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About the NHLBI AIDS Program

NHLBI AIDS Program Mission Statement

The NHLBI AIDS Program provides global leadership for research, training, and education programs to promote research in the areas of HIV-related heart, lung, and blood diseases, as well as blood-based therapies.

The NHLBI AIDS Program believes that critical research in these areas will result in discoveries that enhance the survival and quality of life of patients with HIV, and may also lead to knowledge that benefits all patients with heart, lung, and blood disease.

What is the NHLBI AIDS Program?

Monica Shah, MD - NHLBI AIDS Coordinator

Tremendous progress in the treatment of HIV has led to increased survival and a dramatic evolution of the disease. The clinical challenges confronting the population have now shifted from AIDS-related illnesses to chronic diseases, such as coronary artery disease, chronic obstructive lung disease, and chronic anemia. Multiple studies have demonstrated that the risk of developing heart, lung, and blood (HLB) disease in HIV patients is significantly higher and may be accelerated compared to the general population. In addition, the pathophysiological mechanisms of HIV-related HLB disease may be distinct because of the adverse effects of antiretroviral therapy (ART) and a greater contribution of inflammation, immune activation, microbial translocation, endothelial injury, and coagulation disorders. With the growing burden of HIV-related HLB disease, NHLBI is uniquely poised to take a leadership role in supporting research that addresses the new phase of this epidemic.

Early on, NHLBI recognized that investments in HIV-related research had the potential to benefit not only the HIV population, but all patients with HLB disease. Historically, NHLBI has supported landmark HIV-related research to ensure the safety of the blood supply and pioneering work on the impact of tuberculosis and pneumonia in the HIV population. In addition, recent programs have supported cutting-edge research elucidating the role of inflammation in HIV-related cardiovascular disease, the impact of HIV on the rates of acute myocardial infarction, the role of the microbiome in AIDS- related lung disease, and the unique pathophysiology of AIDS-related asthma and chronic obstructive pulmonary disease (COPD). In addition, current programs are evaluating critical blood-related issues such as HIV and cytopenias, the role of HIV in obstetrical hemorrhage, the factors underlying the apparent low rate of HIV infection in sickle cell disease, and optimal screening strategies for HIV in the blood supply. Another important area of supported research is allogeneic stem cell transplantation in HIV patients with hematologic malignancies.

A primary charge of the NHLBI AIDS Program will be to stimulate more investigator- initiated, peer-reviewed research on HIV-related HLB disease. Other critical responsibilities of the program will be to support and facilitate multi-disciplinary collaboration, teamwork, and communication among both investigators and NIH Institutes. Regular portfolio analysis will be a pivotal strategy to ensure that the team methodically assesses progress, identifies new gaps in the scientific portfolio, and cultivates new areas for research. In addition, systematic portfolio analysis will allow the NHLBI AIDS team to effectively leverage current research programs and determine how best to invest scientific resources.

A recent NHLBI AIDS working group (WG) identified many scientific opportunities in this emerging field. Major basic science gaps that were identified during the WG include the role of inflammation, immune senescence, and microbial translocation. Significant clinical gaps that were highlighted include confirming the safety and efficacy of evidence-based therapies in the HIV population and identifying novel therapies that address the unique pathophysiology of HIV-related HLB disease. Other major recommendations included conducting translational research and early phase trials evaluating cellular and gene-based approaches to cure HIV.

Based on the recommendations of the WG, the NHLBI AIDS team is developing dedicated AIDS-related requests for applications (RFAs) for 2014-15 that highlight the scientific opportunities in the field and emphasize NHLBI as a potential funding source for AIDS research. The goal of these initiatives is to foster a cadre of successful investigators with expertise in both HIV and HLB research. As the AIDS-related HLB scientific community grows, we hope there will be a future concomitant increase in investigator-initiated applications to the NHLBI. We encourage investigators to periodically check the NHLBI AIDS website for updates on these RFAs.

The NHLBI AIDS Program will strive to facilitate and support innovative research that responds to the evolving challenges of this once fatal disease. Ultimately, NHLBI believes that investments in HIV-related HLB research may yield knowledge and discoveries that may not only benefit patients with HIV, but may also improve the survival and quality of life of all patients with HLB disease.

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