Speakers at NIH's 2018 World AIDS Day event shared how far HIV basic research has brought the field and where we are headed. Basic scientific research led to the identification of the HIV virus, paving the way for many breakthroughs in treatment and prevention. Event moderator Dr. Carl Dieffenbach,National Institute of Allergy and Infectious Diseases, noted, "[The] bricks of basic science [knowledge] make up the blocks and foundations upon which we create vaccines and medicines to prevent and treat diseases."
Dr. Larry Corey, Principal Investigator, HIV Vaccine Trials Network, President and Director Emeritus, Fred Hutchinson Cancer Research Center, described the need for a vaccine to curb the 5,000 new HIV infections per day globally. He addressed some key challenges, noting that, "The genetic diversity [of HIV] is greater than [that of] any other pathogen." Dr. Corey observed that vaccine-related research in antibodies has "revolutionized our understanding of the immune response."
Dr. Avindra Nath, National Institute of Neurological Disorders and Stroke, addressed the challenges posed by "reservoirs" in the brain where latent HIV virus remains, even for those whose virus is suppressed by antiretroviral therapy (ART). He described research approaches to either silence the reservoir or to draw the virus out—"kick and kill"—so that the virus can be eliminated entirely.
Dr. Daniel Appella, National Institute of Diabetes and Digestive and Kidney Diseases, explained that HIV can find its way around treatment, eventually leading to drug resistance to ART. He described the molecule 247, or mercaptobenzamide, which appears as effective as other available drugs and is inexpensive to produce. So far, scientists have not been able to generate molecule 247–resistant HIV strains. In addition, it can be delivered topically or via a contraceptive ring.
Dr. Dima Hammoud, Center for Infectious Disease Imaging at the NIH Clinical Center, described how molecular imaging has contributed to HIV science. Molecular imaging is the noninvasive, real-time visualization of biological processes at the molecular and cellular levels in a living subject. One type of molecular imaging—positron emission tomography, or PET—has been used to deepen understanding of the effects of HIV on the brain and central nervous system.
Jeffrey Crowley, Georgetown University Law Center, described how basic HIV science and research formed the foundation for the original National HIV/AIDS Strategy (NHAS) in 2010. Significant scientific progress against HIV has been made since the Strategy was implemented, thereby reinforcing the Strategy's direction and emphasizing the importance of early initiation of HIV treatment.
Dr. Patricia Flatley Brennan, Director, National Library of Medicine (NLM), highlighted the importance of HIV/AIDS in the medical literature and NLM's role in cataloging HIV publications and making them widely available. The NLM houses data from more than 6,500 HIV clinical trials and collects and catalogs HIV research data, including data on HIV protein structures and mutations, a human HIV-1 database, and population surveillance information.
Interestingly, the NLM HIV-1 sequence database was an essential tool in designing one of the vaccines that Dr. Corey described in his presentation. This is a perfect example of how the NLM's Lister Hill Center provides valuable tools to the research community.
Watch the event video.