In addition to the advances made in the HIV space, such as antiretroviral therapies and pre-exposure prophylaxis, the years of research has translated into advances outside the HIV field, including in oncology and other immune diseases.
Extensive research put into HIV/AIDS has yielded benefits across multiple medical fields, according to experts from the National Institutes of Health (NIH)'s Institute of Allergy and Infectious Diseases.
Since the first cases of AIDS were reported in the United States nearly 40 years ago, NIH has invested more than $69 billion in understanding, treating, and preventing HIV/AIDS. In addition to the advances made in the HIV space, such as antiretroviral therapies and pre-exposure prophylaxis, the years of research has translated into advances outside the HIV field, including in oncology and other infectious diseases.
“The enormous investment in HIV research is clearly justified and validated purely on the basis of advances specifically related to HIV/AIDS,” wrote the experts in a commentary. “However, the collateral advantages of this investment above and beyond HIV/AIDS have been profound, leading to insights and concrete advances in separate, diverse, and unrelated fields of biomedical research and medicine.”
HIV specifically and selectively infects and destroys CD4+, the surface protein of T lymphocytes. Research into this mechanism of action has shined a light on the impact that a specific defect in a single component of the immune system has on the entire system. According to the commentary, understanding the vital role CD4+ T cells plays has provided significant insight into other infectious diseases. Research into immune dysfunction in HIV has also carried over into neoplastic diseases, such as non-Hodgkin lymphoma and Kaposi sarcoma, which was discovered to be caused by human herpesvirus.
Studying the pathogenesis of HIV has also enhanced the understanding of persistent immune activation and inflammation that can occurr in other diseases. For example, researchers determined that inflammation led to an increased risk of heart disease in people living with HIV, driving further research into the role of inflammation in heart disease in the absence of HIV.
While targeted antiviral drug development did not begin with HIV, the amount of investment and research put into drug development in the space has resulted in antiretroviral drugs targeting enzymes reverse transcriptase, protease, and integrase. These advances have transformed the targeted drug development field, and this model has since been applied for other viral diseases, including hepatitis C.
Several HIV/AIDS-related tools have also spilled over into other disease states. Lentiviral gene therapy vectors that use inactivated HIV to alter T lymphocytes in order to invoke an immune response are now FDA approved for the treatment of certain cancers, such as acute lymphoblastic leukemia.
“The collateral advantages resulting from the substantial resources devoted to HIV/AIDS research over the past 30 years are extraordinary,” wrote the experts. “From innovations in basic immunology and structural biology to treatments for immune-mediated diseases and cancer, the conceptual and technological advances resulting from HIV/AIDS research have had an enormous impact on the research and public and global health communities over and above the field of HIV/AIDS.”
Schwetz T, Fauci A. The extended impact of human immunodeficiency virus/AIDS research [published online August 28, 2018]. J Infect Dis. doi: https://doi.org/10.1093/infdis/jiy441.