December 2, 2024—Over the past forty years, the landscape of HIV treatment has dramatically transformed. Once regarded as a death sentence, HIV is now a manageable chronic illness thanks to significant advancements in science and public health. Remarkably, AIDS-related deaths have plummeted by 69% since their peak in 2004. A substantial part of this progress can be attributed to the dedicated work of researchers at the Harvard T.H. Chan School of Public Health’s Center for Biostatistics in AIDS Research (CBAR).

In celebration of World AIDS Day on December 1, Michael Hughes, a professor of biostatistics and the director of CBAR, shared insights into the center's pivotal role in HIV/AIDS research, highlighting past achievements, ongoing studies, and future ambitions.

A Leadership Role in HIV/AIDS Research

CBAR plays a critical role in the field by designing and analyzing clinical trials and observational studies for innovative treatments and vaccines targeting those living with HIV. Their comprehensive approach encompasses various demographics, including pregnant individuals, infants, adolescents, and adults of all ages. Moreover, CBAR extends its statistical expertise beyond HIV, contributing to studies on co-infections like tuberculosis and hepatitis, as well as ongoing clinical trials for illnesses like mpox and COVID-19.

With a team of seasoned faculty, research associates, and epidemiologists, CBAR embodies decades of commitment to combatting the HIV/AIDS pandemic. This wealth of experience is invaluable in shaping effective treatment protocols.

Landmark Advancements in Research

The contributions from CBAR to HIV/AIDS research cannot be overstated. Their involvement has led to significant drug approvals and informed the guidelines set by both the U.S. and World Health Organization for HIV treatment and prevention. Notably, three landmark studies initiated by CBAR in the late 20th century were game changers:

1. ACTG Network Clinical Trial: This research demonstrated that antiviral drugs could be administered during pregnancy to prevent maternal-to-child transmission of HIV. Evidence showed that if a mother’s viral load was adequately suppressed, the risk of transmission was minimal.

2. Botswana Harvard Partnership Study: This trial revealed that antiretroviral therapy could effectively suppress maternal HIV levels during breastfeeding, safeguarding infant health.

3. Protease Inhibitors Study: Research showcasing the effectiveness of protease inhibitors combined with other treatments significantly decreased the progression of HIV to AIDS, marking a critical turning point that improved survival rates and the quality of life for patients.

Recently, CBAR researchers have also highlighted advancements in long-acting injectable therapies, daily statins to reduce cardiovascular risks for HIV patients, and the exploration of new hepatitis B vaccines for those who don't respond to existing options.

Current Focus on Viral Reservoirs

CBAR remains on the cutting edge of HIV research, focusing on understanding viral reservoirs that persist in some patients, even those undergoing successful treatment. This challenging yet thrilling area aims to find a functional cure, which would enable individuals to maintain remission without ongoing drug therapy.

Commitment to Training the Next Generation

CBAR is dedicated to nurturing the next wave of public health investigators. With initiatives aimed at supporting early-career researchers, the center fosters collaboration and innovation. The NIH training grant, which supports numerous PhD students and postdoctoral researchers, underscores CBAR's commitment to advancing knowledge in biostatistics and epidemiology as they relate to HIV.

The Ongoing Fight Against HIV/AIDS

Despite the strides made, the global impact of HIV remains significant, with around 40 million people living with the virus and over a million new infections occurring annually. The work at CBAR, along with its international partnerships, is crucial in discovering novel treatments that enhance the health of those living with HIV and curtail transmission rates.

As CBAR continues to break new ground in HIV/AIDS research, their commitment reminds us all that while the face of the epidemic has changed, the fight is far from over. Together, armed with data and driven by compassion, researchers are determined to lead us toward a future where HIV is no longer a public health threat.

—Maya Brownstein