HIV/AIDS continues to be one of the top ten causes of death worldwide. In countries with sufficient health care infrastructure, the development of effective antiretroviral treatment has turned HIV infection into a manageable chronic disease. But even with long-term treatment, the virus remains in the body and is re-activated once treatment is discontinued. Unfortunately, even with intensive studies, a preventive vaccine or a cure against HIV is not yet available.
The different economic and epidemiologic situations in developing and developed countries require different research and treatment priorities. Medical doctors in Europe and North-America are now confronted with the clinical consequences of long-term infection and treatment in their patients. In contrast, the focus in developing countries has to be on sustaining and improving existing therapeutic management with limited resources. Despite the country-specific differences, three focus points can be defined in the global fight against HIV/AIDS:
- Prevention of HIV infection
- Long-term life with HIV
- HIV cure
To address these global challenges, the Thematic Translational Unit (TTU) HIV will focus on the following research areas and projects:
- Prevention of long-term infection: In order to find promising targets for preventive measures, the TTU HIV will especially focus on adaptive immunity and restriction factors against HIV: Recruitment of defined patient cohorts (with a focus on elite controllers and acute HIV infection) in Germany and Africa and strengthening the connection between preclinical and translational research; strengthening of networks with the national registry at the Robert-Koch-Institute.
- Long-term life with HIV: Development of new treatment options with a focus on the existing TTU HIV expertise on liver damage and papillomavirus infection: studies on the vaccination of HIV patients against human papillomavirus; investigations on long-term consequences of HIV infection with a focus on liver damage (in collaboration with the TTU Hepatitis); identification of restriction factors of the immune system, important for control of HIV infection.
- HIV cure: Translation of preclinical results to eradicate HIV by excision of proviral genomes from latently infected cells with a modified recombinase, evaluation in small animal models; development of gene therapeutic approaches and examination of proviral integration sites in patient cohorts.
The methodical focus of the TTU HIV is also anchored within the HIV cure research area: visualization of HIV infection in live animal models under biological safety conditions S3. This infrastructure measure will be developed in close collaboration with the TTU Hepatitis and will be made available to other TTUs once established.
Additional infrastructure measures planned by the TTU HIV are the establishment of a professorship for cohort studies of HIV infection, a professorship for gene therapy and a professorship for international clinical studies as well as a young investigator group for preclinical HIV research.
Hans-Georg Kräusslich, Universität & Universitätsklinikum Heidelberg
Gerd Fätkenheuer, Universität & Universitätsklinikum Köln
Michael Hoelscher, Ludwig-Maximilians-Universität München & Klinikum der Universität München