Division of Acquired Immunodeficiency Syndrome
Encyclopedia
The Division of Acquired Immunodeficiency Syndrome (DAIDS) is a division of the National Institute of Allergy and Infectious Diseases
which is part of the National Institutes of Health
. It was formed in 1986 as a part of the to address the national research needs created by the advent and spread of the HIV
/AIDS
epidemic. Specifically, the Division’s mission is to increase basic knowledge of the pathogenesis, natural history, and transmission of HIV disease and to support research that promotes progress in its detection, treatment, and prevention. DAIDS accomplishes this through planning, implementing, managing, and evaluating programs in (1) fundamental basic research, (2) discovery and development of therapies for HIV infection and its complications, and (3) discovery and development of vaccines and other prevention strategies.
and transmission. HIV pathogenesis research also supports studies of how the immune system responds to the virus. Knowledge gained from these studies enhances the ability of researcher
s to create new agents and vaccine
s to combat HIV infection.
The Division supports a large portfolio of investigator-initiated grants that are pursuing research focused on, but not limited to, the following areas: mechanisms of viral entry and infection, including the role of co-receptors and other cellular accessory molecules; the structure, function, and mechanism of action of viral gene
s and protein
s; development of in vitro and ex vivo assays to monitor virus growth and immune responses against HIV, and animal models for research on the regulation and function of viral proteins and genetic regulatory sequences; the immunological and virological events controlling primary infection; factors effecting latent reservoirs of HIV; and host factors that modulate viral infection and/or disease progression.
The Division's basic research efforts have yielded significant scientific information about HIV. For example, in recent years, DAIDS-funded investigators have identified new structures for viral components of HIV, additional chemokine
co-receptors, and the existence of multiple, persistent HIV reservoirs even with the use of highly active antiretroviral therapy (HAART). Despite these advances, questions still remain about the molecular interactions involved in the regulation of HIV expression and replication. More information is also needed about how the virus evades the immune system in order to identify additional targets against which therapeutic interventions and vaccines can be directed.
s (OIs) are discovered through a number of approaches beginning with basic research on the structure and function of viral and cellular proteins critical to the virus life cycle.
In order to foster drug development of new HIV therapies, DAIDS supports research on potential new cellular and viral therapeutic targets and new approaches to validate targets; molecules that could effectively block HIV replication; improved formulation of existing agents; approaches to restore the immune system of HIV-infected individuals; molecular and genetic approaches to protect susceptible, uninfected cells; combination regimens that impede the emergence of viral resistance; and assays to measure restored immunity of HIV-infected individuals.
The evaluation of new drugs and therapeutic agents in people is another critical aspect of therapeutic research. These clinical studies define which new agents are effective against HIV and its associated OIs and also clarify how best to use these drugs.
DAIDS-sponsored therapeutics research has already had a dramatic impact on our understanding of the pathogenesis and clinical management of HIV infection over the last decade. Studies conducted by DAIDS-funded clinical trials research networks have:
More recent studies have shown that highly active antiretroviral therapy-regimens including reverse transcriptase
and potent protease inhibitor
s-are capable of suppressing HIV viral load to undetectable levels in many infected individuals and partially restoring immune function. Such regimens have had a dramatic impact on HIV mortality in this country.
Nonetheless, treatment failures occur as a result of the development of resistance and/or noncompliance with complicated and often toxic regimens. Moreover, damage to the immune system is incompletely reversed. Thus, there is an ongoing, urgent need for new therapeutic agents and new ways to boost the immunity and rebuild and replace immunity lost to HIV infection. In addition, strategies to address critical questions regarding the long-term effects of antiretroviral therapy and the best approaches to medical management are being developed.
Through a balanced HIV program that integrates both basic research and empiric testing of candidate vaccines, NIAID supports a broad spectrum of research and development on HIV/AIDS vaccines. Preclinical vaccine research and development examines new vaccine concepts or approaches and new ways to deliver HIV antigens to people and to safely induce a potent anti-HIV immune response. Studies in animal models are aimed at defining how a vaccine could protect the host. For now, clinical evaluations in humans provide the only way of determining whether a vaccine candidate could trigger a safe and effective anti-HIV response in people.
