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Han WM, Ohata PJ, Nanthapisal K, Ruengpanyathip C, Sattayamong P, Avihingsanon A, Puthanakit T, Gatechompol S, Hiransuthikul A, Kerr SJ, Ramautarsing R, Ubolyam S, Kroon E, Colby D, Sacdalan C, Seekaew P, Phanuphak N, Ruxrungtham K, Phanuphak P. HIV medicine as double-sided sword: care and prevention. Future Virol 2018. [DOI: 10.2217/fvl-2018-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The 20th Bangkok International Symposium on HIV Medicine Queen Sirikit National Convention Centre, Bangkok, Thailand, 17–19 January 2018.The HIV Netherlands Australia Thailand research collaboration (HIV-NAT) convened the 20th Bangkok Symposium on HIV medicine. The symposium, considered one of the most comprehensive clinical conferences on HIV in the Asia Pacific region, is held annually in January. The 2018 symposium was the second year straight in which the sessions were live webcast via the internet. The highlights of this year's sessions included prevention for HIV, the potentials for an end to HIV, management of hepatitis C infection, and a special session on same-day ART initiation.
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Affiliation(s)
- Win M Han
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Pirapon J Ohata
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Kesdao Nanthapisal
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Chavalun Ruengpanyathip
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Pornwinit Sattayamong
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Anchalee Avihingsanon
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
- Division of Allergy & Immunology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, Thailand
| | - Thanyawee Puthanakit
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, Thailand 4SEARCH, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Sivaporn Gatechompol
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Akarin Hiransuthikul
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Stephen J Kerr
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Reshmie Ramautarsing
- PREVENTION, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Sasiwimol Ubolyam
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Eugene Kroon
- SEARCH, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Donn Colby
- SEARCH, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Carlo Sacdalan
- SEARCH, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Pich Seekaew
- PREVENTION, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Nittaya Phanuphak
- PREVENTION, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
- SEARCH, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
| | - Kiat Ruxrungtham
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
- Division of Allergy & Immunology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, Thailand
| | - Praphan Phanuphak
- HIV-NAT, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
- PREVENTION, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
- SEARCH, Thai Red Cross AIDS Research Centre (TRCARC), 104 Ratchadamri Rd, Pathumwan, Bangkok 10330, Thailand
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Ensoli F, Cafaro A, Casabianca A, Tripiciano A, Bellino S, Longo O, Francavilla V, Picconi O, Sgadari C, Moretti S, Cossut MRP, Arancio A, Orlandi C, Sernicola L, Maggiorella MT, Paniccia G, Mussini C, Lazzarin A, Sighinolfi L, Palamara G, Gori A, Angarano G, Di Pietro M, Galli M, Mercurio VS, Castelli F, Di Perri G, Monini P, Magnani M, Garaci E, Ensoli B. HIV-1 Tat immunization restores immune homeostasis and attacks the HAART-resistant blood HIV DNA: results of a randomized phase II exploratory clinical trial. Retrovirology 2015; 12:33. [PMID: 25924841 PMCID: PMC4414440 DOI: 10.1186/s12977-015-0151-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 02/11/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The phase II multicenter, randomized, open label, therapeutic trial (ISS T-002, Clinicaltrials.gov NCT00751595) was aimed at evaluating the immunogenicity and the safety of the biologically active HIV-1 Tat protein administered at 7.5 or 30 μg, given 3 or 5 times monthly, and at exploring immunological and virological disease biomarkers. The study duration was 48 weeks, however, vaccinees were followed until the last enrolled subject reached the 48 weeks. Reported are final data up to 144 weeks of follow-up. The ISS T-002 trial was conducted in 11 clinical centers in Italy on 168 HIV positive subjects under Highly Active Antiretroviral Therapy (HAART), anti-Tat Antibody (Ab) negative at baseline, with plasma viremia <50 copies/mL in the last 6 months prior to enrollment, and CD4(+) T-cell