1 OCTOBER 2010, VOLUME 11, ISSUE 36

The U.S. has $1.9 billion available for new biotech initiatives that can fight off the biologic threats of the future. And in just the last few days the government's Biomedical Advanced Research and Development Authority handed out contracts worth potentially more than $100 million to help accelerate work on a range of drug and vaccine development technologies. The R&D push is occurring as the Department of Health and Human Services is pushing through a major revamp of its biodefense initiative, which includes $678 million that will go to nonprofit groups that in turn will pump money into small biotech firms working in the field, according to a report in Global Security Newswire. The overall goal, says HHS Secretary Kathleen Sebelius, is to create a "nimble, flexible capacity to produce medical countermeasures rapidly in the face of any attack or threat."

There's been a move afoot for some time to separate the FDA's drug-safety operations from the Center for Drug Evaluation and Research, which now oversees both drug approvals and safety. The thinking is that safety oversight should be independent, rather than cheek-by-jowl with the approvals process. That way, the people involved in approving a drug aren't the same people watching it for potential safety problems.

Well, that movement might have gained some traction. Bloomberg looked at FDA safety records and found that half of the 21 drugs withdrawn since 1995 were linked to cardiovascular problems. Presented with that data, Sen. Charles Grassley (R-Iowa) said it supports his efforts to create the new FDA drug-safety center. "The question is whether there are more drugs that should be on the list, and are not," Grassley tells the news service. Grassley is working with Rep. Rosa DeLauro (D-CT) on a bill that would establish the new center, a separate Office of Surveillance and Epidemiology. Grassley's idea is that the center's staff would proactively study potential safety problems with drugs; he alleges that some red flags are now ignored.

Half of the 21 drugs pulled from the market in the U.S. for safety reasons since 1995 involved heart complications, a finding that is spurring Congress and doctors to call for closer government review of side effects. The products were on the market from 11 months to 30 years, based on a review of Food and Drug Administration data obtained by Bloomberg. GlaxoSmithKline Plc's diabetes drug Avandia, marketed for 11 years, narrowly avoided a recall last week when the FDA restricted its use as a result of a link to heart ailments only uncovered after the drug was in wide use. The agency is now reviewing heart risks for Abbott Laboratories' diet pill Meridia, sold since 1997.

Senator Charles Grassley, an Iowa Republican, said the data supports his recommendation to create an FDA center that would independently study drug safety, saying early warnings within the agency are now sometimes ignored. Doctors say heart risks can best be found in large controlled studies before or after a drug is released, as opposed to an FDA system that depends largely on voluntary reports from doctors and patients.

The United Nations' (UN's) eight Millennium Development Goals (MDGs) (1) are widely accepted as the primary path to alleviating poverty worldwide. This month, world leaders convene to assess progress toward these goals (2). In the countdown to the MDG 2015 deadline and amid protracted economic recession, we need the most efficient, effective, and evidence-based means to accelerate progress toward all MDGs. Challenges must be considered in concert, and solutions must provide multidimensional dividends for the world's poor, or we risk unwisely dividing limited resources and diluting their impact. As authors from diverse communities, we emphasize here the influence that investments in rights-based family planning can have on achieving the MDGs (for endorsements, see supporting online material).

For the first time the elimination of transmission of HIV from mothers to their babies is considered a realistic goal, according to a presentation at a summit in New York on the United Nations' millennium development goals. On 21 September the heads of Unicef, the World Health Organization, UNAIDS, and the Global Fund to fight AIDS, Tuberculosis and Malaria, together with representatives of donor governments and most affected countries, jointly launched a new initiative to promote intensified efforts to reach all mothers and children with the most effective interventions.

Unicef says that although the delivery of proved interventions "has effectively eliminated MTCT [mother to child transmission] in affluent countries, every day more than 1000 children in low and middle income countries are newly infected with HIV via transmission during pregnancy, labour and delivery, and breast feeding." However, new evidence has shown that reducing transmission from a background rate of 30% to less than 5% is now "achievable in resource constrained settings, even where breast feeding is the norm."

Using new data, WHO issued revised guidance on HIV and infant feeding in June, which it says can "significantly improve outcomes in both mothers and their babies and greatly reduce disparities." The new data show that giving antiretroviral drugs to either the HIV infected mother or the HIV exposed infant "can significantly reduce the risk of postnatal transmission of HIV through breast feeding." The revised guidelines recommend two key approaches: treatment, involving lifelong antiretrovirals for HIV positive women in need of treatment; and prophylaxis, involving short term provision of antiretrovirals to prevent transmission from mother to child.

