HIV/AIDS researchers share insights, research at International AIDS Meeting

By By Holly KorschunJuly 23, 2012

More than 50 investigators from the Emory Center for AIDS Research are attending the XIX International AIDS Conference July 22-27.

HIV/AIDS Emory media kit

A catalog of stories, experts and resources on HIV/AIDS  research and work at Emory.

More than 50 faculty researchers from the Emory Center for AIDS Research (CFAR) are attending the XIX International AIDS Conference July 22-27 in Washington, D.C. They will deliver more than 100 oral and poster presentations, ranging from:

  • the history of the epidemic,
  • the current and future state of prevention and treatment,
  • studies of behavior, risk and incidence nationally and in Atlanta,
  • basic and preclinical research, clinical trials, and international studies.

"We are pleased that Emory and its Center for AIDS Research are so well represented at this year’s conference," says Carlos del Rio, a member of the conference organizing committee. Del Rio is the Hubert professor and chair of the Hubert Department of Global Health at Emory’s Rollins School of Public Health and a professor of medicine in Emory School of Medicine.

"Having the meeting in the United States for the first time in over a decade gives us a fantastic opportunity to highlight the U.S. epidemic and to interact with our colleagues from this country as well as from around the world. We are able to involve many of our faculty, postdoctoral fellows, students and staff in the effort to increase momentum in worldwide prevention and treatment efforts. Tremendous progress has been made over the past three decades, and we are very hopeful that this will accelerate and that we will successfully meet the extreme challenge of this epidemic."

With recent advances in both prevention and treatment we may be at the beginning of the end of the HIV epidemic, but achieving the goal of an "AIDS free generation" is going to require the joint efforts of government, academia, community, and those infected and affected with HIV."

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Emory Presentations at the International AIDS Meeting

Brothers Study: HIV infection rates greatly elevated among young black gay and bisexual men in the U.S.
A study by the HIV Prevention Trials Network (HPTN) found greatly elevated rates of new HIV infections occurring among black gay and bisexual men in the U.S. (also known as men who have sex with men, or MSM), particularly young black MSM. The study, called HPTN 061 or the “Brothers” study, found the overall rate of new HIV infections among black MSM in the six cities participating in this study (Atlanta, Boston, New York, Los Angeles, San Francisco, and Washington, D.C.) was 2.3 percent per year, a rate that is nearly 50 percent higher than in white MSM in the U.S. Separate estimates of HIV incidence among black MSM by city are not yet available from the Brothers study.

The study also found that young black MSM—those 30 years of age and younger—acquired HIV infection at a rate of 5.9 percent per year, three times the rate among U.S. white MSM. HPTN 061 enrolled a total of 1,553 MSM and was conducted between 2009-2011. It is the first study to determine the rate of new HIV infection among such a large prospective cohort of U.S. black MSM (referred to as HIV incidence). The Emory University site recruited 292 black men for the study or 19 percent of the total study sample, making it the top enrolling site in the country.

Emory Principal Investigator: Carlos del Rio

Press Release: http://news.emory.edu/stories/2012/07/hptn_061_study_in_msm/campus.html

InvolveMENt Study: Black and White MSM Have Equal Behaviors But Unequal Risks for HIV Infection
Black men who have sex with men (MSM) are more likely than white MSM to be infected with HIV, for reasons that are not well understood. Using data from an Emory study of black and white MSM living in Atlanta, researchers devised a new measure of how many men of each race were both HIV-infected and had enough virus in their system that they could pass it on to others. Using this measure and reported sexual behavior patterns, they developed a computer model that showed HIV-negative black MSM were more than twice as likely to encounter a partner who might transmit HIV to them, even though black and white MSM had comparable sexual behaviors.

Presenter: Eli Rosenberg
Collaborating authors: Colleen Kelley, Brandon O’Hara, Paula Frew, Travis Sanchez, Carlos del Rio and Patrick Sullivan

Press release: http://news.emory.edu/stories/2012/07/hptn_061_study_in_msm/campus.html

Kaiser Health News Video

HIV cases could be reduced with combined prevention efforts
In a study published in the latest edition of The Lancet, researchers propose that biomedical interventions, including pre-exposure prophylaxis, combined with behavioral and structural prevention strategies could prevent as many as 25 percent of new HIV infections among men having sex with men (MSM) globally over the next decade. The research suggests that by combining different prevention strategies such as condom use, counseling and antiretroviral medication, a large number of HIV infections could be prevented.

