With this quarterly newsletter, we hope to keep you updated about advances in HIV cure research and exciting study opportunities for people living with HIV (PLWH) at the UC San Diego Antiviral Research Center Headquarters (AVRC HQ), as well as inform you about the scientific progress that continues to be made towards ending HIV. We’re looking forward to this opportunity to connect with you!
PERTURB Study
This quarter, our featured study is PERTURB, for PLWH. The purpose of the study, officially called “Perturbing the HIV Reservoir with Immune Stimulation,” is to determine the impact of the pneumonia and influenza vaccines on perturbing or disrupting the HIV reservoir, which is the small amount of HIV virus that remains in the body even after undetectable status has been reached with use of antiretroviral therapy.
Participants will be given three injections in a randomized and blinded order over the course of 28 weeks: one influenza vaccine, one pneumonia vaccine, and one placebo. Participants would have already received these vaccines as part of their routine care. After the vaccination, participants will then be monitored at regular time intervals after the injections are given to determine if the vaccines have any effect on the HIV reservoir. Study participants may qualify for up to $600 total in financial compensation. You may be eligible to participate if:
- You have been on treatment for HIV for at least one year
- You are between the ages of 18-65
- You are not allergic to any study vaccines
The lead scientist for this study is Dr. Davey Smith. To chat with the AVRC screening coordinator about enrolling in the study, please call 619-543-8080. You can also read more about the study here: https://clinicaltrials.ucsd.edu/trial/NCT02707692.
Working Towards a Cure
Although major strides have been made in the treatment of HIV, and we know that PLWH who are undetectable cannot pass on HIV through sex (undetectable = untransmittable), Dr. Davey Smith, UCSD's Chief of Infectious Diseases and Global Public Health, stressed the importance of continuing to search for a cure in a recent High Rounds presentation.
In 2017, 1.8 million people acquired HIV. This represents an 18% decrease in new cases of HIV since the year 2010, which speaks to the effectiveness of new prevention tools like PrEP, as well as the power of undetectable = untransmittable. However, we believe that 1.8 million new cases per year, in addition to nearly 37 million PLWH worldwide, is more than enough reason to continue the battle towards finding a cure.
Stigma continues to be one of the greatest barriers in the fight against HIV. In 2017, it was estimated that 75% of PLWH knew their status, of which, 79% of those people were undergoing treatment and 81% of those were undetectable. Dr. Smith discussed how PLWH internalize stigma. Patients have said things like “I feel dirty” and “I deserve it.” Dr. Smith made clear that ending the negative effects of internalized stigma for PLWH, even if they are undetectable, is one of his principal motivators for finding a cure. He noted that there are three main methods currently being explored to cure HIV. One approach involves eliminating latency, or the reservoir of HIV that remains in the body even after undergoing antiretroviral therapy; the second involves enhancing our own immune system’s response to HIV, allowing our immune system to fight HIV itself; the third involves making our own cells resistant to HIV. These approaches continue to be promising pathways towards a cure and will be explored further in future newsletters.
Last Gift Study
Dr. Smith also presented some information about the Last Gift Study at AVRC HQ. The Last Gift Study is committed to understanding the behavior of HIV in the human body. PLWH who have less than six months to live due to a terminal illness are eligible to participate. One of the primary aims of this study is to identify where HIV hides in a person living with HIV. This study is intended for eligible individuals who are willing to consider providing consent to frequent blood draws and a full body donation in the event of death. You can learn more about the study here: https://lastgift.ucsd.edu/
In addition to helping researchers understand where HIV resides in the body in someone who has undergone antiretroviral therapy, the Last Gift Study is shown to provide deep societal and psychological benefits for study participants. Altruism, or a selfless concern for others and a desire to help them, was the main motivator to participation – participants and their family members displayed a sophisticated understanding of the study and its goals, and participants expressed a sense of meaning and purpose by engaging in the study. The affirming, uplifting impact that study participation had on those enrolled also encourages the continued development and exploration of research that focuses on HIV behavior at the end of a person’s lifetime – such research could not only contribute valuable findings towards an HIV cure, but also helps PLWH know that they are making important contributions to future generations at the end of their lifetime. To quote one study participant, “I’m grateful for the opportunity to do something that will make all this meaningful (…) I’m glad I can provide a voice and open dialogue for people to talk about mortality, talk about how their lives can benefit others, and find meaning in all of this.”
We look forward to continuing to update you about the exciting HIV research happening at UC San Diego, and the progress that continues to be made toward finding a cure for HIV.
If you have any questions or comments pertaining to the Cure Registry Newsletter or one of the AVRC's research studies, please email avrcmarketing@health.ucsd.edu.