Stopping the HIV epidemic remains one of the top global health priorities. Since the beginning of the epidemic, the World Health Organization (WHO) estimates that more than 70 million people have been infected with HIV and about 35 million people have died. At the end of 2017, an estimated 36.9 million people were living with HIV due to continued new infections and individuals living longer due to greater access to antiretroviral treatment. Highly active antiretroviral therapy (HAART) limits HIV replication, which subsequently improves health and prolongs the life of HIV-infected individuals. However, HAART is not curative and does not eliminate the virus from the body. HAART cessation is invariably followed by rapid recrudescence of viral replication and progression to AIDS in all but the rarest of cases. Thus, HAART requires lifelong adherence, which many patients find challenging due to side effects, need for strict adherence, resistance, stigma and cost. Because of these limitations, a safe and effective vaccine remains the best hope of controlling the HIV epidemic.
Rhesus macaques develop a disease that closely mimics human acquired immunodeficiency syndrome (AIDS) when infected by simian immunodeficiency virus (SIV) or chimeric simian-human immunodeficiency viruses (SHIV), and represents the best animal model for HIV infection. Given the remarkable similarity of the immune systems of macaques and humans, preclinical vaccine development is heavily dependent on the SIV and SHIV macaque models.
At the ONPRC, we study the immune response to HIV infection using these valuable animal models. Scientists at the Center are at the forefront of those discoveries, learning how both antibodies and killer T cells contribute to control and how these immune responses might be best generated by vaccination. Although a fully effective vaccine is still years away, we are making great strides toward defining the kinds of vaccines that can work to help control or prevent infection.
In addition to HIV vaccine development, a curative approach for HIV infection is now recognized as both a necessary and attainable goal. Indeed, the International AIDS Society Working Group on HIV Cure recently set forth seven key scientific priorities for HIV cure research, one of which was the identification of anatomical and cellular sources of viral persistence in physiologically relevant animal models such as SIV-infected rhesus macaques. At the ONPRC, we are answering this call by defining viral reservoirs during HAART and designing novel approaches to eradicate the virus.