Finding an effective microbicide that could substantially lower women's risk of acquiring HIV infection is an ethical imperative. Women and girls continue to be disproportionally affected by HIV in sub-Saharan Africa. Ethics guidelines for conducting preventive HIV microbicide trials call for steps that intertwine biomedical research and public health. Ethical considerations include adequate studies of the safety of microbicides, the use of placebo controls in future trials once a microbicide is shown to be effective, whether leftover microbicide from a trial that demonstrated efficacy should be made available to the public or used in the control group of a future trial, what preventive measures and treatment should be provided for trial participants during and after the research, and what constitute 'fair benefits' to the community or country when a trial is completed. The Global Campaign for Microbicides conducted a study of the benefits being provided to participants in microbicide trials and others, and found substantial evidence that researchers and sponsors are meeting the obligations stated in ethical guidelines. A cautionary tale of an HIV prevention trial that was prematurely halted demonstrates the need for engagement with the community where trials are carried out.

Over the next decade, some astonishing new technologies will spread to fight global poverty. They're called contraceptives. This is a high-tech revolution that will affect more people in a more intimate way than almost any other technological stride. The next generation of family planning products will be cheaper, more effective and easier to use -- they could be to today's condoms and diaphragms what a smartphone is to the bricklike cellphones of 20 years ago.

Contraception dates back to ancient Egypt, where amorous couples relied on condoms made of linen. Yet after three millennia, although we can now intercept a missile in outer space, we're often still outwitted by wandering sperm. Largely, that's because research on contraception is pitifully underfunded; if only family planning were treated as seriously as baldness! Contraception research just hasn't received the resources it deserves, so we have state-of-the-art digital cameras and decades-old family planning methods.

The situation is particularly dire in poor countries, where some 215 million women don't want to get pregnant yet can't get their hands on modern contraceptives, according to United Nations figures. One result is continued impoverishment and instability for these countries: it's impossible to fight poverty effectively when birthrates are sky high.

Yet impressive new contraceptive technologies are in trials and should address this problem. These new products are expected to hit the market in the coming years, in the United States as well as in the developing world. One is a vaginal ring that releases hormones. There is already such a ring on the market, but it lasts only one month. The new one lasts a year and is being developed by the Population Council, an international nonprofit that researches reproductive health.

Nearly one in five gay and bisexual men in 21 major U.S. cities are infected with HIV, and nearly half of them do not know it, U.S. health officials said on Thursday. Young men, and especially young black men, are least likely to know if they are infected with HIV, according to a study by the U.S. Centers for Disease Control and Prevention.

"We need to reinvigorate our response to preventing HIV among gay and bisexual men," Dr. Jonathan Mermin, director of CDC's Division of HIV/AIDS Prevention, said in a telephone interview. "We can't allow HIV to continue its devastating toll among gay and bisexual men, and in particular, among young black men." Mermin's comments echoed an AIDS policy rolled out in July by the White House that asked states and federal agencies to find ways to cut new HIV infections by 25 percent.

Researchers at the CDC studied 8,153 men who have sex with men in 21 U.S. cities. The men were taking part in the 2008 National HIV Behavioral Surveillance System, which looked at prevalence and awareness of the human immunodeficiency virus or HIV, the virus that causes AIDS. Overall, they found that 19 percent of gay men are infected with HIV. The study found that 28 percent of gay black men infected with HIV, compared with 18 percent of Hispanic men and 16 percent of white men.

For more information, see a press release from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

A global shortage of funds for the fight against HIV means universal access to prevention, treatment and care is unlikely unless HIV programmes get better value for their investments, says a new report by UNAIDS, the UN Children's Fund and the UN World Health Organization.

There is a need "to enhance the impact of current investments by improving the efficiency, effectiveness and quality of programmes, strengthening linkages between programmes, and building systems for a sustainable response," say the authors of Towards Universal Access.

For more information, see press release from UNAIDS "More developing countries show universal access to HIV/AIDS services is possible".

In addition to known antiviral agents such as antibodies and interferons, people also seem to have a similar immune system to that previously identified in plants, according to research carried out by Esther Schnettler at Wageningen University in the Netherlands. Together with the group of Professor Ben Berkhout of the Academic Medical Centre (AMC) in Amsterdam, Schnettler discovered that a protein used by plant viruses to bypass plant resistance can also impair the defence against HIV viruses in people. Schnettler's findings may open up new opportunities for improving health.

