What Will It Take to Reach “an HIV-Free Future”? Experts Discuss Progress for Smithsonian’s Outbreak Series

NIAID Now | January 29, 2019

In observance of World AIDS Day, HIV experts discussed the future of the epidemic with community members at the Smithsonian’s National Museum of Natural History (NMNH) in Washington, D.C. Co-hosted by the American Society for Microbiology (ASM), “Imagining an HIV-Free Future” on December 4 was one in a series of programs related to the new NMNH exhibition, Outbreak: Epidemics in a Connected World.

All programs in the Outbreak series are free and open to the public, as are entry into the museum and exhibit. Along with other groups involved in the research and control of infectious diseases, NIAID worked with NMNH to develop aspects of the exhibit, where visitors can learn how outbreaks begin and how scientists, veterinarians, health care workers, and public health experts and people in other professions prevent, prepare for and respond to emerging disease threats in an increasingly interconnected world.

At last month’s event, HIV experts tempered expectations for an imminent global end to HIV transmission but shared emerging scientific insights that may propel health systems towards that goal over many years of concerted efforts.

Mark Connors, M.D., chief of the HIV-Specific Immunity Section in the NIAID Laboratory of Immunoregulation, described his team’s work with unique clinical trial volunteers known as long-term nonprogressors, sometimes referred to as “elite controllers,” who maintain low or even undetectable levels of HIV in their bodies without medication. These patients account for about 1 in 500 people living with the virus. Understanding the immunological underpinnings of this rare phenomenon can inform HIV vaccine design, Dr. Connors explained. To this end, his research has shown how nonprogressors’ immune systems can effectively destroy HIV-infected cells. His group has also isolated powerful broadly neutralizing antibodies from people living with HIV. Such antibodies are now being evaluated as a possible HIV prevention and treatment modality in clinical trials.

Seble G. Kassaye, M.D., M.S., of Georgetown University and the NIH-funded D.C. Center for AIDS Research, highlighted the underserved population of U.S. women living with HIV. She explained that while there are many successes to celebrate—such as a 90 percent reduction in perinatal (mother-to-child) HIV transmission in the past two decades—the epidemic presents a significant burden for women. Compared with other demographics, such as white men who have sex with men, women in the U.S. may not be reached by appropriate prevention services, like those that connect women with the HIV prevention drug PrEP. Martin Markowitz, M.D., of the Aaron Diamond AIDS Research Center, explained that researchers, with support from NIAID, are evaluating possible candidates for long-acting PrEP alternatives to a daily pill. View an infographic on long-acting forms of HIV prevention in the research pipeline.

Describing the impact a vaccine and cure would have on the epidemic, Dan H. Barouch, M.D., Ph.D., of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, explained that many key demographics continue to experience outsize rates of HIV infection. These include young women in southern Africa. To address their higher risk, young women are participating in a new large Phase IIb HIV vaccine clinical trial, called Imbokodo, that uses a candidate developed in part by his lab. “Imbokodo,” Dr. Barouch explained, translates to “rock” and comes from a South African proverb emphasizing women’s strength and courage, first used by women activists protesting apartheid in the 1950s. The Imbokodo trial is supported by NIAID, the Bill & Melinda Gates Foundation and Janssen.

Watch the archived event livestream on the ASM Facebook page.

IV activism materials on display for “Outbreak: Epidemics in a Connected World,” at the Smithsonian’s National Museum of Natural History, through 2021.

HIV activism materials on display for “Outbreak: Epidemics in a Connected World,” at the Smithsonian’s National Museum of Natural History, through 2021.

Credit: James Di Loreto, Lucia RM Martino & Fred Cochard, Smithsonian Institution
Outbreak opened on May 18, 2018, and will be available for three years. The exhibition features an “animal market” display where visitors can learn how disease-causing pathogens jump from animals—such as chickens, rodents, or bats—to humans. An Aedes aegypti mosquito replica—400 times larger than life—suspended from the ceiling also serves as an example of a vector, or carrier, capable of transmitting diseases like Zika, yellow fever, chikungunya and dengue fever to humans.

The exhibit also displays colorful, microscopic images of viruses, including some taken at NIAID laboratories, and three-dimensional models of pathogens like E. coli, Zika virus and influenza virus created with free files from NIH’s 3D Print Exchange. Visitors can also explore a timeline of the HIV/AIDS pandemic and case studies of other outbreaks, including SARS, Nipah and Ebola, before playing an interactive multi-player game that simulates a public health crisis.

Content last reviewed on January 29, 2019