-2) and IL-7 in infected individuals, and in the perspective to utilize therapeutic vaccination protocols for a better control of such a life-long infection. In favor of the hypothesis that immunotherapy stills bears relevance for the management of HIV infection it should be emphasized that multiresistant strains of HIV are continuously generated and pose a daily problem to the physician in terms of making the right choice of therapeutic strategy. On a more scientific ground, viral eradication still remains in the myths rather than in the realistic scenario of combination therapy whereas the issue of associated infections, such as hepatitis C virus, and tumors emerging in HAART-treated individuals create novel opportunities for exploring the concept of immunological restoration in HAART-treated individuals

19 UNE DIVISION DE Concevoir des avancées thérapeutiques dans le VIH VIH/AP institutionnelle - /2007 En savoir plus sur le VIH :

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