Plants defend themselves against viruses by attacking, deactivating and breaking down genetic material in a process called RNA silencing. Viruses try to bypass this defence by producing proteins that block it. Schnettler researched the functioning of these silencing suppressor proteins in plants, recognising that the improvement of plant defences would enable more sustainable cultivation by reducing the need for chemical pesticides to combat insects and pathogens.

Scientists in China and Hong Kong are designing a gel containing an experimental drug which they hope can reduce HIV infections in women. The search for such a prophylaxis is gaining urgency in China with sex becoming the number one mode of HIV transmission and new HIV infections rising sharply among Chinese women.

The gel acts as an "entry inhibitor" -- blocking the human immunodeficiency virus (HIV) from gaining entry into host cells, Chen Zhiwei, director of the AIDS Institute at the University of Hong Kong, said in an interview. The experimental treatment drug used in this gel has passed animal tests and a small safety test in people, Chen said. Chen and his colleagues are now preparing to convert it into a microbicide - a gel that is inserted into the vagina or rectum before sex to prevent transmission of HIV, which causes AIDS.

HIV-infected individuals who begin antiretroviral therapy (ART) soon after acquiring the virus may have stronger immune responses to other pathogens than HIV-infected individuals who begin ART later, a new study from the National Institutes of Health has found. This finding suggests that early initiation of ART may prevent irreversible immune system damage and adds to the body of evidence showing significant health benefits from early ART.

Scientists from the National Institute of Allergy and Infectious Diseases, part of NIH, measured the quantity and qualities of B cells in blood samples taken from three groups of study volunteers: men who had been infected with HIV for fewer than 6 months; men who had been infected with HIV for 6 months or more (often for several years); and men who were not infected with HIV. The HIV-infected men began taking ART for the first time once they entered the study.

B cells make proteins called antibodies that can flag pathogens for destruction by the immune system and prevent them from infecting cells. At the outset of the study, the number of B cells in the blood of both groups of HIV-infected men was significantly lower than the number of B cells in the blood of the uninfected men. Once the two groups of HIV-infected men began ART, however, the numbers of B cells in their blood increased significantly and to similar degrees.

Also see: Moir S, et al. B cells in early and chronic HIV infection: evidence for preservation of immune function associated with early initiation of antiretroviral therapy. Blood, 2010.

Background In south India, general population HIV prevalence estimates range from 0.5 to 3%. To focus HIV prevention efforts, it is important to understand whether HIV transmission is driven by commercial sex.

Methods A dynamic HIV/sexually transmitted infection transmission model was parameterized using data from Belgaum and Mysore in south India. Fits to sexually transmitted infection/HIV data from female sex workers (FSWs) and their clients for each district were obtained. Model HIV/herpes simplex virus-2 (HSV-2) prevalence projections for the general population were cross-validated against empirical estimates not used to fit model. The model estimated the proportion of incident HIV/HSV-2 infections due to HIV/HSV-2 transmission between FSWs/clients, their noncommercial partners and other low-risk partnerships. The relative impact of a generic intervention targeting different partnerships was explored.

Results The model's general population HIV/HSV-2 prevalence projections agreed well with empirical estimates. Recent increases in condom use resulted in decreasing HIV epidemics in both settings. For men, most incident HIV/HSV-2 infections (>90%) directly result from commercial sex, whereas for women most are due to bridging infections from clients of FSWs (80-90%) with the remainder mainly due to commercial sex. Less than 1.5% of incident infections are due to low-risk partnerships. Intervention impact is maximized through targeting commercial sex but substantial impact could also be achieved through targeting noncommercial partners of clients.

Discussion In southern India, HIV transmission could be driven by FSWs and their clients. While efforts to reduce HIV transmission due to commercial sex must continue, prevention programmes should also consider strategies to prevent transmission from clients to their noncommercial partners.

