The Acute HIV and the HIV Eradication Programs at the University of North Carolina are dedicated to developing and conducting research involving acute HIV infection (AHI) and new developments towards the eradication of HIV.
The UNC AHI program facilitates immediate access to care and provides clinical trials to persons diagnosed with AHI. (More information about AHI) In 1998, UNC collaborated with Duke University (Durham, NC) and Emory University (Atlanta, GA) to research the detection of AHI and treatment possibilities linked to HIV infection detected in the acute phase. Studies looked at the potential benefit of antiretroviral therapy initiated during the earliest stage of HIV infection. In November of 2002, the UNC AHI program in collaboration with the North Carolina Department of Health and Human Services, Division of Public Health, Communicable Disease branch and the North Carolina State Laboratory of Public Health, instituted the Screening and Tracing Active Transmission (STAT) program which utilizes HIV RNA testing of antibody negative specimens from publicly-funded testing sites to identify acute HIV infections. Disease intervention specialists (DIS) provide urgent notification, confirmatory testing, contact tracing, and immediate referral to specialty medical care. UNC continues to work with the state of NC to detect, evaluate and treat individuals diagnosed with AHI throughout the state of North Carolina. (View open AHI studies)
In 2006 UNC became a clinical site for Duke University’s HIV Vaccine Development Grant entitled the Center for HIV/AIDS Vaccine Immunology (CHAVI). As part of CHAVI, the UNC AHI program enrolls acutely infected subjects into an ongoing observational study for the purpose of studying the biology of HIV-1 transmission and developing new vaccine strategies to overcome key immunological roadblocks in HIV vaccine design. The CHAVI program is still actively pursuing the development of an HIV vaccine, the active enrollment of participants into clinical trials ended in December 2011.
The AHI program is committed to community outreach, continuing education and consultation for health care providers. As we enter the third decade of the HIV epidemic, the UNC AHI Program remains committed to the development of new strategies to detect and prevent the spread of HIV infection.
In 2010, HIV eradication studies under the direction of Dr. David Margolis opened at UNC. This research focused on eradication is still in the early phases. Much of the analysis and data to date has been obtained from ex vivo studies, as well as a few Phase I clinical trials.
Despite having highly effective medication to treat HIV infection; the medication, alone, is incapable of eradicating the virus. When HAART is stopped, viral replication re-emerges. The recent focus of research lies in the identification, activation and elimination of the CD4 resting cells (View open Eradication studies) Scientists at UNC are looking at various ways to express the virus from the latently infected cells. One drug being studied is called Vorinostat (SAHA). Dr. Margolis, in a proof of concept study, demonstrated significant increase in the expression of viral RNA when SAHA was given in a clinical trial.
Although this was an enormous breakthrough, there are many questions that remain unanswered. There continues to be ongoing research in this field. UNC is also looking at combining the activation and expression of the virus from the latent cell with other therapies.