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The Division of Acquired Immunodeficiency Syndrome (DAIDS) is a division of the
National Institute of Allergy and Infectious Diseases The National Institute of Allergy and Infectious Diseases (NIAID, ) is one of the 27 institutes and centers that make up the National Institutes of Health (NIH), an agency of the United States Department of Health and Human Services (HHS). NIAID's ...
, which is part of the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
. It was formed in 1986 as a part of the initiative to address the national research needs created by the advent and spread of the
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
/ 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.


Scientific areas of focus


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 progression 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 Research is "creative and systematic work undertaken to increase the stock of knowledge". It involves the collection, organization and analysis of evidence to increase understanding of a topic, characterized by a particular attentiveness t ...
s to create new agents and
vaccine A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified.
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 In biology, the word gene (from , ; "... Wilhelm Johannsen coined the word gene to describe the Mendelian units of heredity..." meaning ''generation'' or ''birth'' or ''gender'') can have several different meanings. The Mendelian gene is a b ...
s and
protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residues. Proteins perform a vast array of functions within organisms, including catalysing metabolic reactions, DNA replication, res ...
s; development of ''in vitro'' and ''ex vivo'' assays to monitor virus growth and
immune response An immune response is a reaction which occurs within an organism for the purpose of defending against foreign invaders. These invaders include a wide variety of different microorganisms including viruses, bacteria, parasites, and fungi which could ...
s 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 affecting 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 Chemokines (), or chemotactic cytokines, are a family of small cytokines or signaling proteins secreted by cells that induce directional movement of leukocytes, as well as other cell types, including endothelial and epithelial cells. In additio ...
co-receptors, and the existence of multiple, persistent HIV reservoirs even with the use of
highly active antiretroviral therapy The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multip ...
(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 infections (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 and potent protease inhibitors-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 lymphocyte A cytotoxic T cell (also known as TC, cytotoxic T lymphocyte, CTL, T-killer cell, cytolytic T cell, CD8+ T-cell or killer T cell) is a T cell, T lymphocyte (a type of white blood cell) that kills cancer cells, cells that are infected by intracel ...
s (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 A T cell is a type of lymphocyte. T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response. T cells can be distinguished from other lymphocytes by the presence of a T-cell r ...
s,
immune response An immune response is a reaction which occurs within an organism for the purpose of defending against foreign invaders. These invaders include a wide variety of different microorganisms including viruses, bacteria, parasites, and fungi which could ...
s induced by current vaccine candidates, and the impact of HIV and
human leukocyte antigen The human leukocyte antigen (HLA) system or complex is a complex of genes on chromosome 6 in humans which encode cell-surface proteins responsible for the regulation of the immune system. The HLA system is also known as the human version of th ...
diversity. In addition, the relevance of SIV/
SHIV The word Shiv or shiv may refer to: People with the name * Shivnarine Chanderpaul, a West Indies cricketer nicknamed Shiv Arts, entertainment, and media * Shiv, a fictional location in Magic: The Gathering, see Dominaria * Shiv, a villain in the ...
models and the utility of novel vaccine designs must be explored. With regard to prevention research, new
microbicide An antimicrobial is an agent that kills microorganisms or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals ...
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 The AIDS Clinical Trials Group network (ACTG) is one of the largest HIV clinical trials organizations in the world, playing a major role in setting standards of care for HIV infection and opportunistic diseases related to HIV and AIDS in the Unit ...
* AIDS Research and Reference Reagent Program * Centers for AIDS Research * HIV Prevention Trials Network * 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 Network * 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 Study The Multicenter AIDS Cohort Study (MACS) is an ongoing cohort study involving over 6,000 men, including both those infected with HIV, as well as HIV-negative men. The MACS has four main sites: Baltimore, Pittsburgh, Los Angeles, and Chicago. The Lo ...
* 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 Study The Women's Interagency HIV Study (WIHS) was established in August 1993 to investigate the impact and progression of HIV disease in women. he WIHS enrolls both HIV-positive and HIV-negative women. The core portion of the study includes a detaile ...


References


External links

* {{AIDS HIV/AIDS organizations in the United States Allergy and Infectious Diseases 1986 establishments in the United States