HIV/AIDS and Tuberculosis: A Lethal Convergence

HHMI/CSIS Symposium May 12, 2005 9:00 AM to Noon CSIS Headquarters Room B1 A/B 1800 K St., NW Washington, DC 20006

The Howard Hughes Medical Institute and the Center for Strategic and International Studies invite you to attend a symposium to discuss global public health policy issues associated with the alarming spread of human immunodeficiency virus (HIV) and tuberculosis (TB) in some regions of the world.

As HIV/AIDS rates have risen around the world, TB cases have skyrocketed. An estimated 2 billion people worldwide are infected with the TB bacterium, although many may never show any signs of illness. People infected with both HIV and TB have a much greater risk of developing AIDS and active TB. But TB can be deadly in people whose immune systems have been weakened by HIV infection.

The good news is that TB in people living with HIV is treatable and curable, but special treatment may be needed. In specific regions of the world, co-infection of HIV and TB is spreading at an alarming rate, taking a terrible toll in human lives and threatening to undermine already fragile public health agencies. The speakers have a front line view of these epidemics. They are running active research programs that are trying to develop novel ways to thwart HIV and TB. More importantly, however, they are committed to moving their work out of academic laboratories and into the field to implement programs to stem the tide of these deadly illnesses.

Confirmed speakers include:

Bruce D. Walker, M.D.

HHMI Investigator; Director of the Division of AIDS at the Harvard Medical School

The goal of Dr. Walker's research is to understand the immune control of chronic viral infections, such as HIV, and to use this information to develop interventions to induce immunologic control in persons with otherwise progressive infections. In his research, he uses human clinical specimens and focuses on the rapid translation of research advances at the bench to clinically relevant interventions at the bedside. His work focuses entirely on human diseases, studying cohorts in the United States and in KwaZulu-Natal Province, South Africa, where he has personally been involved in building research capacity at the epicenter of the HIV epidemic in sub-Saharan Africa.

Richard E. Chaisson, M.D.

Professor of Medicine and Director of The Johns Hopkins Center for Tuberculosis Research, Johns Hopkins Bloomberg School of Public Health

Tuberculosis is the leading infectious cause of death in the world, and about two billion people are latently infected with M. tuberculosis . Although preventive therapy has been shown to be effective, utilization of prophylaxis has been limited by poor adherence, toxicity and drug resistance. Dr. Chaisson's group has conducted a series of drug trials aimed at developing novel regimens for the prevention of TB in high risk individuals. Their first trial was in HIV-positive patients in Haiti. Since then, Dr. Chaisson's group has launched three trials for the prevention of TB in high risk patients in the U.S., Brazil and South Africa. He has shown that novel, short-course regimens are highly effective for the prevention of TB, and that supervision of therapy promotes adherence. More widespread use of novel preventive regimens would significantly improve global TB control.

Ann M. Ginsberg, M.D., Ph.D.

Head of Clinical Development, Global Alliance for TB Drug Development. At the Global Alliance for TB Drug Development (TB Alliance),

Dr. Ginsberg leads the clinical development of new drugs to improve treatment of tuberculosis. The TB Alliance is a public-private partnership whose mission is to halt the rise and reverse the spread of the world's oldest infectious disease by developing new, faster-acting and affordable TB medicines. Since its founding in 2000, the TB Alliance has built a portfolio of drug discovery and development projects which it continues to enhance and progress through the drug development process. The novel compounds and regimens to be registered will not only shorten TB treatment and be safer and more efficacious in treating multidrug-resistant TB, but will also improve therapy specifically for AIDS patients by enabling simultaneous treatment of AIDS and TB in co-infected patients.

William R. Jacobs, Ph.D.

HHMI Investigator at Albert Einstein College of Medicine

Dr. Jacobs has developed novel genetic approaches to make mutations and transfer genes in M. tuberculosis. With these tools, he has identified drug targets and novel virulence factors of M. tuberculosis, many of which are enzymes or products of complex lipid metabolism. These complex lipids are unique among bacterial pathogens and likely to contribute significantly to the pathogenic property of mycobacteria. Development of novel interventions requires new knowledge. For example, novel vaccines will require knowledge of protective antigens and of protective effector mechanisms. Understanding the mechanisms by which M. tuberculosis infects susceptible hosts, establishes and maintains persistent infections, and resists both innate and adaptive immune responses should aid in vaccine design and interventions.

Philip C. Onyebujoh, M.D., Ph.D.

Manager, Proof of Principle and Implementation Research on Tuberculosis and Leprosy, World Health Organization

A clinical immunologist, Dr. Onyebujoh has contributed significantly in studying the link between HIV/AIDS and tuberculosis. At the World Health Organization in Geneva, he has been active in building collaborative TB and HIV/AIDS programs in Ethiopia, Kenya, Malawi, Mozambique, South Africa, Tanzania, Uganda and Zambia. The mission of the programs is to develop effective strategies for managing the overlapping TB and HIV/AIDS epidemic in those countries.

William Rodriguez, M.D.

Instructor in Medicine, Harvard Medical School and Brigham and Women's Hospital, Division of Infectious Disease

Dr. Rodriguez is applying microchip technologies to the development of HIV diagnostic tests for use in resource-poor settings. He has been an expert consultant on HIV care for the William Jefferson Clinton Foundation, and has extensive experience in needs assessment, design and implementation of HIV treatment programs in the Caribbean. He is also the Associate Clinical Director for the Vietnam-Harvard-CDC AIDS Partnership, which has developed HIV training materials and curricula, and conducted week-long training courses for physicians and health care personnel in Vietnam.

Issues to be addressed include:

• What strategies limit the spread of the HIV and TB co-epidemics in the developing world? Are we too late?
• What is basic research teaching us about HIV and TB? Are research breakthroughs coming fast enough? Are they being translated into novel treatments quickly enough?
• What is science learning about why these epidemics are occurring? Can the answers be applied to other global public health crises?
• How can the public and private sectors advance initiatives to contain the spread of these infectious pathogens?
• What is the worldwide community of scientists and clinicians doing to improve the public health and scientific capacity of developing nations?

If you would like to attend the symposium, please RSVP by email to biotech@csis.org with your full contact information. Questions can be directed to Adrianne George at (202) 775-3181.

The event will be held in the CSIS conference center at 1800 K Street, NW in Washington, DC. Upon entering the building, please take the elevator down to the B1 level. The closest metro stops are Farragut West on the Orange Line and Farragut North on the Red Line