Major HIV treatment conference in Paris--finding reports online.
(1) If a Web link in this article does not work, the site may have been reorganized. In that case go to the home page (usually the first part of the Web address, through the .com or .org) and look for the IAS (International AIDS Society) conference reports from there.
(2) It is best to read or skim through all the titles on the Web pages shown below. If there are many titles, a shortcut is to use the search (find) command in your browser. But this browser search will miss relevant articles if the titles do not happen to use the same words you specify.
Best Organized Site: Clinical Care Options, http://clinicaloptions.com/go/ias2003
This site, written primarily for medical professionals, may become the best Web presentation, and perhaps the most useful coverage of this conference overall.
Its IAS conference coverage is organized as seven tracks:
* Daily news
* First-line antiretroviral therapy
* Antiretroviral resistance & salvage therapy
* Clinical implications of studies of HIV pathogenesis
* Pharmacology & adverse effects of therapy
* Metabolic complications and lipodystrophy
* Opportunistic infections and coinfections
The daily news stories include protease inhibitors and cardiovascular disease, sex differences in fat redistribution (including noting that lipoatrophy is much more common in people with HIV than had been expected), new T-20 information, high drug resistance in newly diagnosed people with HIV in Europe, and a number of reports on particular protease inhibitors and other antiretrovirals.
The other six sections include over 50 "capsule summaries" that present major clinical trials or other important conference presentations in a standardized table format. (For example, in the "Metabolic Complications and Lipodystrophy" track, the capsule summary on cardiovascular disease in a large cohort receiving antiretroviral therapy has outline-type presentations divided into these categories: Summary and key conclusions; Background; Summary of study design; Baseline characteristics of study population; and Main findings. Other capsule summaries can have different section titles, and narrative is allowed when needed.) This kind of presentation may seem strange at first, but we found it effective for presenting key information quickly. In August, Clinical Care Options expects to add analysis of the same information by three experts in each of the six areas covered in these tracks--hopefully building on the capsule summaries, and providing more scrutiny and debate on the clinical implications than a single author's comments.
You need to register on the site to read the articles--a free, one-time process that takes five to ten minutes. Most Web browsers can keep track of your user name and password, avoiding the need to log on every time you use the site.
Quick Summaries for Patients: The Body, http://www.thebody.com/confs/ias2003/complete.html
This page has titles and links to more than 50 short reports, divided into 25 topic areas (as of July 25, 2003). Readers can scan the titles, or search for a particular word in any of the titles, using the search function provided by most browsers. For example, we searched for "lipoatrophy" (which means fat wasting--lipoatrophy can cause a sunken-face appearance, and often means that one's antiretroviral regimen needs to be changed). We found a topic area with five reports on lipoatrophy, and an additional report outside that topic area.
Some of the other topic areas involve:
* Drug resistance
* Antiretroviral therapy
* Complications of antiretroviral therapy
* Clinical trial results While The Body is designed for patients, the IAS conference was held for medical professionals; some medical terms are unavoidable. If you want to search for a drug, the generic name is usually the best--although you might want to try other names as well. For example, Fuzeon (the brand name of the drug also known as T-20) appears in a title as the generic name, enfuvirtide. More importantly, be aware that different research can be confusing and contradictory, and some will be found to be wrong. Science is normally that way near the leading edge; only in schoolbooks are there usually clear lines between right and wrong ideas.
Reports for physicians: Medscape, http://www.medscape.com/viewprogram/2536
The Medscape HIV site reviews important late-breaker presentations (results too late to be submitted for regular consideration for the conference, but allowed in by a special procedure because of their value and timeliness). Late breaker session #1 includes the high rate of resistance found in Europe that was widely reported in the general press, the failure of week-on-week-off antiretroviral treatment, and the very important study showing that HIV transmission by breastfeeding could be prevented by treating the infant with either 3TC or nevirapine. Late breaker session #2 included a Canadian study on factors associated with resistance development (chiefly high viral load--and intermediate adherence between 60% and 90%), good results from atazanavir in avoiding metabolic toxicities, and promising results from two new drugs active against many resistant viruses--SPD754, a nucleoside analog, and TMC114, a protease inhibitor.