To assess the pharmacokinetics of dapivirine in plasma and dapivirine concentrations in cervicovaginal fluids (CVF) and cervicovaginal tissues following vaginal administration of dapivirine microbicide gel in healthy, HIV-negative women for 10 days. A randomized, double-blind, phase I study was conducted at a single research center in South Africa. A total of 18 women used dapivirine gel (0.001%, 0.005%, or 0.02%) once daily on Days 1 and 10 and twice daily on Days 2-9. Pharmacokinetics of dapivirine were assessed in plasma on Days 1 and 10. Dapivirine concentrations were measured in CVF on Days 1 and 10 and in cervicovaginal tissues on Day 10. Safety was evaluated through laboratory tests (hematology, clinical chemistry, and urinalysis), physical examinations, and assessment of adverse events. Plasma concentrations of dapivirine increased over time with gel dose and were greater on Day 10 (Cmax 31 to 471pg/ml) than Day 1 (Cmax 23 to 80pg/ml). Tmax was 10-12h on Day 1, and 9h on Day 10. Concentrations in CVF generally increased with dose but were highly variable among participants. Mean peak values ranged from 4.6-8.3*106 pg/ml on Day 1 and from 2.3-20.7*106 pg/ml on Day 10 across dose groups. Dapivirine was detectable in all tissue biopsies on Day 10 at concentrations of 1.0-356×103 pg/mg.

Conclusions Dapivirine was widely distributed throughout the lower genital tract with low systemic absorption when administered in a vaginal gel formulation for 10 consecutive days. The gel was safe and well tolerated.

HIV/AIDS is a global pandemic and is the leading infectious cause of death among adults. Although antiretroviral (ARV) therapy has dramatically improved the quality of life and increased the life expectancy of those infected with HIV, life-long suppressive treatment is required and a cure for HIV infection remains elusive; frequency of dosing and drug toxicity as well as the development of viral resistance pose additional limitations. Furthermore, preventative measures such as a vaccine or microbicide are urgently needed to curb the rate of new infections. The capabilities inherent to nanotechnology hold much potential for impact in the field of HIV treatment and prevention. This article reviews the potential for the multidisciplinary field of nanotechnology to advance the fields of HIV treatment and prevention.

Long synthetic peptides (LSPs) have a variety of important clinical uses as synthetic vaccines and drugs. Techniques for peptide synthesis were revolutionized in the 1960s and 1980s, after which efficient techniques for purification and characterization of the product were developed. These improved techniques allowed the stepwise synthesis of increasingly longer products at a faster rate, greater purity, and lower cost for clinical use. A synthetic peptide approach, coupled with bioinformatics analysis of genomes, can tremendously expand the search for clinically relevant products. In this Review, we discuss efforts to develop a malaria vaccine from LSPs, among other clinically directed work.

Objective To compare the prevalence of sexually transmitted infections (STIs) (including HIV) and of high-risk sexual behaviour in the following three groups: primary infertile relationships, secondary infertile relationships and fertile relationships. Primary infertility is here defined as never having conceived before, secondary infertility as infertility subsequent to having conceived at least once.

Design Unmatched case-control study.

Methods Sexually active infertile women aged 21-45 years presenting at an infertility clinic of the Kigali Teaching Hospital, Rwanda and their male partners were invited to participate. Fertile controls who had recently delivered were recruited from the community. In a face-to-face interview, participants were asked about sociodemographic characteristics and their sexual behaviours, and tested for HIV and STIs.

Results Between November 2007 and May 2009, 312 women and 254 partners in infertile relationships and 312 women and 189 partners in fertile relationships were enrolled. Involvement in a secondary infertile relationship was associated with HIV infection after adjusting for sociodemographic covariates for women (adjusted OR (AOR)=4.03, 95% CI 2.4 to 6.7) and for men (AOR=3.3, 95% CI 1.8 to 6.4). Involvement in a primary infertile relationship, however, was not. Secondary infertile women were more likely to have engaged in risky sexual behaviour during their lifetime compared with primary infertile and fertile women. Men in primary and secondary infertile relationships more often reported multiple partners in the past year (AOR=5.4, 95% CI 2.2 to 12.7; AOR=7.1, 95% CI 3.2 to 15.8, respectively).

Conclusions Increased HIV prevalence and risky sexual behaviour among infertile couples is driven by secondary infertility. Infertile couples, and especially those with secondary infertility, should be targeted for HIV prevention programmes and their fertility problems should be addressed.