NIAID also supports comprehensive research on other biomedical/behavioral prevention approaches, including drugs and/or vaccines that prevent mother to infant HIV transmission, including during breastfeeding, microbicides for preventing sexual transmission of HIV, interventions that reduce behaviors that expose people to HIV, programs to reduce intravenous drug abuse, measures to control other sexually transmitted diseases (STDs), and antiretroviral therapies that may reduce the spread of HIV from infected people to their partners. This comprehensive vaccine and prevention program has led to a number of significant scientific advances in vaccine and prevention research. In the past, NIAID supported researchers have improved antigenicity through modifications to the envelope protein, elucidated the envelope structure of HIV, advanced our understanding of the role of cellular responses in controlling HIV, developed improved assays for measuring cytotoxic T lymphocytes (CTLs), developed new and better animal models for testing candidate vaccines, and evaluated promising candidates in animal and clinical studies.
In order to accelerate identification of effective vaccine candidates, future studies will need to address the significance of latently infected resting T cell
s, immune responses induced by current vaccine candidates, and the impact of HIV and human leukocyte antigen
diversity. In addition, the relevance of SIV
/SHIV
models and the utility of novel vaccine designs must be explored. With regard to prevention research, new microbicide
s need to be developed and tested and new regimens for preventing maternal-infant transmission during breastfeeding, which are effective and practical for developing countries, need to be explored. Lastly, because the majority of new infections are occurring in the developing world, NIAID's vaccine and prevention research activities are conducted on a global scale. These research programs are designed to define global research priorities, ensure the clinical relevance of future vaccine and prevention strategies to human populations most in need, strengthen collaborations with local investigators worldwide, and support training and infrastructure development in developing countries.
The coordination of this complex program of AIDS research is an important function of DAIDS. By surveying developments in key scientific areas, DAIDS assesses ongoing needs in biomedical research as well as requirements for outreach activities and for training scientific investigators. As part of this process, DAIDS works with advisory groups and community and health professional organizations, evaluating and redirecting program emphases to respond to changing research needs.
National Institute of Allergy and Infectious Diseases
The National Institute of Allergy and Infectious Diseases is one of the 27 institutes and centers that make up the National Institutes of Health , an agency of the United States Department of Health and Human Services...
which is part of the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
. It was formed in 1986 as a part of the to address the national research needs created by the advent and spread of the HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
/AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
epidemic. Specifically, the Division’s mission is to increase basic knowledge of the pathogenesis, natural history, and transmission of HIV disease and to support research that promotes progress in its detection, treatment, and prevention. DAIDS accomplishes this through planning, implementing, managing, and evaluating programs in (1) fundamental basic research, (2) discovery and development of therapies for HIV infection and its complications, and (3) discovery and development of vaccines and other prevention strategies.
Basic research
HIV pathogenesis research increases our understanding of the biology of HIV by studying the virus' life cycle, virus-host interactions, and mechanisms of disease progressionHIV Disease Progression Rates
Following infection with HIV-1, the rate of clinical disease progression varies between individuals. Factors such as host susceptibility, genetics and immune function, health care and co-infections as well as viral genetic variability may affect the rate of progression to AIDS.-Rapid progressors:A...
and transmission. HIV pathogenesis research also supports studies of how the immune system responds to the virus. Knowledge gained from these studies enhances the ability of researcher
Researcher
A researcher is somebody who performs research, the search for knowledge or in general any systematic investigation to establish facts. Researchers can work in academic, industrial, government, or private institutions.-Examples of research institutions:...
s to create new agents and vaccine
HIV vaccine
An HIV vaccine that protects vaccinated individuals from HIV infection is the goal of many HIV research programmes. Currently, there is no effective vaccine against HIV, the virus that causes AIDS...
s to combat HIV infection.
The Division supports a large portfolio of investigator-initiated grants that are pursuing research focused on, but not limited to, the following areas: mechanisms of viral entry and infection, including the role of co-receptors and other cellular accessory molecules; the structure, function, and mechanism of action of viral gene
Gene
A gene is a molecular unit of heredity of a living organism. It is a name given to some stretches of DNA and RNA that code for a type of protein or for an RNA chain that has a function in the organism. Living beings depend on genes, as they specify all proteins and functional RNA chains...
s and protein
Protein
Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...
s; development of in vitro and ex vivo assays to monitor virus growth and immune responses against HIV, and animal models for research on the regulation and function of viral proteins and genetic regulatory sequences; the immunological and virological events controlling primary infection; factors effecting latent reservoirs of HIV; and host factors that modulate viral infection and/or disease progression.
