The Armed Forces Research Institute of Medical Sciences (AFRIMS) in Bangkok is a Special Foreign Activity of Walter Reed Army Institute of Research (WRAIR), hosted by the Royal Thai Army and staffed by American and Thai personnel. For more than 50 years, AFRIMS has been the premier platform for the study of infectious diseases of military importance in the Asia-Pacific region.
Today, AFRIMS plays a key role in international HIV vaccine development and cure efforts and works in close partnership with MHRP and Thai partners such as the Thai Ministry of Public Health, Mahidol University, the Thai Red Cross, Chiang Mai University and the Royal Thai Army.
AFRIMS boasts high-quality clinical trial support and exemplary sample management and analysis capabilities, and as a result, the program collaborates with many academic and research organizations. It played a critical role in the landmark RV144 “Thai Study,” a 16,000 person study which was the only HIV vaccine trial to date to demonstrate modest (31%) efficacy of a potential HIV vaccine.
MHRP’s researchers at AFRIMS have the unique capability to interrogate the impact of HIV on mucosal surfaces. This research directly translates into supporting MHRP’s product development in the context of prophylactic vaccines as well as in cure studies. Read more about the Cellular and Mucosal Immunology Laboratory (CMIL) at AFRIMS.
The capacity to further understand both mechanisms of HIV vaccine protection and potential studies to “cure” or eradicate HIV are strengthened by complementary nonhuman primate studies conducted in collaboration between the AFRIMS Department of Retrovirology and the AFRIMS Department of Veterinary Medicine.
HIV Vaccine Studies
Following the RV144 trial, AFRIMS and MHRP initiated several follow-on clinical studies with Thai collaborators to conduct intensive immunogenicity research related to RV144. The data is informing future clinical research by providing insights into the immune mechanisms generated by the RV144 regimen and the effects of an additional boost. Another proposed study will compare different doses of protein and a different adjuvant developed to try to induce higher and more durable antibody responses.
HIV Acute Infection and Cure Studies
In addition to follow-on studies from RV144, MHRP also helps lead and support a vast acute infection study in Thailand called RV254/SEARCH010, along with small treatment interruption studies aimed at inducing HIV remission, or a functional cure. They also conducted the landmark RV217 acute infection study.
Community Advisory Board
AFRIMS established the Community Advisory Board in 2011 as a formal advisory mechanism for all stage of the research life-cycle. The CAB includes community representatives, local government officers, and non-government organizations who work the HIV advocacy field. Good Participatory Practice guidelines are applied for fostering relationships with stakeholders and AFRIMS.
Collaborating Clinical Sites:
Royal Thai Army Clinical Research Center (RTA-CRC), Bangkok
The RTA-AFRIMS CRC has a clinical research site in Bangkok located on the RTA-AFRIMS campus. This site is in collaboration with the Phramongkutklao Hospital TB clinical unit. RTA-AFRIMS has conducted nine Phase I/II HIV vaccine trials including multi-site RV306 Phase II HIV vaccine trial and Phase II HIV-V-A004. RTA partners also helped conduct RV144.
Mahidol University, Bangkok
The VTC is a clinical facility located at the Faculty of Tropical Medicine in Bangkok that was established in 1960. The VTC has conducted a number of HIV vaccine clinical trials, and has been involved in vaccine research in diarrheal diseases, malaria and viral infections. Collaborators at the VTC conducted RV305 and helped conduct RV144.
Thai Red Cross AIDS Research Centre (TRCARC), Bangkok
TRC-ARC is a major collaborating site with AFRIMS, South East Asia Research Collaboration in HIV (SEARCH) and MHRP. Studies focus on neuro AIDS, HIV immunology/virology, vaccine development, sexual health, opportunistic and co-infections. RV254 is conducted at the TRCARC, a collaboration with MHRP to identify acutely infected individuals and place them onto antiretroviral therapy immediately. MHRP is also conducting treatment interruption studies within the RV254 cohort as part of an effort to identify effective remission strategies.