Entamoeba histolytica (Eh), the protist that causes amebic dysentery and liver abscess, has a truncated Asn-linked glycan (N-glycan) precursor composed of seven sugars (Man5GlcNAc2). Here we show that glycoproteins with unmodified N-glycans are aggregated and capped on the surface of Eh trophozoites by the anti-retroviral lectin cyanovirin-N and then replenished from large intracellular pools. Cyanovirin-N co-caps the Gal/GalNAc adherence lectin, as well as glycoproteins containing O-phosphodiester-linked glycans recognized by an anti-proteophosphoglycan monoclonal antibody. Cyanovirin-N inhibits phagocytosis by Eh trophozoites of mucin-coated beads, a surrogate assay for amebic virulence. For technical reasons, we used the plant lectin Concanavalin A rather than cyanovirin-N to enrich secreted and membrane proteins for mass spectrometric identification. Eh glycoproteins with occupied N-glycan sites include Gal/GalNAc lectins, proteases, and 17 previously hypothetical proteins. The latter glycoproteins, as well as 50 previously hypothetical proteins enriched by Concanavalin A, may be vaccine targets, as they are abundant and unique. In summary, the anti-retroviral lectin cyanovirin-N binds to well-known and novel targets on the surface of Eh that are rapidly replenished from large intracellular pools.

The relationship among oral and systemic health and HIV shedding in saliva is not well-understood. We hypothesized that oral and systemic health are associated with HIV shedding in saliva of HIV-infected women. Saliva from 127 participants enrolled in the Women's Interagency HIV Study (WIHS) was collected at repeated visits over a 5.5-year study period (October 1998 through March 2004) and was evaluated for HIV-1 RNA. Demographic, lifestyle, and systemic and oral health characteristics were evaluated as possible correlates of salivary HIV-1 shedding. Multivariate models showed significantly increased risk of HIV-1 shedding in saliva as blood levels of CD4 cell counts decreased (p < 0.0001) and HIV RNA increased (p < 0.0001). Diabetes (p = 0.002) and a high proportion of gingival bleeding sites (p = 0.01) were associated with increased likelihood, while anti-retroviral therapy (p = 0.0003) and higher levels of stimulated saliva flow rates (p = 0.02) were associated with a lower likelihood of HIV-1 RNA shedding in saliva.

Broadly neutralizing Abs to HIV-1 are well described; however, identification of Ags that elicit these Abs has proven difficult. Persistent infection with GB virus type C (GBV-C) is associated with prolonged survival in HIV-1-infected individuals, and among those without HIV-1 viremia, the presence of Ab to GBV-C glycoprotein E2 is also associated with survival. GBV-C E2 protein inhibits HIV-1 entry, and an antigenic peptide within E2 interferes with gp41-induced membrane perturbations in vitro, suggesting the possibility of structural mimicry between GBV-C E2 protein and HIV-1 particles. Naturally occurring human and experimentally induced GBV-C E2 Abs were examined for their ability to neutralize infectious HIV-1 particles and HIV-1-enveloped pseudovirus particles. All GBV-C E2 Abs neutralized diverse isolates of HIV-1 with the exception of rabbit anti-peptide Abs raised against a synthetic GBV-C E2 peptide. Rabbit anti-GBV-C E2 Abs neutralized HIV-1-pseudotyped retrovirus particles but not HIV-1-pseudotyped vesicular stomatitis virus particles, and E2 Abs immune-precipitated HIV-1 gag particles containing the vesicular stomatitis virus type G envelope, HIV-1 envelope, GBV-C envelope, or no viral envelope. The Abs did not neutralize or immune-precipitate mumps or yellow fever viruses. Rabbit GBV-C E2 Abs inhibited HIV attachment to cells but did not inhibit entry following attachment. Taken together, these data indicate that the GBV-C E2 protein has a structural motif that elicits Abs that cross-react with a cellular Ag present on retrovirus particles, independent of HIV-1 envelope glycoproteins. The data provide evidence that a heterologous viral protein can induce HIV-1-neutralizing Abs.

Purpose of review Male circumcision has become an important component of HIV prevention strategies in Africa. Results of recent trials have renewed interest in this ancient procedure and its potential application in the reduction of sexually transmitted infections (STIs). With renewed interest comes controversy, which has always been a close companion to circumcision.

Recent findings Following the three randomized trials in Africa demonstrating the protective effects of male circumcision on HIV infection, studies have reported other benefits of circumcision including protection from certain STIs, including human papillomavirus and herpes simplex virus 2. With data accumulating on the public health benefits of circumcision and the endorsement of circumcision from WHO, investigators have begun to evaluate the feasibility, safety and cost of implementation of large-scale circumcision programs. Limitations of circumcision have also been explored.

Summary Male circumcision will likely play an important role in HIV/STI prevention programs in Africa; the inclusion of circumcision in the health policy of developed countries will require further investigation.