number ≥200 cells/μL. Subjects from a parallel observational study (ISS OBS T-002, Clinicaltrials.gov NCT0102455) enrolled at the same clinical sites with the same criteria constituted an external reference group to explore biomarkers of disease. RESULTS The vaccine was safe and well tolerated and induced anti-Tat Abs in most patients (79%), with the highest frequency and durability in the Tat 30 μg groups (89%) particularly when given 3 times (92%). Vaccination promoted a durable and significant restoration of T, B, natural killer (NK) cells, and CD4(+) and CD8(+) central memory subsets. Moreover, a significant reduction of blood proviral DNA was seen after week 72, particularly under PI-based regimens and with Tat 30 μg given 3 times (30 μg, 3x), reaching a predicted 70% decay after 3 years from vaccination with a half-life of 88 weeks. This decay was significantly associated with anti-Tat IgM and IgG Abs and neutralization of Tat-mediated entry of oligomeric Env in dendritic cells, which predicted HIV-1 DNA decay. Finally, the 30 μg, 3x group was the only one showing significant increases of NK cells and CD38(+)HLA-DR(+)/CD8(+) T cells, a phenotype associated with increased killing activity in elite controllers. CONCLUSIONS Anti-Tat immune responses are needed to restore immune homeostasis and effective anti-viral responses capable of attacking the virus reservoir. Thus, Tat immunization represents a promising pathogenesis-driven intervention to intensify HAART efficacy.
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Affiliation(s)
- Fabrizio Ensoli
- Pathology and Microbiology, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy.
| | - Aurelio Cafaro
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Anna Casabianca
- Department of Biomolecular Science, University of Urbino, Urbino, Italy.
| | - Antonella Tripiciano
- Pathology and Microbiology, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy. .,National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Stefania Bellino
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Olimpia Longo
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Vittorio Francavilla
- Pathology and Microbiology, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy. .,National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Orietta Picconi
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Cecilia Sgadari
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Sonia Moretti
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Maria R Pavone Cossut
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Angela Arancio
- Pathology and Microbiology, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy. .,National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Chiara Orlandi
- Department of Biomolecular Science, University of Urbino, Urbino, Italy.
| | - Leonardo Sernicola
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Maria T Maggiorella
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Giovanni Paniccia
- Pathology and Microbiology, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy. .,National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Cristina Mussini
- Division of Infectious Diseases, University Policlinic of Modena, Modena, Italy.
| | - Adriano Lazzarin
- Division of Infectious Diseases, S. Raffaele Hospital, Milan, Italy.
| | - Laura Sighinolfi
- Unit of Infectious Diseases, University Hospital of Ferrara, Ferrara, Italy.
| | - Guido Palamara
- Department of Infectious Dermatology, San Gallicano Hospital, Rome, Italy.
| | - Andrea Gori
- Division of Infectious Diseases, San Gerardo Hospital, Monza, Italy.
| | - Gioacchino Angarano
- Division of Infectious Diseases, University of Bari, Policlinic Hospital, Bari, Italy.
| | - Massimo Di Pietro
- Unit of Infectious Diseases, S.M. Annunziata Hospital, Florence, Italy.
| | - Massimo Galli
- Institute of Tropical and Infectious Diseases, L. Sacco Hospital, University of Milan, Milan, Italy.
| | - Vito S Mercurio
- Department of Infectious Diseases, S. Maria Goretti Hospital, Latina, Italy.
| | - Francesco Castelli
- Division of Tropical and Infectious Diseases, Spedali Civili, Brescia, Italy.
| | - Giovanni Di Perri
- Clinic of Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy.
| | - Paolo Monini
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
| | - Mauro Magnani
- Department of Biomolecular Science, University of Urbino, Urbino, Italy.
| | - Enrico Garaci
- Istituto Superiore di Sanità, Rome, Italy, present address University of Tor Vergata, Rome, 00173, Italy.
| | - Barbara Ensoli
- National AIDS Center, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, 00161, Italy.
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