Date: Thu, 27 Jun 1996 11:27:23 -0700 (PDT) From: Rex Wockner Subject: WOCKNER STORY--INT'L AIDS CONFAB WILL BE UPBEAT ---------------------------------------------------------------- Copyright (c) 1996 Rex Wockner. All rights reserved. Do not publish, broadcast, or cybertransport without permission. ---------------------------------------------------------------- << VANCOUVER INT'L AIDS CONFAB WILL BE UPBEAT >> by Rex Wockner And now for something completely different: This year's XI International Conference on AIDS in Vancouver, B.C., July 7-12 will be upbeat. Key to the optimism is recent successes in lowering HIV viral load and increasing CD4 immune-system cells by combining the older nucleoside-analog drugs (AZT, ddI, ddC, d4T, 3TC) with each other and/or with the new protease-inhibitor drugs (saquinavir [Invirase], indinavir [Crixivan], ritonavir [Norvir]). These wildly expensive combo therapies, along with continued improvements in preventing and treating AIDS opportunistic infections, have a lot more people with AIDS living a lot longer, at least in the so-called First World. Some of the drug combinations reduce viral load in some people to the point where it cannot be detected. Some observers have even theorized that long-term viral suppression could cause the virus to die out in some patients. The optimism is fueled further by other categories of new drugs that are showing promise as they wind through the testing pipeline -- among them, nucleotide [tide not side] analogs and non-nucleoside reverse transcriptase inhibitors. There are problems though. Most patients eventually develop resistance to both nucleoside analogs and protease inhibitors. And in the case of the two most-promising proteases, indinavir and ritonavir, resistance to one can make the other useless. Secondly, all the drugs have side effects. The highly effective Norvir, for example, makes a lot of people sick enough (with nausea, weakness and other problems) to destroy their quality of life, and it also prevents use of numerous standard AIDS drugs that it cross-reacts with. Nearly all anti-HIV drugs cause peripheral neuropathy, nerve damage that must be monitored very closely. Information Overload A record number of abstracts -- 5,626 -- have been received by this year's conference. Plenary talks and debates will focus on such matters as "Antiviral Therapy and Viral Load," "HIV Genetic Diversity," "The Epidemic of HIV among Young Gay Men," "Empowerment, Community Mobilization and Social Change in the Face of AIDS," "Molecular Biology and Drug Development," "HIV Vaccines," and the relative contribution of viral factors vs. host [human] factors in the progression of HIV disease. "Community Forum 96" will precede the conference. The two- day gathering brings together 500 HIV-positive people and community-organization workers -- "100 from each of the five regions of the world ... to develop regional action plans and policy statements, strengthen skills, and investigate means of training empowerment and sustainability in the face of AIDS." AIDS activist groups will attend the conference both as participants, and in some cases, protesters. One topic that has activists riled up is Canadian Prime Minister Jean Chretien's refusal to speak at the conference opening ceremonies. Canadian AIDS workers suspect Chretien fears being booed over his government's failure to renew the National AIDS Strategy, which expires in two years. "The Canadian government is about to jettison a 10-year commitment to the fight against the AIDS epidemic," says Julia Zarudzka, chair of AIDS Vancouver. Chretien likely also remembers the Fifth International Conference on AIDS in Montreal in 1989. Three hundred members of ACT UP/New York, Reaction SIDA (Montreal) and AIDS Action Now (Toronto) commandeered the stage for an hour, demolishing the opening ceremonies. Later, they relentlessly heckled then-Prime Minister Brian Mulroney throughout his 20-minute address. For further information on this year's confab: XI Conference on AIDS, 1090 West Pender St., Vancouver, B.C. V6E 2N7, Canada. Phone: (800) 780-AIDS or (604) 878-9995. Fax: (604) 668-3242. E- mail: aids96@hivnet.ubc.ca. Web: http://www.interchg.ubc.ca/aids11/aids96.html -end-