Single-dose nevirapine (NVP) is effective in reducing mother-to-child transmission (MTCT) of HIV; however, the subsequent development of drug resistance is problematic. The pharmacokinetic profile of the HIV entry inhibitor maraviroc after a single intrapartum dose in rhesus macaques was studied to determine whether maraviroc could serve as an alternative to NVP in a single-dose strategy. Four pregnant macaques received an oral dose of maraviroc 2 h before delivery, and both infant and maternal plasma maraviroc concentrations and CCR5 receptor occupancy on CD4+ lymphocytes were measured over time. Maximum plasma maraviroc concentrations were found at delivery (2-h-postintrapartum dose) in both the mothers and infants, with median concentrations of 974 ng/ml (range, 86 to 2,830 ng/ml) and 22 ng/ml (range, 4 to 99 ng/ml), respectively. Maraviroc was detected in the plasma of mothers up to 48 h after dosing but only as long as 3.5 h in the infants. The median fetal-maternal area under the concentration-time curve (AUC) ratio was 0.009 (range, 0.000 to 0.015). Maraviroc receptor occupancy data showed evidence of unprotected CCR5 receptors on CD4+ cells in the mothers 24 to 48 h after dosing. Extremely low CCR5 expression on CD4+ cells of newborn macaques prevented determination of receptor occupancy in the infants. In rhesus macaques, maraviroc was poorly transferred across the placenta and was quickly cleared from the infants' blood. The low concentrations of fetal maraviroc and short pharmacokinetic profile in infants suggest that a single maternal intrapartum dose of maraviroc would not be effective in reducing the risk of MTCT of HIV.

Human immunodeficiency virus type 2 (HIV-2) infection affects about 1-2 millions individuals, the majority living in West Africa, Europe and India. As for HIV-1, new strategies for the prevention of HIV-2 infection are needed. Our aim was to produce new vaccine immunogens that elicit the production of broadly reactive HIV-2 neutralizing antibodies (NAbs). Native and truncated envelope proteins from the reference HIV-2ALI isolate were expressed in vaccinia virus or in bacteria. This source isolate was used due to its unique phenotype combining CD4-independence and CCR5 usage. NAbs were not elicited in BALB/c mice by single immunization with a truncated and fully-glycosylated envelope gp125 (gp125t) or a recombinant polypeptide comprising the C2, V3 and C3 envelope regions (rpC2-C3). A strong and broad NAb response was, however, elicited in mice primed with gp125t expressed in vaccinia virus and boosted with rpC2-C3. Serum from these animals potently neutralized (median 50% neutralizing titter 3200) 6 out of 6 highly divergent primary HIV-2 isolates. Co-receptor usage and V3 sequence of NAb sensitive isolates were similar to that of the vaccinating immunogen (HIV-2ALI). In contrast, NAbs were not reactive on 3 X4 isolates that displayed major changes in V3 loop sequence and structure. Collectively, our findings demonstrate that broadly reactive HIV-2 NAbs can be elicited using a vaccinia virus vector-prime/rpC2-C3-boost immunization strategy and suggest a potential relationship between escape to neutralization and cell tropism.

The readers of Nature should be an optimistic bunch. Every week we publish encouraging dispatches from the continuing war against disease and ill health. Genetic pathways are unravelled, promising drug targets are identified and sickly animal models are brought back to rude health. Yet the number of human diseases that can be efficiently treated remains low -- a concerning impotency given the looming health burden of the developed world's ageing population. The uncomfortable truth is that scientists and clinicians have been unable to convert basic biology advances into therapies or resolve why these conversion attempts so often don't succeed. Together, these failures are hampering clinical research at a time when it should be expanding.

Enter translational research. The concept has been pushed hard over the past decade by funders as a way to bridge the gap between the laboratory and the clinic. New money has been found to foster high-risk, high-reward research, develop the necessary tools and methodologies, fill knowledge gaps, and change academic culture to foster collaboration. The term translational was well-chosen. Those who work at the bench and the bedside speak in separate tongues: scientists of hypotheses and mechanisms; clinicians of populations and effects. Two communities divided by uncommon language.

Startling results of such a translational effort were described in a recent paper in the New England Journal of Medicine (K. T. Flaherty et al. N. Engl. J. Med. 363, 809-819; 2010), and on page 596 Bollag et al. offer more details.

