Aids conference to focus on drugs, prevention

New drugs, easier ways to take them and improving access for those who need them are the issues expected to dominate the 14th International Aids conference that begins on Spain's Catalan coast tomorrow.

Scientists have not found a cure for Aids and there is no end in sight to the epidemic that has infected 40 million people worldwide and is still spreading.

But the 14,000 doctors, researchers, politicians and Aids activists attending the week-long meeting will hear about novel compounds that attack the virus in a different way, the latest vaccine results, why more emphasis must be put on prevention and how money from the Global Fund to Fight Aids, Tuberculosis and Malaria should be spent.

"There are three main messages that can emerge from the conference - simplification of therapy, new families of compounds and therapeutic vaccines," said Dr Jose Gatell, a co-chair of the conference, which is held every two years.

Existing antiretroviral drugs that have given Aids sufferers a new lease on life but have been difficult to take will be simplified and better tolerated by patients.

Results on trials of two new types of drugs, - fusion inhibitors and integrase inhibitors - are expected. They will complement the existing arsenal of anti-Aids therapies.

"Having two completely new families of compounds may represent a kind of revolution in antiretroviral therapy at the same level that the introduction of protease inhibitors represented back in 1996," said Gatell.

Fusion inhibitors, designed to prevent HIV from entering cells, could be commercially available in a few months. Integrase inhibitors, which aim to block a vital step in virus replication, are still a few years away.

But together they represent the biggest advance in drug therapy since the introduction of antiretroviral therapy.

With no major advances expected on a preventive vaccine and so few sufferers in poor countries getting anti-Aids drugs, emphasis on better prevention is expected to take centre stage.

Epidemiologist Dr Jordi Casabona, Gatell's co-chair of the meeting, said the emerging Aids epidemics in China, India, eastern Europe and the former Soviet Union and growing number of cases in sub-Saharan Africa are proof that better efforts are needed to stop new infections.

"On a global scale, I am sure we will have worse scenarios to come," Casabona said.

An entire track of the conference is devoted to prevention - the use of condoms, microbicides and ways of changing behaviour.

"On a political level, access to drugs will be one issue and the second one will be the global political commitment," he added.

Gatell is excited about data from studies of therapeutic vaccines which will be presented and could lay the groundwork for a preventive vaccine.

"The whole concept of therapeutic vaccines is very relevant. It may allow, in the future, to interrupt therapy or not have the necessity of doing it for life," he said.

"We may need some modifications or different doses but all the studies we are doing on therapeutic vaccines might also be very useful for preventive vaccines."

Research has also shown that if there is enough political and social commitment, providing anti-Aids drugs to developing countries with an elementary health infrastructure can work.

"The recommendation that is going to emerge is that this is feasible," said Gatell.