AIDS research symposium details advances

Harvard AIDS researchers detailed recent advances in the fight against the ongoing global pandemic Wednesday (June 24), including new vaccine strategies, insights into the disease’s progression in the world’s hardest-hit regions, and new knowledge about the body’s immune response against infection.

The presentations were part of the Harvard University Center for AIDS Research’s (CFAR) 9th Annual Symposium, highlighting recent research by investigators supported by CFAR and by the Harvard Initiative for Global Health’s (HIGH) Global Infectious Disease Program.

Harvard CFAR Director Bruce Walker, a professor of medicine at Harvard Medical School, director of the Ragon Institute of MGH, MIT and Harvard, and co-chair of the Global Infectious Diseases Program at HIGH, introduced the event.

Walker tracked the evolution of Harvard’s Center for AIDS Research, which is part of a national program funded by the National Institutes of Health that created similar centers around the United States. Walker outlined achievements of the past five years, saying that the center has successfully fostered collaboration among researchers at the University and served as a catalyst for research into AIDS and HIV.

Over the past five years, Walker said, CFAR has given 73 awards to researchers, many of which were for early feasibility studies or for support of scholars in the early stages of their careers. The majority of the awards, 82 percent, went to junior investigators — assistant professors and below. The early financial support from CFAR, totaling $1.8 million, brought in $54 million in subsequent grants and led to 72 publications.

The symposium featured presentations from eight investigators whose work spans everything from stigma in central Haiti to RNA interference to the behavior of the immune system’s natural killer cells.

Ingrid Bassett, an instructor in medicine at Harvard Medical School and Massachusetts General Hospital, outlined several research efforts, including one evaluating the efficacy of separate voluntary counseling and testing (VCT) clinics in South Africa.

South Africa, Bassett said, is one of the nations hardest hit by AIDS and is home to the largest number of HIV-infected people in the world, with 5.4 million. The South African government has rolled out an antiretroviral drug program with the voluntary counseling and testing sites as its point of entry. The problem, however, is that the VCT program doesn’t seem to be working very well, with just 30 percent of South Africans having been tested for HIV.

Bassett and colleagues at McCord Hospital in Durban, South Africa, examined the potential effectiveness of a testing program that was offered as part of routine care. The alternative would offer patients a test during their regular doctor visit, rather than referring them to a VCT clinic, which requires them to make a second visit to attend the clinic and get HIV testing and counseling. The results, she and colleagues found, were a fivefold increase in the detection of new HIV cases per week in the routine testing program, to 39 from eight for the VCT program.

The trial, Bassett said, shows that a routine testing program not only uncovers more HIV cases, it also indicates that such a program is acceptable to patients.

“People are seeing … that this is just part of regular care,” Bassett said. “Incorporating it into general care makes people feel it’s routine.”

Dan Barouch, associate professor of medicine at Harvard Medical School and Beth Israel Deaconess Medical Center and director of the Harvard CFAR Vaccines Program, described the challenges faced by vaccine researchers and recent work toward creating a vaccine that would have the breadth necessary to immunize against HIV. HIV, Barouch said, presents one of the biggest challenges in vaccine creation ever faced by science because it mutates so quickly that the virus is different in different places around the world. That creates a problem because a vaccine that is effective in one place may not be elsewhere.