Presenting Author: Patrick Sullivan

Press Release: http://news.emory.edu/stories/2012/07/hiv_cases_could_be_reduced/

IL-21 boosts immune function in SIV-infected primates

An immunity-stimulating protein, IL-21, has shown promising effects in a non-human primate model of HIV infection. Treatment with IL-21 can improve several markers of immune system function in rhesus macaques infected with SIV (simian immunodeficiency virus), sciences at Yerkes National Primate Research Center and Emory University School of Medicine report.

In the intestines of the SIV-infected macaques, IL-21 boosted the levels of immune cells that are important for resisting opportunistic infections, the researchers found. IL-21 has been tested in clinical trials with people fighting skin and kidney cancer, but not with people living with HIV.

"We are excited about the data because this is the first study that shows a therapeutic intervention is able to preserve - if only temporarily, the intestinal levels of Th17 cells in nonhuman primates," says senior author Mirko Paiardini, PhD, Yerkes researcher and assistant professor of pathology and laboratory medicine at Emory University School of Medicine.

Presenting Author: Mirko Paiardino

Press release:http://news.emory.edu/stories/2012/07/il21_boosts_immune_function_in_SIV_infected_primates/

Target cell restriction may limit mother-infant transmission of SIV in sooty mangabeys

It is known that natural SIV hosts, including sooty mangabeys, do not progress to AIDS despite high viral loads. Strikingly, natural hosts also rarely transmit SIV from mother to infant. In this study, researchers found limited expression of the main HIV/SIV coreceptor CCR5 on CD4+ T cells from infant natural host sooty mangabeys compared to the non-natural host rhesus macaques.  They conclude that the availability of CD4+CCR5+ SIV target cells dictates the rate of mother-to-infant transmission in nonhuman primates.

Presenting Author: Ann Chahroudi

Poster Presentations

Poverty, urbanization and HIV: A county-level assessment of black and white HIV prevalence in the United States
Using publicly available county-level data, researchers examined relationships among race, poverty, urbanization, and HIV prevalence. They found that poverty explains racial disparities in HIV only in poor, central urban counties. Therefore, in suburban cities, smaller towns and rural areas, race-related factors other than poverty (such as stigma and sexual networks) may be driving racial HIV disparities and may require unique interventions.

Presenter: Adam Stephen Vaughan
Collaborating Author: Patrick Sullivan

Measuring population transmission potential: An alternative metric of HIV transmission risk in men who have sex with men (MSM) in the US 
Researchers show that commonly used HIV metrics such as the community viral load, population viral load, and the continuum of HIV care may not be useful for understanding disparities in transmission, as they do not adjust for HIV prevalence.  The research team proposes a new metric, the transmission potential prevalence (TPP), that combines data on HIV prevalence and viral suppression that may better describe HIV transmission risk in populations of different HIV prevalence, particularly for black and white MSM.

Presenter: Colleen Kelley
Collaborating Authors: Eli Rosenberg, Brandon O’Hara, Paula Frew, Travis Sanchez, Carlos del Rio, Patrick Sullivan

Newly adopted HIV prevention behaviors won’t last without new strategies for sustainability
There is significant decay in newly adopted HIV prevention behaviors within six months of their adoption, and prevention behaviors continue to decay over a 24-month follow-up period, researchers found. Thus, for behavior change to be durable, new and innovative strategies need to be designed to sustain and amplify newly adopted HIV prevention behaviors.

Presenter: Ralph DiClemente
Collaborating Authors: Jennifer Brown, Jessica Sales, Eve Rose

Proton pump inhibitor and protease inhibitor use are associated with fragility fracture risk in HIV-infected male veterans
The use of proton pump inhibitors and protease inhibitors were independently associated with the risk of fragility fractures in HIV patients. This adds to known risk factors for these fractures including cardiovascular disease, stroke, BMI and alcohol use.

Presenter: David Rimland

Cancer proportionate mortality in HIV patients in the Veterans Aging Cohort Study
Among HIV patients the proportion of deaths for which cancer was the underlying cause has steadily increased and was 19.2 percent in 2007-2009. Most cancer deaths are now due to non-AIDS-defining cancers (80 percent of all cancers). The four leading causes of cancer death in the most recent period were lung, liver, lymphoma, and colorectal.

