Meeting Purpose and Background
Many countries have made progress in reducing new HIV infections through comprehensive prevention efforts, but despite their proven effectiveness of the prevention techniques, they have failed to halt the global HIV epidemic. A safe and effective HIV vaccine is the best long-term solution.
An HIV vaccine will likely be derived from an understanding of what defines protective immunity. With the failures to date of HIV vaccine trials, it is apparent that the research community still lacks an adequate understanding of what constitutes correlates of protection against HIV infection. Many research groups seek to identify the mechanisms of protection in subjects who are HIV exposed yet remain uninfected (EU), including highly exposed-persistently seronegative male and female sex workers (HEPS), highly exposed male and female intravenous drug users (EU-IVDU), discordant male and female couples (EU-DC), and patients accidentally exposed to HIV via blood products (EU-BP).
Research on EU groups has identified potential correlates of protection. However, the development of correlates has been hampered by small sample sizes and inconsistencies in the assays and approaches used. The small scale of the studies, both in terms of numbers of individuals studied and the parameters examined, is a primary reason for slowness in the advance of knowledge on the targets of protective immune response to HIV. The result is an inability to compare epidemiological and laboratory data among the investigators conducting these studies.
In order to show conclusively whether or not a genetic factor is important in mediating resistance to infection, researchers need to combine large data sets that include as many EU subjects as possible, and they need to replicate those findings in other populations. Researchers need to take the same approach in order understand the biologic role of innate and adaptive responses to HIV and what role they play in mediating protection.
Further, it has become apparent that protection against HIV infection is likely multi-factoral. Several unique correlates of protection have been identified and in some cases confirmed by a number of investigators. It is probable that protection from HIV infection likely involves many factors acting either alone or in concert. The relative contribution of each factor cannot be assessed unless a comprehensive, systems biology approach is utilized, which requires large samples sizes. Knowledge could be accelerated if researchers on EU groups as well as thought leaders from related specialties such as genetics, immunology and systems biology could come together to collectively examine current knowledge and obstacles relevant to HIV immunity.
The International Symposium on Natural Immunity to HIV is launching this partnership through the sharing of current knowledge and hypotheses on HIV immunity and determining how to accelerate scientific advancements through collaboration. In partnership with the Public Health Agency of Canada and the University of Manitoba, the International Centre for Diseases is hosting a worldwide event that will bring together top researchers from around the world to share research and form collaborations. This event, titled the “International Symposium on Natural Immunity to HIV” (ISNIH), will be held in Winnipeg, Canada, November 15-17 2009. Although individual meetings such as the proposed Symposium have immediate value, they have limited long-term impact. Supporting and sustaining collaborations will be paramount to maximizing the benefit of the research discoveries and expediting solutions. Therefore, a consortium on natural immunity to HIV will be proposed and discussed at the Symposium as a mechanism to encourage and sustain collaboration. This consortium will assemble the approaches and considerable data generated by individual investigators over the past 20 years to develop an understanding of what constitutes natural immunity to HIV infection. As well, it will alleviate current roadblocks to understanding the results of findings in EU cohorts by providing a large, robust research platform upon which prospective correlates of protection can be assessed.
The potential goal of the consortium will be to enable international collaborations to study the immunological and genetic correlates of protection in HIV exposed but uninfected individuals to inform vaccine development. As well, the research may lead to other insights into HIV pathogenesis that will enable the design of microbicides and possible therapeutic agents.
The consortium model has been very effective in advancing scientific discovery in a number of areas of HIV research. For example, the HIV Controller Consortium is an international collaboration to examine the immune responses to HIV that elite controllers generate. The goal of these studies is to provide insights that will help define the crucial parameters present in persons who are able to control HIV infection. These findings could assist in the development of vaccines and new therapies. Another example is the International AIDS Vaccine Initiative’s Neutralizing Antibodies Consortium which works to speed the discovery of a vaccine to prevent HIV/AIDS through collaboration on one of the field’s most enduring challenges - stimulating the human immune system to make broadly neutralizing antibodies against HIV. The proposed consortium on natural immunity to HIV could model these successful consortiums to achieve the common goal of expediting research results.
Symposium Goals, Objectives, Outputs and Outcomes
The goals of the Symposium are two-fold: to share knowledge and enhance collaborations; and to establish the parameters for the formation of an international consortium on natural immunity to HIV.
The objectives of the Symposium:
- Establish the baseline of current knowledge on correlates of HIV protection.
- Identify research gaps and collaborative opportunities.
- Set an international research agenda.
- Establish the terms of reference and structure for an international consortium on natural immunity to HIV.
The outputs of the Symposium:
- Publication of one or more papers to capture the literature review, conference proceedings and future directions.
- Creation of new research collaborations.
- Creation of an e-community/network through an interactive website.
- The creation of an international consortium on natural immunity to HIV.
The outcomes of the Symposium:
- Establishment of the international consortium on natural immunity to HIV.
- New and expanded international collaborative research activities.
- Advancement in scientific knowledge on correlates of HIV protection.
- Improved knowledge translation and dissemination of research findings.
- Acceleration of knowledge on vaccine development strategies.