Advancements in science and public health, significantly influenced by statistical expertise, have transformed HIV from a probable death sentence into a manageable chronic condition, reducing AIDS-related deaths by 69% since 2004. The Center for Biostatistics in AIDS Research (CBAR) at Harvard T.H. Chan School of Public Health has been at the forefront of these efforts since 1995.
CBAR's Role in HIV/AIDS Research
CBAR provides crucial leadership in designing and analyzing clinical trials and observational studies focused on new HIV treatments and vaccines. Their work spans the entire lifespan, addressing the needs of pregnant individuals, infants, children, adolescents, and adults. According to Michael Hughes, professor of biostatistics and director of CBAR, their expertise extends to other diseases prevalent in people living with HIV, such as tuberculosis, hepatitis B and C, and heart and liver diseases. During the COVID-19 pandemic, CBAR also contributed to clinical studies evaluating potential treatments for the virus and is currently involved in similar research for mpox.
Key Advancements in HIV/AIDS Treatment
CBAR's involvement in research has significantly contributed to the approval of drugs for HIV/AIDS treatment and prevention, influencing guidelines by both the U.S. and the World Health Organization. Landmark trials include:
- A clinical trial demonstrating the effectiveness of antiviral drugs in preventing mother-to-child transmission of HIV during pregnancy, labor, and delivery. Subsequent studies reinforced that suppressed viral levels in mothers drastically reduce transmission risk.
- Research showcasing that antiretroviral drug combinations can suppress HIV viral levels in breastfeeding mothers, preventing transmission to their infants.
- A clinical trial that introduced protease inhibitors in combination with other drugs, markedly reducing the progression of HIV to AIDS and improving survival rates. This marked a turning point, leading to more potent, easier-to-administer, and better-tolerated treatment combinations.
More recent studies have highlighted the efficacy of long-acting, injectable antiretroviral therapy and the potential of statins to reduce cardiovascular events in people living with HIV. CBAR has also supported the licensure of treatments for HIV and other infectious diseases in children and pregnant individuals.
Current Research Focus
CBAR's current research is heavily focused on understanding persistent HIV viral reservoirs in individuals undergoing treatment. The goal is to identify why these reservoirs persist and whether antibody treatments can effectively target them. This challenging yet promising area of research aims to achieve a functional cure for HIV infection, allowing individuals to remain in remission for extended periods without ongoing treatment.
Training and Collaboration
CBAR is committed to supporting early career investigators through collaborations and training programs. They actively engage with networks like ACTG, IMPAACT, and PHACS. Michael Hughes also highlighted a National Institutes of Health training grant supporting PhD students and a postdoc in biostatistics and epidemiology methods research related to HIV.
Ongoing Impact and Motivation
Despite the transformation of HIV infection into a more manageable chronic disease, the global impact of the HIV pandemic remains significant, with approximately 40 million people living with HIV and over a million new infections annually. CBAR's collaborative work with researchers worldwide is crucial for developing new treatment options that improve the health of people living with HIV and minimize the risk of transmission.
