HIV / AIDS

AIDS Research Advisory Committee

The AIDS Research Advisory Committee (ARAC), which consists of leading HIV scientists, advocates and community members, meets three times a year on the NIH campus in Bethesda, Md. to advise NIAID on its HIV/AIDS research programs. ARAC provides broad scientific, programmatic, and budgetary advice; reviews the status of projects managed by NIAID’s Division of AIDS; helps identify critical gaps in research; and reviews/approves all concepts for new NIAID-directed HIV/AIDS research initiatives.

 The NIAID Office of Cyber Infrastructure and Computational Biology (OCICB) distributes bioinformatics software designed for and by NIAID investigators on the Exon Web site. The bioinformatics software on the Exon Web site includes tools for visualizing and analyzing complex genomic data. The applications on the Exon site are used by subject matter experts in the biological sciences at NIAID and are freely distributed to the public scientific community.
In addition to the bioinformatics applications on the Web site, Exon has also been used to host complex supplemental data at the request of NIAID investigators, including 3-D visualizations of mosquito swarms and transcriptomes for insect vectors of infectious diseases.

NIAID supports six clinical trial networks that conduct domestic and international human studies focused on the institute’s highest HIV/AIDS research priorities including:

• New HIV prevention methods
• Vaccine research and development
• Microbicides to prevent HIV acquisition and transmission
• Strategies to prevent mother-to-child HIV transmission
• New drug development and optimizing clinical management of HIV/AIDS, including co-morbidities.          

HIV prevention is not a one-size-fits all approach. To be successful, we must understand the sociocultural factors that contribute to HIV risk or protection, particularly among communities at greatest risk for HIV infection. NIAID is developing and testing behavioral interventions focused on men, women and adolescents at high risk for HIV infection and interventions geared toward people infected with HIV to reduce their risk of transmitting HIV to others. The strategies under investigation are multifaceted and include HIV counseling, testing for HIV and sexually transmitted diseases, substance abuse and mental health screenings, and referral for medical treatment and care.

One of NIAID’s greatest success stories is that its research led to the development of numerous antiretroviral drugs to treat HIV/AIDS turning what was once a uniformly fatal disease into a manageable chronic condition for many. Currently, there are 31 FDA-approved antiretroviral drugs available to people infected with HIV. Although these medications have enabled people infected with HIV to lead longer and healthier lives, drug resistance, tolerability and toxicity remain issues for some patients. NIAID is working to find new and more effective therapeutic products, drug classes, and combinations as well as safe and effective treatments for dangerous AIDS-related co-infections, such as hepatitis, malaria and tuberculosis.
NIAID is also exploring therapies that suppress the amount of HIV to such low levels that an HIV-infected person would no longer need treatment because his or her immune system could keep the remaining virus in check, creating in essence a “functional cure.”

Currently, women make up half of all people worldwide living with HIV. Many women are not in a position to refuse sex or negotiate condom use with their male partners, leaving them vulnerable to HIV infection. To provide women with an HIV prevention tool they can initiate, NIAID is testing microbicides — gels, foams or creams — that can be applied topically inside the vagina to prevent sexual transmission of HIV and other sexually transmitted infections. NIAID is also researching topical microbicides that can be applied rectally to prevent HIV infection among men who have sex with men.

Historically, vaccines have been our best weapon in the fight against mankind’s worst infectious diseases, including smallpox and polio. HIV, however, is different from other infectious diseases in that the human body seems incapable of mounting an effective immune response to block the virus from progressing to disease. Further, there is not one documented case of anyone being truly cured of HIV infection. NIAID is conducting fundamental research to better understand how the HIV interacts with the human immune system and is testing the most promising vaccine candidates when scientifically appropriate. And although a vaccine to prevent HIV infection remains the goal, NIAID is also examining vaccines that could significantly alter the course of disease and infectiousness of people infected with HIV, which could provide positive health benefits both for infected individuals and the larger community.