John Y. Killen, M.D.,
Director, DAIDS
This open meeting was held on January 30 in the Executive Board Conference Room at the Natcher Conference Facility, located on the NIH campus, and was chaired by Dr. Ashley Haase, Chairman of ARAC. Dr. Killen opened the meeting by welcoming three new members of the AIDS Subcommittee and ARAC, Drs. Jerrold Ellner, Paula Pitha-Rowe, and W. Gary Tarpley. He then presented his Director's report, beginning with the announcement that NIH had received an overall budget increase of 5.6 percent, with an increase of 6.7 percent for NIAID, and that this funding had been secured for NIH throughout the remainder of the year. He announced that Dr. Johnston, Deputy Director of DAIDS would be leaving very soon and thanked her for her many contributions to the Division. He then mentioned two recently released documents: the second edition of the NIAID HIV/AIDS Research Agenda, which describes the current status of research needs and priorities and serves as a tool for evaluation and prioritization, and a paper entitled ANIAID HIV/AIDS Vaccine Research and Development: Strategy and Opportunity,@ that describes the Institute's strategic approach to achieving the goal of a safe and effective HIV vaccine. Dr. Killen emphasized that partnerships with the public and private sectors are critical, and that NIAID supports a wide range of activities that make major contributions in the fields of vaccine research and development. He stated that the Institute intends to negotiate development plans for vaccine candidates with industry partners. Next, Dr. Killen discussed events surrounding anti-retroviral therapy and the role NIH played in its development, the ongoing program review and evaluation activities taking place in the Division, and the remaining research awards made in fiscal year 1995.
Status of Perinatal HIV Transmission Research -- Dr. James Balsley, Dr. Gwendolyn Scott, and Dr. Kenneth McIntosh
In association with the presentation of two FY`97 research concepts later in the meeting, Dr. Balsley opened this session by stating that the goal of NIAID research in pediatric disease is to identify and support development of improved interventions to prevent and treat HIV infection and its sequelae in infants, children, and adolescents. He then introduced two expert researchers in this field.
Dr. Scott addressed natural history, mechanisms of transmission, and risk factors associated with perinatal infection. Two notable statistics she quoted in her presentation were: (1) that for each of the 6,000 cases of AIDS reported in children in mid-1995, there were an additional 2-3 HIV-infected children who did not meet reporting criteria, and (2) that AIDS is the fourth leading cause of death in children ages 1-4 in the U.S.
Dr. McIntosh's presentation focused on potential intervention approaches, particularly the prevention of vertical transmission in relation to what is now known about pathogenesis. Discussions with the committees included risk of transmission to the mother during breast-feeding, vaccine clinical trials, passive immunization, monoclonal candidates, and the role of ruptured membranes.
Dr. Balsley introduced the first two concept presentations by describing NIAID's large portfolio of work, both national and international, directed at reducing the perinatal HIV-1 transmission rate and developing a regimen that is effective, inexpensive, and deliverable to large numbers of women worldwide.
Concept Review: Women and Infants Transmission Study (WITS) -- Dr. Mary Glen Fowler
The WITS is a collaborative, multi-center effort aimed at determining factors related to HIV transmission and disease progression in HIV-infected pregnant women and their offspring. This particular initiative will support longitudinal clinical, virologic, and immunologic evaluations, as well as an extensive repository of maternal and infant blood specimens in an effort to develop more targeted prevention and therapeutic strategies within the U.S.. The concept was approved.
Concept Review: Prevention of Perinatal HIV-1 Transmission - International Trials -- Dr. Mary Glen Fowler
The objectives of the international trials initiative are to assess cost-efficient approaches designed to prevent perinatal HIV transmission feasible in international settings, and to further the understanding of the mechanisms of mucosal transmission. This prevention research complements perinatal trials in the AIDS Clinical Trials Group in the United States and builds on international perinatal studies currently underway. The concept was approved.
In the context of the discussion of this initiative, concerns about the HIVNET's (HIV Prevention Trials Network) scope of research were raised. Dr. Killen agreed with several members' suggestion that an independent review of HIVNET was in order, and would be pursued.
NIAID Approach to Acute HIV Infection and Early Disease - Introduction-- Dr. John Y. Killen
Dr. Killen presented NIAID's research priorities regarding acute infection, including: (1) examination of the influence of viral and host factors on disease course and (2) early intervention.
Concept Review: Acute Infection and Early Disease Research Network -- Dr. Carla Pettinelli
The Acute Infection and Early Disease Research Network initiative will support innovative, integrated, investigator-initiated research on acute and early HIV-1 infection. It will support both single-center and multi-center clinical trials to intensively examine acute/early infection pathogenesis and perform in-depth studies on factors that influence response to interventions. The concept was approved.
Concept Review: National Cooperative Drug Discovery Groups for the Treatment of HIV Infection (NCDDG-HIV) -- Dr. Nava Sarver
The NCDDG-HIV initiative focuses on innovative, high-risk research not pursued or minimally pursued by the private sector, and strongly encourages industry participation. This initiative will continue the support for multi-component, multi-disciplinary groups exploring new targets and the use of targeted assays to discover new therapies for HIV. Each new group will pursue or focus on a self-defined therapeutic approach or target(s) with the goal of transferring basic research findings and therapeutic leads to the private sector for further development. The concept was approved.
[Please phone Ms. Anne P. Claysmith, Executive Secretary, ARAC, at 301/402-0755 if you wish to receive a copy of the ARAC/AIDS Subcommittee Joint Meeting Summary via FAX.] back to top |