HIV/AIDS
Fred Hutch is a longtime leader in the global fight against HIV/AIDS. Our research on prevention, treatment and potential cures includes active studies and statistical assistance to studies in countries on five continents. We use our expertise in virology and immunology to investigate HIV at the molecular level, with the goal of identifying events that lead to infection and transmission and to understand the complex relationship between HIV and the immune system.
HIV Vaccine Trials Network
Our researchers play key roles in several large-scale networks dedicated to the elimination of HIV/AIDS. They include the HIV Vaccine Trials Network, which is based at Fred Hutch. HVTN is the world’s largest publicly funded international collaboration conducting clinical trials of HIV vaccines, with thousands of participants joining every year.
defeatHIV
Fred Hutch hosts defeatHIV, a multi-institutional consortium focused on cell and gene therapy approaches to eliminate HIV from reservoirs of latently infected cells. HIV in these reservoirs reactivates if patients stop taking antiviral drugs.
Statistical Center for HIV/AIDS Research and Prevention
We are home to the Statistical Center for HIV/AIDS Research and Prevention, or SCHARP. SCHARP helps researchers worldwide and is staffed by experts in clinical and laboratory data management, programming and statistics.
HIV/AIDS Network Coordination
The Office of HIV/AIDS Network Coordination (HANC), based at Fred Hutch, works with HIV/AIDS Clinical Trials Networks of the U.S. National Institutes of Health (NIH) to create a more integrated, collaborative, and flexible research structure to develop safe and effective drugs, prevention strategies, and vaccines.
To ensure that diverse communities are included in HIV/AIDS research and that their cultures are respected, HVTN and defeatHIV work with community advisory boards — organizations that help community members understand HIV/AIDS science and engage with our researchers in the planning and implementation of trials.
We provide our communities with workshops and ongoing educational programs on equity and anti-oppression issues. We also develop case studies on ways to increase participation in vaccine trials, reduce disparities and improve the recruitment, retention, and training of ethnic minorities.
For more information about HIV prevention trials, see the HVTN website descriptions of ongoing clinical studies, specific trial protocols, and — in the Seattle area — studies that are currently enrolling participants at the Seattle Vaccine Trials Unit.
HIV/AIDS Research
Fred Hutch scientists, biostatisticians and epidemiologists study the evolutionary history of HIV and track the course of the epidemic. We analyze the results of experimental vaccines and microbicides to prevent the disease. In addition to the design and oversight of HIV vaccine clinical trials at HVTN, our researchers study mechanisms of natural protection found in a small subset of people who can suppress the virus without medication. We also search for broadly neutralizing antibodies, rare proteins that could work against multiple strains of HIV. We are testing new vaccines designed to get immune cells to produce such antibodies reliably — the holy grail of HIV vaccine research. We continue to study new technologies with the goal of curing HIV in people who are already infected.
Designing a Broadly Neutralizing Vaccine
Most HIV/AIDS vaccines fail because the immune proteins, or antibodies, that they generate zero in on specific surface features of the virus that can rapidly change their shape through genetic mutation whenever the virus makes copies of itself. These mutations allow the virus to hide from antibodies.
But some antibodies, known as broadly neutralizing antibodies, are able to block many variants of a virus. We are designing vaccines that cause the body to make this type of antibody against HIV. They target parts of the HIV surface that cannot change shape without crippling the virus. In theory, the virus cannot evade such a vaccine. Tests will show if the vaccine works.
Cell and Gene Therapy to Cure HIV
Through the defeatHIV program, we are testing ways to:
- Genetically engineer blood cells to be resistant to HIV replication
- Develop gene therapy techniques that mutate HIV and render it incapable of replicating in an infected person
- Deliver synthetic proteins that stop HIV reactivation
- Stop the proliferation of cells that sustain the HIV reservoir
HIV Vaccines and the Microbiome
Our scientists are exploring how the microbiome — the vast community of bacteria and other foreign microbial life that inhabits our bodies — interacts with the immune system and may influence vaccine responses.
The failure of one experimental HIV vaccine may have been due to a “cross-reaction” with bacteria in the human gut. Components of the vaccine that were meant to trigger an immune response against HIV instead targeted a similar-looking feature on the cell membranes of common gut bacteria. The vaccine was apparently fooled, as if by a decoy, into reacting against the bacteria instead.
HIV and the Immune System
We are learning how protective antibody responses against HIV develop. For instance, infants can generate protective antibodies more quickly than adults. Work by our scientists suggests that the immune responses of infants hold insights that could help improve HIV vaccine design.
Our researchers are also studying how HIV slips past our immune system. Using a cutting-edge approach called deep mutational scanning, our scientists have compiled a library of every possible genetic mutation that affects the proteins on the surface of HIV. Their tests are showing how the structure of each mutation affects the ability of HIV to escape antibodies. This information can help us design a more effective vaccine.
Studying HIV-Positive People Who Stay Symptom Free
Researchers led by Dr. Julie McElrath are investigating why about 1 percent of people who are living with HIV can naturally suppress HIV without medication. The goal is to find out if these “long-term nonprogressors,” or “elite controllers,” carry unknown biological mechanisms that protect them from HIV. If researchers can duplicate these mechanisms, they may be able to prevent HIV progression and improve outcomes among a much broader group of people with HIV. The studies are based at the Seattle Vaccine Trials Unit, one of more than 40 HVTN research sites around the world.
The AMP Study
The HVTN Antibody Mediated Prevention Study comprises a pair of trials that are investigating whether an infusion of antibodies — rather than a conventional vaccine — can protect people from HIV. It will find out if broadly neutralizing antibodies can block the virus in at-risk populations. The two trials are operating in 46 sites worldwide and have enrolled more than 4,600 volunteers.
Our HIV/AIDS Researchers
Our interdisciplinary scientists and clinicians work together to prevent, diagnose and treat HIV/AIDS and related diseases.
Patient Treatment & Care
Seattle Cancer Care Alliance, our clinical care partner, gives patients access to the comprehensive, world-class treatments developed at Fred Hutch.
A Patient’s Story
First HIV, Then Cancer
When Bill Hall tested positive for HIV in 1986, he assumed it was a death sentence. The next 10 years were a blur of visiting friends in the hospital and going to funerals. Then he began taking an antiretroviral cocktail that kept the virus in check. He survived. But in 2007, he had another shock: he was diagnosed with non-Hodgkin lymphoma. He continues to survive and says, “I’m actually doing quite well, considering.”