Report on the 8th European Congress of Clinical Microbiology and Infectious Diseases, Lausanne, Switzerland May 25–28, 1997

This biennial conference is organized by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).More than 5000 people attended the meeting in Lausanne, presenting and discussing a very broad range of topics from right across the field of infection.Multiple parallel sessions at the meeting means that this report is a very personal selection of the oral presentations.These were dominated by invited speakers giving state-of-the-art summaries.A.S. Fauci from NIH set the tone of the meeting in discussing host factors and the pathogenesis of HIV disease.This focused on the role of cytokines and chemokines in determining viral entry into cells and subsequent replication.The difference between the macrophage tropic virus seen early in infection and the T cell tropic virus found later is critical in this respect.IL-10 appears to have the ability, at least in vitro, to suppress replication of the early M tropic virus.This holds the promise of another focus for attack on the virus.A dramatic presentation was made of the results from the WHO register of coinfection with Leishmania and HIV by P. Desjeux.Twenty-one centres across the world report to the register.Visceral leishmaniasis in association with HIV shows worse survival and a poor response to treatment.Thus far 692 cases have been reported and more than 90% are from southern Europe with 60% of them from Spain.Over 90% are young males and 79% are intravenous drug users; 84% have a typical clinical presentation, but the remainder present with atypical symptoms.The organism can be found throughout the body of these individuals, including in the buffy coat of the blood.It may well be that they have increased infectivity.The majority of infections are in patients with a CD4 count of Ͻ0.2 ϫ 10 9 cells/l.Remarkably, the infections in IVD users cluster in time and space, and these individuals have a new zymodeme not previously found in humans, dogs or sandflies.These factors suggest that transmission may be occurring directly from person to person through needle