Outside the late breakers, some of the reports currently on the site include:
* Treatment access initiatives in developing countries;
* 48-week data for enfuvirtide (Fuzeon, T-20);
* Update on treatment interruption (15 abstracts were presented at the conference);
* Viral dynamics and fitness;
* Drug resistance update;
* New approaches to antiretroviral therapy;
* Complications of antiretroviral therapy;
Note: this site requires free registration. Also, early news reports now on the site may be replaced later by CME (continuing medical information) modules.
The National AIDS Treatment Advocacy Project now has more than 15 articles, on subjects including antiretroviral regimens, drug resistance, hepatitis C treatment, human growth hormone, and methadone interactions.
HIV and Hepatitis.com, http://www.hivandhepatitis.com/2003icr/2ndias/main.html
This site has over 40 articles on clinical trials, new experimental antiretrovirals, viral resistance, dosing, complications of antiretroviral therapy (over 15 articles), salvage therapy, pharmacology, drug supply, treatment interruption, preventing transmission, immune reconstitution, and vaccines.
IAPAC AIDScan, http://www.iapac.org
The International Association of Physicians in AIDS Care published the daily newsletter AIDScan on the four days of the conference, with short articles on over a dozen major topics.
Kaiser--Video Webcasts, and Transcripts, http://www.kiasernetwork.org/paris2003
This site has video "webcasts" and also transcripts of selected sessions. But there are serious limitations:
* The slides, central to most of the presentations, are not available.
* Only a small fraction of the talks have webcasts or transcripts--mostly the large, general lectures and debates with important background information, but little new data (as that might be proprietary).
* The video images are often poor quality--and the transcripts include many errors, so they must be read cautiously. (The alternative would have been major delays, if all the speakers in each session had to edit and return the transcripts of their remarks before the session could go online.)
Official IAS Conference Site, http://www.ias2003.org/
The conference abstracts--given to participants as a book, and also as a CDROM--are not online as of the end of July, but are expected to be on this site in a few weeks. The Final Programme--a 3-megabyte PDF file of the 350-page program book given to participants--is currently available (except that the Late Breakers section has been omitted).
Comment on Webcast and Future Conference Technology
The Present: For now we have found that the best way to present conference information for those who were not in the meeting is through expert reviews, like those on most of the sites mentioned above. When webcasts are used, they should show good-quality reproduction of the speaker's slides, not poor-quality video of the speaker. Often the talks are useless without the slides.
Many conferences provide abstracts online before the meeting, but this one did not. When people travel from around the world to spend a few days together, they need to study and plan in advance so they can best use their time for meeting and working with others. Not having the abstracts ahead of time hurts participants, as well as those who need the information but were not at the conference.
The Future: We believe the next big improvement will be speakers creating presentations designed primarily for viewing online. These will allow flexible arrangements of charts, animated charts, sound, text, and video--and allow interactive pathways through the material if desired, including intelligent searches based on authors' marks or annotations. Templates will allow easy learning and setup for simple presentations, such as a series of slides with a recorded voice lecture for each.
Then anyone could view the presentation in its original quality at any time, either before, during, or after the meeting, and from anywhere in the world. At the conference, speakers could take a few minutes to explain an abbreviated view of their presentation, then open the session to discussion; listeners could take few notes because they would know they could review the full information any time, and search for exactly what they needed. Audience comments and/or group decisions could be added to the permanent online record if the author desired. These presentation modules would replace the abstract, slides, pointer, lecture, webcast, transcript, and more, all in perfect technical quality.
Then conferences could shift focus from hundreds of people sitting in auditoriums for lectures, to working groups that come together to build relationships and get things done. And the other six billion people who could not get to the meeting could still participate in that work.
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|Title Annotation:||International AIDS Society Conference on HIV Pathogenesis and Treatment, July 13-16, France|
|Author:||James, John S.|
|Publication:||AIDS Treatment News|
|Date:||Jul 25, 2003|
|Previous Article:||HIV drugs approved as of August 2003.|
|Next Article:||Nelson Mandela on treatment access.|