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

02577_1 EVALUATION OF HIV-INFECTED WOMEN SCREENED FOR A CLINICAL TRIAL OF MICROBICIDE SAFETY, THAILAND

McLean, Catherine*
Kantipong, P**, Chaowanachan, T***, Van De Wijgert, J****, Medtanavyn, T*****, Braunstein, S****, Whitehead, SJ*,***, Siraprapasiri, T***, Tappero, JW*,***.
*National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, USA; **Chiang Rai Hospital, Thailand; ***Thailand MOPH – U.S. CDC Collaboration; ****The Population Council, USA; *****Chiang Rai Provincial Health Office, Thailand

Background: Few candidate microbicide safety trials have been conducted among HIV-infected women. We screened HIV-infected women for participation in a safety and acceptability trial of a candidate microbicide (Carraguard“) in Northern Thailand. Eligibility criteria included abstinence or an HIV-infected husband/steady sex partner, regular menstrual cycles, not currently taking antiretroviral (ARV) therapy, and a CD4 cell count of 50-500 cells/µL. We report the clinical findings from women screened.

Methods: HIV and syphilis serological tests and CD4 cell counts were performed for all women screened. Women were referred for HIV clinical evaluation, including chest radiograph, and received pneumocystis carinii (PCP) and/or fungal prophylaxis, if indicated. For women meeting preliminary eligibility criteria, a pelvic examination with Pap smear was performed. Husbands/steady sex partners were offered HIV testing.

Results: Overall, 144 women were screened; nine (6%) tested HIV negative. Among 135 HIV-infected women, 40 (30%) did not meet CD4 cell count criteria; 26 (19%) had <50 CD4 cells/µL, and 14 (10%) had >500 CD4 cells/µL. Overall, 64 (47%) women had CD4 cell counts <200 cells/µL. Among 114 women with HIV care evaluations, 40 (35%) received fungal and/or PCP prophylaxis. Among 95 women with CD4 50-500 cells/µL, 53 (56%) were abstinent. Thirty-four (36%) had a husband/steady sex partner who was tested for HIV, and 19 (56%) tested HIV positive. Six (4%) had reactive serologic tests for syphilis and were treated. Pap smear results were available for 57 women tested; eight (14%) were > Class II, and these women were referred for colposcopy and excluded from participation. One woman was diagnosed with active tuberculosis, received treatment, and was excluded. At this time, 35 women have been enrolled.

Conclusions: As part of screening for this study, women learned their CD4 count and received care for HIV-related conditions. For those eligible, knowledge of CD4 count may increase their ability to access to antiretroviral treatment. Overall, 47% of women screened may be eligible for ARVs as the Thai government expands HIV treatment programs for persons with CD4 cell counts <200 cells/µL; many may not have been previously aware of their eligibility. We identified many discordant couples who received intensive counselling to reduce the risk of HIV transmission to the uninfected partner.

Dr. Catherine McLean
Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-02, Atlanta, GA 30333, USA
(Telephone) (404) 639-8467 (Fax) (404) 639-8610 (E-mail) CMcLean@cdc.gov