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MHRP researchers and Thai collaborators discuss RV254/SEARCH 010, which is providing knowledge about the earliest HIV events that could provide clues to developing an effective HIV vaccine or even help identify ways to achieve a functional cure.

In Thailand, MHRP researchers collaborate with the Thai Red Cross AIDS Research Centre to identify acutely infected individuals and place them onto ART immediately. Researchers have found that this very early initiation of ART results in immune restoration and a very small or undetectable reservoir of HIV DNA, very similar characteristics to “elite” HIV controllers. 

Samples from more than 170,000 individuals have been collected from voluntary testing and counseling clinics in Bangkok. Samples found to be negative with routine testing undergo a Nucleic Acid Test (NAT). More than 340 people have been found to be acutely infected have been enrolled in this cohort, and nearly all of them opted to start ART within days of discovering their status.  

MHRP has begun treatment interruption substudies studies stemming from this cohort as part of an effort to identify effective remission strategies. One of these studies in the RV254 Thai cohort showed that infusion of a bNAb in virally suppressed, early treated volunteers was associated with a modestly delayed rebound of HIV after interruption of antiretroviral therapy (ART). The study was the first randomized controlled trial to demonstrate this effect of VRC01. One of the 13 participants who received VRC01 remained virally suppressed for 42 weeks post-treatment interruption. This study provides the basis for future studies in early treated people with combination bNAbs of higher potency. In addition, researchers will investigate the samples from this study to identify factors that might have contributed to the delay in rebound. MHRP presented findings from the study at the 2017 IAS.

MHRP was a founding member of the International Neurological HIV Cure Consortium (INHCC), an international alliance dedicated to studying HIV’s impact on the central nervous system in the hopes of leveraging those findings to discover a cure for HIV. Using MHRP’s novel acute cohorts, INHCC has launched a number of studies aimed at determining the immediate and long-term cognitive and behavioral impacts of acute HIV infection. 

Protocol Chair: Dr. Sandhya Vasan