Preventing shape-shifting in a key segment of protein from HIV can prime an immune system to develop antibodies against the virus. Such antibodies, elicited against specific protein segments, could one day serve as the basis for a vaccine to fight many different strains of HIV or other swiftly mutating viruses. Although a small percentage of individuals infected with HIV develop 'broadly neutralizing antibodies' that disarm different strains of the virus, researchers have so far been unable to develop a vaccine that coaxes the immune system into making such antibodies.

To get around this problem, researchers have tried to extract a key bit of protein -- or epitope -- that a neutralizing antibody recognizes, in the hope that the immune system will react more strongly to the epitope in isolation. However, without the rest of the protein to hold it in place, the segment generally loses its recognizable stable structure.

UNAIDS and AVAC invite stakeholders in biomedical HIV prevention research to join a webinar on the draft second edition of the Good Participatory Practice (GPP) Guidelines for biomedical HIV prevention trials on Tuesday, 05 October from 9am - 10am US Eastern Time / 3pm - 4pm Geneva time. Click here to register for the call.

The objectives of the call are to orient stakeholders to the second edition of the GPP guidelines, provide an opportunity for discussion and questions around GPP issues and the second edition, and encourage stakeholders to review the guidelines and send comments on the draft second edition by 31 October.

The GPP guidelines were created to set global standards for stakeholder engagement in biomedical HIV prevention trials. The GPP guidelines are intended to provide trial funders, sponsors and implementers with systematic guidance on how to effectively engage with all stakeholders in the design and conduct of biomedical HIV prevention trials.

The GPP guidelines were first published in 2007. Following consultation with global stakeholders, the guidelines were revised and a second edition was released as a draft at the International AIDS Conference in Vienna in July. This draft is open for public comment until 31 October 2010. The final version of the second edition of the guidelines will be released in late 2010. Comments on the draft section edition can be sent to avac@avac.org.

October 21-24
Infectious Diseases Society of America 48th Annual Meeting, Vancouver, Canada.
For more information or to register, contact:
IDSA at 1300 Wilson Blvd, Suite 300, Arlington, VA 22209, US.
Phone: (703) 299-0200
Fax: (703) 299-0204
Web site: http://www.idsociety.org/

November 03-07
American Society of Tropical Medicine and Hygiene, Atlanta, GA, US.
For more information or to register, contact:
American Society of Tropical Medicine and Hygiene at 111 Deer Lake Road, Suite 100, Deerfield, IL 60015, US.
Phone: (847) 480-9592
Fax: (847) 480-9282
Web site: http://www.astmh.org//AM/Template.cfm?Section=Home1&WebsiteKey=452e1eb1-b2d5-48a7-857a-c789a07c27d1

The Regional Knowledge Hub for HIV/AIDS Surveillance in collaboration with the WHO Collaborating Centre on HIV surveillance in Zagreb, Croatia, WHO-EMRO, and the CDC/Iran Ministry of Health has the pleasure of announcing a new training course scheduled to be held from November 21- 25th 2010 in Tehran, Iran called "Training course on Facility Based HIV Surveillance". In this short course, participants will be introduced to the main components of HIV surveillance systems, to strategic planning of an effective surveillance system, to the different methodologies of facility based HIV surveillance including the design of data collection tools, data collection processes, data analysis and reporting.

Please apply early as the number of participants is limited. Apply online at: http://www.hivhub.ir/application
Deadline: 1st Oct. 2010
For more information and inquiries, please contact us at info@hivhub.ir.

The 2010 HIV Prevention Leadership Summit (HPLS) will be held December 12-15, in the nation's capital, Washington, D.C. This year's Summit is specifically designed for grantees funded by the Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention-state and local health departments, community planning group (CPG) members, capacity building assistance providers, community-based organizations, and other interested HIV prevention partners - and will feature workshops, discussions and plenary sessions. The Summit will offer AIDS directors, program managers, executive directors, HIV prevention program staff, CPG members, and other HIV prevention partners a forum to disseminate and exchange information to enhance their program planning and management with innovative strategies to for implementing HIV prevention programs. Attendees will also receive important information, skills building, and opportunities to share lessons learned.

Submissions will be reviewed and selected by the HPLS Executive Planning Committee, and authors will be notified if they are accepted to serve as a presenter. HPLS is NOT an abstract driven conference this year and only poster submissions will be reviewed. Due to space limitations, not all presentations can be accepted. Submissions are due Monday, October 4, 2010 by 12:00 midnight EST.  

Centers for Disease Control and Prevention's Division of STD Prevention has recently redesigned their internet website into a cleaner, fresher, and more modern format. Although the look is new, readers will still get the same helpful information about sexually transmitted diseases (STDs). Visit http://www.cdc.gov/std/default.htm to see the redesigned website. 

