MHRP’s RV217, an ambitious early capture acute HIV infection cohort study led by Clinical Deputy Director Dr. Merlin Robb, concluded in late 2018 after nine years of research activity.
The study, sponsored by the Division of AIDS at the National Institute of Allergy and Infectious Diseases, began in 2009 and prospectively followed a group of high-risk volunteers in East Africa and Thailand, tracking HIV status and characterizing progression through the acute stages of HIV infection. Volunteers were enrolled before they began to show detectable HIV antibodies, and if they became infected, researchers were able to capture samples from some of the earliest stages of HIV infection – in some cases within days.
Local researchers screened 5436 volunteers over the course of the study, and 153 incident cases were observed. 235,950 blood-draw visits occurred, and the 86% rate of volunteer visit compliance was key to Rv217’s success.
“We were able to capture people with HIV infection before they had symptoms and before they had antibodies, which is how a diagnosis of HIV is usually made, and while their viral loads were actually very low,” said Dr. Robb. “We were able to define the symptoms and signs during the acute interval, and intensively evaluate the relationship between the virus and host immune response.”
RV217 provided the first characterization of acute HIV infection, and the study’s impact on HIV research will last beyond its conclusion. The New England Journal of Medicine publication stemming from the study has been cited more then 100 times, and 21 additional papers have been published using RV217 samples and data.
RV217 demonstrated that viral and immune events during acute infection are abrupt and decisive, meaning they play a role in later disease outcomes over many years of HIV infection, influencing clinical decisions about early testing and treatment.