We are starting to get some of that very important Research.  Focus is now on the effector T- cells namely CD 8 cells.  It has been known for a pretty long time that an elevation of CD 8 in people who are infected with HIV is good.  These people do better with or without antiretroviral therapy.  In fact the non progressors and the innate survivors of HIV infection all had elevated CD 8 levels.  Now attention is being directed to CD 8 vaccines.  Agents that stimulate CD 8 cells are being developed that elevated the CD 8 cells in a persons body hoping that this will offer some type of protection from HIV.  The verdict is still out but the CD 8 cell is an important marker for a patient doing well in their HIV infection.

      The other part of the immune system that is very important if a successful immune response is to be developed from a vaccine is neutralizing antibodies.  In general the higher the neutralizing antibody the more protection from HIV, and vaccines that stimulate neutralizing antibodies are the one most likely to be candidates for protection from HIV.  There are really no effective vaccines at this time that stimulates high levels of neutralizing antibody.  

     Finally a monoclonal antibody that blocks HIV has stimulated the interest of researchers.  A lot of research is going on in this area. One thing that is certain about our foundations work with bone marrow stem cells, is we need to do find more markers namely antibodies of define the positive effect we have seen with blue green algae.  We need to monitor NK cells, neutralizing antibodies, to see what effect of blue green algae has on these important immunological markers.

The first part of the afternoon session of CROI solely dealt with social issues and HIV.  As most people know this is the first American Conference in 35 years that was open to HIV+ people from other countries.  They no longer have to worry about being arrested if they come to this country for a conference and somehow there HIV status is found out.  One can understand how Ronald Reagan developed the policy in the 80's but it is hard to figure out how Bill Clinton and his administration did not change the policy.  It took Barrack Obama and his administration to change the policy which should have been changed years ago.  It is another step in removing the stigma associated with HIV positivity. 

     There was a discussion about disclosure of HIV status to discordant HIV couples, one couple being HIV+ and one couple being HIV-.  Despite many attempts at counseling of HIV+ people the consensus was that most people who are HIV+ do not disclose their status but practice safe sex.  The factual data might have a lot to do with this result. An HIV+ person who has an undetectable viral load, < than 400 copies/ml has essentially 0 chance of transmitting the virus, even if that person practices unprotected sex.  If fact the Swedish government put forth a controversial statement not too long ago that HIV+ people who are suppressed on ARV do not have to practice safe sex.  This view has been criticized by a lot of countries, but certainly an HIV+ person who practices safe sex can do so without any chance of passing the virus on. 

    There was another talk about prevention especially in resource poor countries.  The single most effective way to prevent HIV transmission from an infected partner is to treat the uninfected person with antiretroviral drugs before having sex.  All other methods except abstinence have failed to prevent HIV infection.  The antiretroviral drugs are no longer real toxic, and it seems that treatment as prevention will be the next great push especially in resource poor countries.