Clinical cohorts for HIV remission
The project “Clinical cohorts for HIV remission” will continue and expand ongoing research around the treatment of primary HIV infection (TopHIV) Cohort of patients with acute HIV infection. Beyond studies about their immune responses and reservoir formation, selected TopHIV individuals will be enrolled into interventional clinical trials using immune modulators, such as checkpoint inhibitors or broadly neutralising antibodies, as truly translational research initiatives. Finally, with the support of the Translational Platform HIV (TP-HIV), rare and highly valuable patient groups such as post-treatment controllers, elite controllers as well as control groups of untreated HIV-patients will be identified in a German-wide collaboration network for HIV remission research.
Identification of early HIV infection and immediate start of antiretroviral therapy are attractive strategies to limit HIV viral reservoir formation, to preserve HIV-specific adaptive immune responses, and to prevent viral escape against antibody and cytotoxic T lymphocytes (CTL)-responses.
Patients with early block of HIV replication soon after infection are believed to have better chances for spontaneous immune-mediated control of viral replication in case of ART interruption (“post-treatment controller”) and are preferred candidates for immune interventions in order to achieve a “remission” after interventional procedures such as latency reversing therapies, treatments with broadly neutralising antibodies (bNAbs) or other immune interventions.
TopHIV
With the support of TP-HIV, TopHIV was established to identify and enroll patients with primary HIV infection from partner centres throughout Germany. New treatment strategies are rapidly being tested here. Using interdisciplinary approaches, the research group is investigating, among other things, the formation of the virus reservoir - i.e. of active HI viruses hidden in the body. In doing so, the group focuses on the relationship between congenital or adaptive immune dysfunctions and microbiomal disorders in the digestive tract of patients with acute HIV infection.
The goals of Top-HIV are:
The focus of TopHIV is to identify new therapeutic strategies that allow antiretroviral therapy to be interrupted without the virus load rising again.
The goals in detail:
- To define standard ART combinations for these patients and to collect biomaterials for national and international collaborations;
- Better understanding of reservoir formation, systemic inflammatory response and ART-mediated immune system restoration in the early phase of HIV infection;
- Examination of changes in the intestinal microbiome and mucosal barrier during acute HIV infection.
