HIV 10 years later - Where do we stand now?

A wide variety of up-to-date results and knowledge were presented at the 10th International AIDS Meeting, Yokohama. Epidemiologically, most interest was focused on the discovery of a new HIV subtype O, which cannot be reliably detected by currently available ELISA kits. Clinically, it is gradually appreciated that one single most important parameter is the viral load; the extent of viral load can help explain many clinical observations. Another eye-catching finding was the report of a clinical follow-up of a group of long-term nonprogressors. If the underlying operative mechanism can be elucidated, we can learn the necessary elements for halting HIV infection progression. Therapeutically, the trend has shifted to combination therapy, preferentially 3-drug combination of 2 RT inhibitors and 1 protease inhibitor. For the vaccine development, many novel vectors were introduced, but their potentials are unknown at present. The successful application of single-cell in situ PCR has changed our perception of HIV infection. This powerful technique can detect a single viral genome inside cells and revealed that a large proportion of cells already harbor HIV genomes soon after the entry of HIV into the body. A direct viral effect may fully explain subsequent T cell depletion without invoking a lot of indirect mechanisms such as apoptosis.