Presenter: David Rimland

The IPV-GBM Scale: a new scale to measure intimate partner violence among gay and bisexual men
The prevailing image of domestic violence is often that of a woman being abused by her male partner. However, researchers are now realizing that this kind of violence can also occur in relationships among gay and bisexual men. This is a concern because violence can cause mental and physical harm, and there are indications that it increases HIV risk. Because the tools used to measure violence may not be valid for gay and bisexual men, researchers developed a new scale to measure violence in this population. If researchers start to use this scale, they may get a more accurate idea of how much violence is occurring among gay and bisexual men, and the ways that violence might increase HIV risk.

Presenter: Catherine Finneran
Principal Investigator: Rob Stephenson 

Social network characteristics and sexual risk-taking among men who have sex with men in Atlanta, GA
This study shows that the characteristics of friends and associates may be an important factor in HIV risk for gay and bisexual men. Gay and bisexual men were asked to describe five people who were their friends, or with whom they often associated. Men with more lesbian, gay, or bisexual friends had more sexual HIV risk, but if these friends were in relationships, they had less sexual risk. Also, gay and bisexual men who were more “out” to their friends had less sexual risk. When developing ways to prevent new HIV infections in gay and bisexual men, working with gay/bisexual men’s social networks could help them lower their HIV risk.

Presenter: Catherine Finneran
Principal Investigator: Rob Stephenson

Perceived HIV seriousness, risk, and inability to avoid HIV among MSM in Australia, Brazil, Canada, South Africa, Thailand, the United Kingdom, and the United States
Little prior research has been done across different countries to compare gay, bisexual, and other men who have sex with men. Researchers conducted a study in seven countries that looked at men’s perceptions of their HIV risk. They found that men who never have safe sex view their HIV risk as about the same as men who always have safe sex, which is likely an incorrect perception. They also found that men in relationships said their HIV risk was lower than men not in relationships, and that younger men view HIV as a more serious threat. Prevention efforts should be focused on people at highest HIV risk, and researchers should combat the myth that relationships automatically protect against HIV.

Presenter: Catherine Finneran
Principal Investigator: Rob Stephenson

Scientific and programmatic implications of safer injection facilities for persons who inject drugs illicitly
Researchers studied the effects of reducing HIV and HCV infections and overdose mortality through developing safer injection facilities. The research was originally published in Drug and Alcohol Dependence in 2011.

Poster Presentation: Wednesday, July 25, noon.
Presenter: Salaam Semaan

Tenofovir associated proximal renal tubular dysfunction in HIV infected children and adolescents
The AIDS drug tenofovir may be associated with proximal tubular dysfunction (PTD), but there is limited information in children. Researchers conducted a prospective study measuring risk of PTD in HIV-infected children and adolescents on TDF versus non-TDF containing regimens. In addition, b2-microglobinuria was evaluated as a marker for early detection of PTD among TDF users. They found a small increased risk of developing PTD in female pediatric patients exposed to TDF for more than one year. B2-microglobulin was not a useful marker for early detection of PTD.

Presenter:Andres F. Camacho-Gonzalez
Collaborating Authors: Laurence Greenbaum, Rana Chakraborty

Placental Hofbauer cells may help protect the fetus from HIV exposure
Researchers have found that placental Hofbauer Cells may be important in protecting the fetus from HIV-1 exposure from an infected mother.

Presenter: Rana Chakraborty
Collaborating author: Erica L. Johnson

Characterization of memory T cells and CCR5 expression in HIV-1-infected human cord blood
Low levels of CCR5 expression in cord blood CD4+ memory T cell populations are associated with low rates of HIV-1 infectivity. This data may explain why vertical transmission of HIV-1 occurs relatively infrequently in HIV-1-exposed infants even in the absence of recommended medical interventions.

Presenter: Rana Chakraborty
Collaborating authors: Joy T. Thurman, Kyle Pontiff, Erica L. Johnson

Measuring Population Transmission Potential: An Alternative Metric of HIV Transmission Risk in Men who Have Sex with Men (MSM) in the US  Researchers show that commonly used HIV metrics such as the community viral load, population viral load, and the continuum of HIV care may not be useful for understanding disparities in transmission, as they do not adjust for HIV prevalence. They propose a new metric, the transmission potential prevalence (TPP), that combines data on HIV prevalence and viral suppression that may better describe HIV transmission risk in populations of different HIV prevalence, particularly for black and white MSM.

Presenter: Colleen Kelley
Collaborating Authors: Eli Rosenberg, Brandan O’Hara, Paula Frew, Travis Sanchez, Carlos del Rio, and Patrick Sullivan

Emory Media Coverage from the AIDS Meeting

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