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HIV-Related Research in the Division of Blood Diseases and Resources (DBDR)
HIV-Focused Research Goals
AIDS-related research in the Division of Blood Diseases and Resources (DBDR) encompasses a broad spectrum of topics ranging from basic biology to medical management of blood diseases and the use of blood (hematopoietic stem/progenitor cell-based transplants, T-cells) based-therapies. A major focus of AIDS-related activities in DBDR has been improving the adequacy and safety of the nation's blood supply. DBDR supports pivotal research in transfusion medicine and blood banking, including research to evaluate blood donation screening, manufacturing, and processing technologies. DBDR also has a major responsibility for supporting research in hematopoiesis and hematopoietic cell biology and disease. This includes hematopoietic stem cell transplantation research and the application of stem cell/progenitor cell biology findings to the development of novel cellular therapy approaches to potentially cure chronic diseases such as HIV.
Previously Funded Studies
Research on blood and HIV has focused in great part on transfusion safety and has led to an understanding of staging of the infection, the development and evaluation of new assays for detection of HIV markers among blood donors and transfusion recipients, and a better understanding of the natural history and pathogenicity of HIV infection.
Among the major advances resulting from the conduct of NHLBI-supported studies (including the Retrovirus Epidemiology Donor Study (REDS) and its successor, REDS-II) are: development/refinement of the incidence-window period models that have been employed globally to estimate residual risk of transfusion-transmitted HIV; establishment of HIV replication dynamics (doubling time during the so-called "ramp-up viremia") and a staging classification system (Fiebig Staging) to classify newly diagnosed persons, which is now used worldwide; contribution to the development of nucleic acid amplification technology (NAT) for HIV, hepatitis viruses, and other emerging pathogens and, projection and subsequent documentation of substantial reduction in the infectious window period risk by NAT screening; and establishment of the concept of transmitted/founder (T/F) viruses as well as studies of clusters of HIV infected blood donors and transfusion recipients, which contributed to the understanding of HIV quasispecies, bottleneck of transmission, and rates and viral and immune correlates of quasispecies evolution.
Selected blood-related research examples of interest to the NHLBI AIDS Program include, but are not limited to, studies that:
Accordingly, future research on the interaction between HIV and both the vascular endothelium and hematopoietic cell elements could lead to a greater understanding of the impact of HIV on stem cell development, endothelial perturbation leading to activation of coagulation and thrombosis, and the microbiome; as well as lead to the discovery of innovative cell and gene therapies for the eradication and cure of HIV.
Selected HIV-Related Publications Supported by the NHLBI DBDR