Also, several new items were recently added to the site:

Updated Factsheet: HIV among Gay, Bisexual and Other Men Who Have Sex with Men (MSM)
The HIV among Gay, Bisexual and Other Men Who Have Sex with Men (MSM)factsheet has recently been updated with information from the 2008 HIV Surveillance Report: Diagnoses of HIV infection and AIDS in the United States and Dependent Areas.

MMWR: Prevalence and Awareness of HIV Infection Among Men Who Have Sex With Men --- 21 Cities, United States, 2008
Men who have sex with men (MSM) are at increased risk for infection with human immunodeficiency virus (HIV). In 2006, 57% of new HIV infections in the United States occurred among MSM. To estimate and monitor risk behaviors, CDC's National HIV Behavioral Surveillance system (NHBS) collects data from metropolitan statistical areas (MSAs) using an anonymous cross-sectional interview of men at venues where MSM congregate, such as bars, clubs, and social organizations.

New CDC Site: Gay and Bisexual Men's Health
Gay and bisexual men and other men who have sex with men (MSM) represent an incredibly diverse community. Gay and bisexual men have both shared and unique experiences and circumstances that affect their physical health and mental health needs as well as their ability to receive high-quality health services.

Concepts represent early planning stages for program announcements, request for applications, or solicitations for Council's input. Council approval does not guarantee that a concept will become an initiative.

• Consortia for AIDS Vaccine Research in Nonhuman Primates
• Innovation for HIV Vaccine Discovery
• Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery
• Next Generation PrEP II
• Integrated Preclinical/Clinical Program for HIV Topical Microbicides
• Centers for AIDS Research and Developmental Centers for AIDS Research

Journalists Against AIDS (JAAIDS) Nigeria, on behalf of Partners of the Red Ribbon Awards, hereby invites entries for the 2010 edition of the Red Ribbon Awards on HIV/AIDS in Nigeria. The Red Ribbon Awards is an annual event instituted since 2001 to honour outstanding media response to the HIV and AIDS epidemics in Nigeria. The awards presentation will hold in Lagos by December 2010. Entries are being accepted though 15 October 2010.

Award Categories

A. INDIVIDUAL EFFORT
Best Feature Report (Print)
Best Television Feature
Best Radio Feature
Best HIV/AIDS Cartooning
Outstanding Informed Commentary (Print)
Best Local Language Reporting (Radio)
Best Reporting on New HIV Prevention Technologies (Print) - sponsored by NHVMAS. Please send in your entries

B. CORPORATE CATEGORY
Best Newspaper Editorial

C. COMMUNITY CATEGORY
Breakers of Silence Award (Organization) 
Breaker of Silence Award (Individual)
Special Recognition Award
Omololu Falobi Young Achiever's Award (Individual)

AWARD PRIZES
Prizes for recipients of Red Ribbon Awards include: Cash prizes of N100,000. Red Ribbon plaques and certificates will be given to every winner. Certificates of recognition and consolation prizes will be given to runners-up.

For full details and eligibility criteria for the Media and Community categories, visit: http://www.nigeria-aids.org/

International Rectal Microbicides Advocates (IRMA) would like to share our excitement at receiving another grant from Elton John AIDS Foundation (EJAF) towards the good work we are doing to advance the rectal microbicide agenda. EJAF has consistently supported IRMA and her vision of safe, effective, acceptable and accessible rectal microbicides for the women, men, and transgender individuals who need them. We are incredibly thankful for their leadership and their vision. Here is the link to EJAF's announcement of their entire slate of August 2010 awards: http://www.ejaf.org/pages/grants/2010.html.

The Sixth EDCTP Forum will be held from 9 to 12 October 2011 in Addis Ababa, Ethiopia. The theme of the Forum is Strengthening Research Partnerships for Better Health and Sustainable Development, taking into account the past, present and the future of EDCTP. This Forum provides an international platform for the presentation and discussion of frontier research for everyone involved in combating the three main poverty-related diseases (HIV/AIDS, malaria and tuberculosis) and the appropriate capacity development and networking activities. It presents a unique opportunity to establish and reinforce cooperation and synergy among EDCTP stakeholders at various levels including scientific, policy, funding and political interactions. Scientists involved in EDCTP-funded projects are particularly encouraged to use this opportunity to share new developments and results from their projects.