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Understanding the History of HIV Infection Is Vital To Develop a Vaccine

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"CHAVI's goal is to conduct research that overcomes current barriers to AIDS vaccine development. These barriers include understanding which of the body's immune responses to stimulate in order to fight off HIV-1 and understanding the specific type of virus that is transmitted from person to person," Haynes said. Cohen, a member of CHAVI's Scientific Leadership Group, leads the center's Study Site Core B, also known as the Acute HIV-1 Infections Network Core. This is one of five study cores in support of the vaccine initiative.

Cohen described the project, CHAVI-001, as an observational study that will gather information at clinics in Africa (Malawi and South Africa) and in North Carolina, where patients statewide will be referred to UNC and Duke. The initial goal of CHAVI-001 is to identify people with HIV still in its earliest stages, before seroconversion. When people develop antibodies to HIV, they "seroconvert" from antibody-negative to antibody-positive, a process that may take from as little as a few weeks to several months or more after infection with HIV. During the study, each individual's health will be tracked, and interviews aimed at identifying their sexual partners will try to determine the person who transmitted the disease, thus completing a "transmission pair."

"Since the epidemic began 25 years ago, only about 1,000 people in the earliest stages of HIV infection have been identified," Cohen said. "Even more troubling, only a handful of transmission pairs have been reported. CHAVI has the resources to find them in substantial numbers." According to Cohen, knowledge of the viral requirements for transmission is crucial to understanding how to make a vaccine against HIV. That's why one needs HIV both from the recipient and the person who transmitted it. Also important to vaccine development is knowledge of the immunological environment in which transmission occurred, Cohen said. This
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