2016 HIV Cure Summit
Investigators at amfAR Institute for HIV Cure Research deliver progress report
Exactly 12 months since amfAR established its Institute for HIV Cure Research, Institute researchers reported on their progress at the 2016 World AIDS Day HIV Cure Summit, December 1. The Summit was held at the University of California, San Francisco, where the Institute is based.
“I’d like to thank our entire San Francisco community and especially the people living with HIV that are here with us today,” said Institute Director Dr. Paul Volberding, a professor of medicine at UCSF, in his opening remarks. “Because we want to move as quickly as possible towards a cure, our involvement with the community is especially important.”
Dr. Volberding is a pioneering HIV/AIDS physician and researcher who encountered his first AIDS patient on his first day of work at San Francisco General Hospital (SFGH) in July 1981. He was a founder of one of the nation’s first AIDS-designated clinics in Ward 86 at SFGH and helped develop the San Francisco Model, a comprehensive HIV treatment model that was emulated around the world.
A Cornerstone of HIV Cure Research
“The Institute forms the cornerstone of our cure research efforts,” said amfAR CEO Kevin Robert Frost. “We’ve made a commitment to invest $100 million in cure research over the next five years and in the first year alone we’ve already committed $40 million to this effort. The Institute represents about $20 million of that.”
Frost said there was broad consensus in the scientific community that the barrier to achieving a cure is overcoming the persistent HIV reservoir. He introduced a series of five short animated films that amfAR has created in an effort to explain the significance of the reservoirs and the challenges involved in locating and depleting them.
The summit was organized around the four research modules that form the structure of the amfAR Institute and that each relate to the HIV reservoir: Chart, Understand, Record, and Eradicate.
Dr. Peter Hunt reported on the efforts of his team to chart, or pinpoint, the precise locations of the reservoir. Dr. Hunt’s team is the first to have generated data showing the different cell types that are expressing virus in tissues. In an effort to identify signatures of latently infected cells in tissues, the researchers are using a kind of “facial recognition software for the HIV reservoir.” This sophisticated technology– CyTOF – uses 38 markers to form a multidimensional description of the cells’ surface.
“Shock and Kill”
Dr. Warner Greene leads the “Understand” module, which is focused on a cure strategy called “shock and kill.” His team is working to identify agents that can effectively “shock” the virus out of hiding so that it can be killed by the immune system or interventions such as a therapeutic vaccine or broadly neutralizing antibodies.
Dr. Greene’s primary focus is on stimulators of the body’s innate immune response called toll-like receptors. “These are the first line of defense – the first barrier,” he said. “What we’re trying to do is to stimulate that response because it magically influences the adaptive immune response – the antibody production and CTL formation. Stimulating these receptors is like the adjuvant that makes vaccines more potent. Maybe if we combine a toll-like receptor agonist with a vaccine, we can make the vaccine more potent, and ideally the toll-like receptor will also act as a shocking agent and make the cells visible for a more efficient attack by the vaccine.”
Dr. Satish Pillai and his team are charged with recording, or measuring, the size of the persistent HIV reservoir. Dr. Pillai and his colleagues are developing highly sensitive tools that are more effective at identifying tiny amounts of residual virus—as few as ten in a million cells may be infected in a person on antiretroviral therapy. “We’ve teamed up with a company called Raindance Technologies to develop a strategy to identify HIV nucleic acids in clinical samples with unprecedented sensitivity,” Dr, Pillai said.
Testing Cure Interventions
Dr. Steven Deeks, who leads the “Eradicate” module, aims to take the experimental interventions developed by Institute researchers and test them in clinical trials. “My job for the past year has been to help develop an infrastructure and get all the protocols in place to begin to do studies in people. We’ve done that. And now we’re set to start doing clinical studies of some of the ideas that are coming out of the institute.”
Approximately 200 people attended the half-day summit, which concluded with a lively panel discussion involving all of the presenters along with veteran HIV treatment advocate Matt Sharp.
The researchers’ presentations are available here:
Introduction/Overview – Dr. Paul Volberding
Professor of Medicine, UCSF
Director, UCSF AIDS Research Institute
Co-Director, UCSF-Gladstone Center for AIDS Research
Chart – Dr. Peter Hunt
Associate Professor, Division of Experimental Medicine
Understand – Dr. Warner Greene
Director and Nick and Sue Hellmann Distinguished Professor of Translational Medicine
Gladstone Institute of Virology and Immunology
Professor of Medicine, Microbiology and Immunology, UCSF
Co-Director, UCSF-Gladstone Center for AIDS Research
Record – Dr. Satish Pillai
Associate Professor of Laboratory Medicine, UCSF
Associate Investigator, Blood Systems Research Institute
Eradicate – Dr. Steven Deeks
Professor of Medicine