Microbicides 2004 Microbicides 200428-31 March 2004, Hilton London MetropoleThe conference42 million men, women and children worldwide were living with HIV by the end of December 2002 (source: UNAIDS), including five million newly-infected during that year alone. Another 45 million people will become infected between 2002 and 2010, unless the current transmission rates can be vastly reduced. Of the 42 million, 29.4 million live in sub-Saharan Africa and 58% of them are women. Not only are women more susceptible to HIV infection, many are powerless to insist on the use of condoms or other methods of protecting themselves. In this context, and with the knowledge that an effective HIV vaccine is unlikely to be available for several years, the need for an effective topical microbicide grows ever more urgent. 2004 should prove to be a landmark year in the field of microbicide development as the first Phase III trials of novel products are due to start – the next step along the road to making a microbicide available to the millions worldwide in desperate need of protection.The aims of the Microbicides 2004 conference are to:Report novel or innovative work in the microbicides fieldProvide updates on recent microbicides research, divided into three tracks: basic science, clinical science, and behavioural science (including public health and the microbicide marketplace)Provide a forum for the discussion of new developments in microbicide research including ethical, clinical, behavioural and methodological issuesPresent opportunities for knowledge-sharing between microbicide researchers, public-health workers and advocacy organisations.There will be an opening ceremony on the evening of Sunday 28 March at which politicians, policy makers and the international media are expected. The conference will run for a full three days, each of which will contain:Scientific overviews and presentations with plenary sessions, invited lecturers and presentations of original researchWorkshops to review issues unique to microbicides such as trial design and outcome measures, and ethical issues in the clinical trials of microbicidesPoster sessions. Focus on LondonFollowing the successful Microbicides conferences in Washington in 2000 and Antwerp in 2002, March 2004 sees the focus move to London.The venue is the Hilton Metropole Hotel, two minutes by taxi from Paddington station and the Heathrow Express, with a journey time from the airport of 15 minutes. The hotel is in walking distance of Hyde Park and London’s main shopping streets, and close to Imperial College. Accommodation will be available at the venue and other hotels in the vicinity.London in March offers a variety of diversions for out-of-conference relaxation, including sight-seeing and shopping; the arts and the theatre; and pubs, clubs and restaurants to suit every taste. Conference staff will be on hand to help delegates plan their spare time.To book your place or find out more information, e-mail info@microbicides2004.org.uk or telephone the Event Office on +44 (0) 20 7720 4411
Oral: invited speaker Oral: Track A Oral: Track B Oral: Track C Poster: Track A Poster: Track B Poster: Track C Abstract only Authors

02407 VAGINAL FLORA CHARACTERISTICS OF HIV+ WOMEN ENROLLED IN A PHASE I CELLULOSE SULFATE STUDY: HPTN 049

Justman, Jessica
El-Sadr, W; Gai, F; Mâsse, B.R; Hoesley, C; Maslankowski, L; Mayer, K, Timoney, M.T; Allen, N; Kwiecien, A.; Soto-Torres,L; Mauck, C.
For The HPTN 049 Study Team

Background: Vaginal microbicides, if effective, may be used by HIV+ women to prevent sexual transmission of HIV. These products may affect vaginal flora.. However, there are few data on the vaginal flora characteristics of HIV+ women..

Methods: Eligibility criteria included CD4+ lymphocyte count >200cells/mm3, HIV-1 RNA <50,000 c/mm3, negative pregnancy test, normal Pap smear, no sexually transmitted infections (STI) in the preceding 6 months and no vaginal symptoms or discharge. A pelvic examination, including pH measurement and wet mount exam of vaginal fluid, was conducted prior to any microbicide use.

Results: 55 HIV+ women enrolled thus far: mean age 37.9 y, 64% African American, 15% Latina, median CD4 583 cells/mm3, viral load 184 c/mm3. Antiretroviral therapy (ART) was used by 71%. Mean vaginal pH was 5.0 (range 3.5-7.0, SD 0.7), and 69% of women had a pH above normal pH of 4.5. Using clinical criteria (ph> 4.5, positive amine test and >20% clue cells), 15% of the women had bacterial vaginosis (BV). Wet mount exam did not reveal T.vaginalis or C.. albicans. Neither vaginal pH > 4.5 nor BV were associated with age, ART use, CD4 count, viral load or history of STI.

Conclusions: These asymptomatic, highly selected HIV-infected women had a high prevalence of elevated vaginal pH and incidental BV at baseline. As BV may act as a co-factor in the heterosexual transmission of HIV, the impact of vaginal microbicides on BV warrants further study.

Jessica Justman, MD
Division of Infectious Diseases, Bronx-Lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 10457
(Telephone) 718 960 1436 (Fax) 718 960 2054 (E-mail) jjustman@bronxleb.org