The Division's basic research efforts have yielded significant scientific information about HIV. For example, in recent years, DAIDS-funded investigators have identified new structures for viral components of HIV, additional chemokine
Chemokine
Chemokines are a family of small cytokines, or proteins secreted by cells. Their name is derived from their ability to induce directed chemotaxis in nearby responsive cells; they are chemotactic cytokines...
co-receptors, and the existence of multiple, persistent HIV reservoirs even with the use of highly active antiretroviral therapy (HAART). Despite these advances, questions still remain about the molecular interactions involved in the regulation of HIV expression and replication. More information is also needed about how the virus evades the immune system in order to identify additional targets against which therapeutic interventions and vaccines can be directed.
Therapeutics
Therapeutics for treating HIV-1 and its associated opportunistic infectionOpportunistic infection
An opportunistic infection is an infection caused by pathogens, particularly opportunistic pathogens—those that take advantage of certain situations—such as bacterial, viral, fungal or protozoan infections that usually do not cause disease in a healthy host, one with a healthy immune system...
s (OIs) are discovered through a number of approaches beginning with basic research on the structure and function of viral and cellular proteins critical to the virus life cycle.
In order to foster drug development of new HIV therapies, DAIDS supports research on potential new cellular and viral therapeutic targets and new approaches to validate targets; molecules that could effectively block HIV replication; improved formulation of existing agents; approaches to restore the immune system of HIV-infected individuals; molecular and genetic approaches to protect susceptible, uninfected cells; combination regimens that impede the emergence of viral resistance; and assays to measure restored immunity of HIV-infected individuals.
The evaluation of new drugs and therapeutic agents in people is another critical aspect of therapeutic research. These clinical studies define which new agents are effective against HIV and its associated OIs and also clarify how best to use these drugs.
DAIDS-sponsored therapeutics research has already had a dramatic impact on our understanding of the pathogenesis and clinical management of HIV infection over the last decade. Studies conducted by DAIDS-funded clinical trials research networks have:
- helped to define international guidelines for the treatment of primary HIV infection and associated opportunistic infections and prophylactic regimens for these secondary infections,
- identified biological markers, such as CD4+ counts and viral load for predicting a drug's effectiveness and disease progression, and
- demonstrated the use of antiretroviral drugs for preventing mother-to-infant transmission.
More recent studies have shown that highly active antiretroviral therapy-regimens including reverse transcriptase
Reverse transcriptase inhibitor
Reverse-transcriptase inhibitors are a class of antiretroviral drug used to treat HIV infection, tumors, and cancer. RTIs inhibit activity of reverse transcriptase, a viral DNA polymerase enzyme that retroviruses need to reproduce.-Mechanism:...
and potent protease inhibitor
Protease inhibitor
Protease inhibitor can refer to:* Protease inhibitor : a class of medication that inhibits viral protease* Protease inhibitor : molecules that inhibit proteases...
s-are capable of suppressing HIV viral load to undetectable levels in many infected individuals and partially restoring immune function. Such regimens have had a dramatic impact on HIV mortality in this country.
Nonetheless, treatment failures occur as a result of the development of resistance and/or noncompliance with complicated and often toxic regimens. Moreover, damage to the immune system is incompletely reversed. Thus, there is an ongoing, urgent need for new therapeutic agents and new ways to boost the immunity and rebuild and replace immunity lost to HIV infection. In addition, strategies to address critical questions regarding the long-term effects of antiretroviral therapy and the best approaches to medical management are being developed.
Vaccine and prevention research
The discovery and development of an HIV/AIDS vaccine for the prevention of HIV infection and AIDS is a high priority of the NIAID.Through a balanced HIV program that integrates both basic research and empiric testing of candidate vaccines, NIAID supports a broad spectrum of research and development on HIV/AIDS vaccines. Preclinical vaccine research and development examines new vaccine concepts or approaches and new ways to deliver HIV antigens to people and to safely induce a potent anti-HIV immune response. Studies in animal models are aimed at defining how a vaccine could protect the host. For now, clinical evaluations in humans provide the only way of determining whether a vaccine candidate could trigger a safe and effective anti-HIV response in people.
NIAID also supports comprehensive research on other biomedical/behavioral prevention approaches, including drugs and/or vaccines that prevent mother to infant HIV transmission, including during breastfeeding, microbicides for preventing sexual transmission of HIV, interventions that reduce behaviors that expose people to HIV, programs to reduce intravenous drug abuse, measures to control other sexually transmitted diseases (STDs), and antiretroviral therapies that may reduce the spread of HIV from infected people to their partners. This comprehensive vaccine and prevention program has led to a number of significant scientific advances in vaccine and prevention research. In the past, NIAID supported researchers have improved antigenicity through modifications to the envelope protein, elucidated the envelope structure of HIV, advanced our understanding of the role of cellular responses in controlling HIV, developed improved assays for measuring cytotoxic T lymphocytes (CTLs), developed new and better animal models for testing candidate vaccines, and evaluated promising candidates in animal and clinical studies.
