The research goals of UniCamillus in the field of HIV/AIDS
- Describe the framework of the epidemic and analyze the determinants
- Identify the epidemiological, biological and behavioral factors of transmission which favor the persistence of stable levels of incidence of infections.
- Experiment new surveillance tools which allow for a more accurate monitoring of the spread of the infection including new laboratory methods (serological and molecular) behavioral investigations and development of mathematical models.
- Analyze the biological determinants in many populations (host and virus) and social assistance (for example: access to cures, adherence), progress of the illness and the incidence of opportunistic pathologies of particular relevance in public health and also in relation to the specific population subgroups (e.g. newborns, children, migrants, elderly).
- Design and evaluate the innovative tools of epidemic control.
- Lead research activities on development, evaluation and implementation of interventions aimed at favoring access to diagnoses of infection and cures as well as programs for HIV tests.
- Design and evaluate the modification interventions of behaviors aimed at people with HIV infections.
- Lead research on determinants of behaviors at risk and on the evaluation on the interventions of reducing risks with particular attention placed on subgroups of populations with a higher probability.
The research for welfare strategies:
- Optimize the welfare strategies for patients with HIV/AIDS infection.
- Lead studies aimed at optimizing the use of economic resources in the prevention and cure of HIV infections as well as the development of cost-effectiveness models which are specific for Italy.
- Identify the determinants of the infections associated to the health welfare of patients with HIV infections and evaluate strategies to reduce the incidence.
- Develop and evaluate integration models between health services for patients with HIV infections and comorbidities.
Etiology and Pathogenesis and development of vaccines
A - Etiology and Pathogenesis
- Molecular biology of HIV infections.
Study of the structure/function and pathogenetic meaning of HIV gene products also in relation to the cellular interactors, tropism and cellular damage and death.
Study of HIV isolates (in terms of receptor, cell tropism, subtypes, recombinants, resistant mutants). Viral and dynamic fitness of the quasispecies.
Identification of new therapeutic targets through the study of molecular interactions among the viral and host factors (cellular and humoral) by also using high-throughput technologies of proteomics, genomics and gene expression and silencing
- Factors of the host (genetic and immunology)
- Factors of the host which conditions the susceptibility/resistance to infection, transmission, progression of AIDS (subpopulations of uninfected exposed individuals, elite controllers, long term non progressors , fast progressors).
- Mechanisms whose determinants of the adaptive and innate immunity (pro and anti-inflammatory response) change the lifecycle of HIV in the target cells, in the various tissues, organs and all those involved (including mucosal infection and immunity).
- Analysis of the epitopic specificities (both B and T) of the adaptive immunity and their relevance to the mechanisms of protection and/or progression.
- Pathogenesis of acquired immunodeficiency and progression in AIDS.
- Immunopathogenesis of immunodeficiency in acute and chronic infections: immune activation, cell death, dysregulation of T cells and other effector and mediator cells of the host in the different virus reservoirs.
- The effect of early events on the progression of the illness. Role of: first infection, immune activation, invasion of GALT and SNC, formation of viral reservoirs and infected cells.
B – Development of vaccines
- “Research grade” development and production of antigens of HIV for preclinical and vitro studies (also in collaboration with pharmaceutical and biotechnology companies).
- Development of biotechnological products for prevention and therapy, among which: monoclonal antibodies, microbicides, innate immunity factors, ligands of the receptor complex of the virus.
- Development of new immunogens which induce neutralizing antibody responses or cellular immunity.
- Development/use of new adjuvants.
- Development and selection of vaccine candidates in animal models. Studies of safety and immunogenicity. Effectiveness studies and validation of vaccine candidates.
- Development and validation of laboratory tests aimed at identifying correlates of vivo protection.
- Strategies for the mobilization and eradication of viral reservoirs.
Clinic and therapy
A) Untreated HIV+ people
- Development of rapid diagnosis markers for the recognition of the infection and progression finalized at identifying the moment to begin the therapy.
- X-ray treatment of the naïve patient aimed at the optimal sequential use of the classes of drugs.
- Definition of the indicators for a personalized therapy based on the host’s characteristics and profiles of the individual drugs.
- Studies piloted on innovative therapeutic strategies.
- Studies on the treatments for special types of seropositive patients (children, adolescents, pregnant women, advanced naïve).
- The “elite” subjects and LTNP.
B) HIV+ people in treatment
- Diagnostic methods aimed at optimizing the antiretroviral treatment (TDM, ultrasensitive HIV rna, HIV Dna, viral fitness, early markers of failure, predictive markers of collateral effects….)
- The immune alternations of the treated patient with viremia control: persistence of immune activation, IRIS, inadequate immune reconstitution
- Study of the infection dynamic and the different compartments (ELP, GALT, SNC) and the role supported by the persistence infection (latency).
- Identification of the therapeutic strategies aimed at the “sustainability” of a long-life treatment (induction-maintenance, STI, IN/OFF, sequencing) studies of the pharma economics.
- Savings study of classes of drugs
C) Causes of ineffectiveness/failure of the therapy