In order to accelerate identification of effective vaccine candidates, future studies will need to address the significance of latently infected resting T cell
T cell
T cells or T lymphocytes belong to a group of white blood cells known as lymphocytes, and play a central role in cell-mediated immunity. They can be distinguished from other lymphocytes, such as B cells and natural killer cells , by the presence of a T cell receptor on the cell surface. They are...
s, immune responses induced by current vaccine candidates, and the impact of HIV and human leukocyte antigen
Human leukocyte antigen
The human leukocyte antigen system is the name of the major histocompatibility complex in humans. The super locus contains a large number of genes related to immune system function in humans. This group of genes resides on chromosome 6, and encodes cell-surface antigen-presenting proteins and...
diversity. In addition, the relevance of SIV
SIV
SIV or Siv may refer to:* Simian immunodeficiency virus, a virus found in primates and related to HIV* Siv, a character in the children's fiction book series Guardians of Ga'Hoole...
/SHIV
Shiv
The word Shiv or shiv may refer to:* Shiv , a type of sharp weapon* Shiva, a Hindu deity* A fictional location in Magic: The Gathering, see Dominaria* Shiv, a villain in the animated series Static Shock...
models and the utility of novel vaccine designs must be explored. With regard to prevention research, new microbicide
Microbicide
Microbicides for sexually transmitted diseases, are pharmacologic agents and chemical substances that are capable of killing or destroying certain microorganisms that commonly cause human infection, for example the human immunodeficiency virus....
s need to be developed and tested and new regimens for preventing maternal-infant transmission during breastfeeding, which are effective and practical for developing countries, need to be explored. Lastly, because the majority of new infections are occurring in the developing world, NIAID's vaccine and prevention research activities are conducted on a global scale. These research programs are designed to define global research priorities, ensure the clinical relevance of future vaccine and prevention strategies to human populations most in need, strengthen collaborations with local investigators worldwide, and support training and infrastructure development in developing countries.
The coordination of this complex program of AIDS research is an important function of DAIDS. By surveying developments in key scientific areas, DAIDS assesses ongoing needs in biomedical research as well as requirements for outreach activities and for training scientific investigators. As part of this process, DAIDS works with advisory groups and community and health professional organizations, evaluating and redirecting program emphases to respond to changing research needs.
Major Programs
- Acute Infection and Early Disease Research Program
- Adult AIDS Clinical Trials Group
- AIDS Research and Reference Reagent Program
- Centers for AIDS Research
- HIV Prevention Trials NetworkHIV Prevention Trials NetworkThe HIV Prevention Trials Network is an international organization that develops and tests the safety and efficacy of primarily non-vaccine interventions designed to prevent the transmission of HIV....
- HIV Therapeutics: Targeting Research Gaps
- HIV Vaccine Design and Development Teams
- HIV Vaccine Research and Design Program
- HIV Vaccine Developmental Resources Contracts
- HIV Vaccine Trials NetworkHIV Vaccine Trials NetworkThe HIV Vaccine Trials Network is a non-profit organization which connects physicians and scientists with activists and community educators for the purpose of conducting clinical trials seeking a safe and effective HIV vaccine. Collaboratively, research professionals and laypeople review...
- Innovation Grant Program
- Novel HIV Therapies: Integrated Preclinical/Clinical Program
- Integrated Preclinical/Clinical Vaccine Development Program
- Laboratory Methods to Assess Responses to HIV Vaccine Candidates
- Multicenter AIDS Cohort StudyMulticenter AIDS Cohort StudyThe Multicenter AIDS Cohort Study is an ongoing clinical study involving over 6,000 men infected with HIV. The study, a program of the Division of Acquired Immunodeficiency Syndrome, has been ongoing for over 25 years and has resulted in over 1,000 scientific publications....
- Mucosal Immunity in Pathogenesis/Prevention of Human Disease Program
- Mechanisms of AIDS Pathogenesis Collaborative Teams
- National Cooperative Drug Discovery Groups – OI
- Pediatric AIDS Clinical Trials Group
- Simian Vaccine Evaluation Units
- Terry Beirn Community Programs for Clinical Research on AIDS
- Women and Infants Transmission Study
- Women's Interagency HIV StudyWomen's Interagency HIV StudyThe Women's Interagency HIV Study is a longitudinal, observational cohort study of women infected with and at risk for HIV infection in the United States.-Funding:...