Carl W Dieffenbach’s research while affiliated with National Institute of Allergy and Infectious Diseases, National Institutes of Health and other places

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Publications (37)


Forty years of investment in HIV research: progress towards ending the HIV pandemic and preparation for future pandemics
  • Article
  • Full-text available

November 2022

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39 Reads

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9 Citations

Sarah W. Read

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Peter Kim

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Mary Marovich

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[...]

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Anthony S. Fauci
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Improvements in Virologic Control Among PWH Over Time: Narrowing the Gap Between Those With and Without STIs

August 2022

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24 Reads

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2 Citations

AIDS and Behavior

Using the incidence of bacterial sexually transmitted infection (STI) as a surrogate for condomless sexual behavior, we assessed the association between STI and uncontrolled HIV replication among in-care persons with HIV (PWH) enrolled in a longitudinal HIV cohort study in the District of Columbia (the DC Cohort). Although STI occurrence initially correlated with higher HIV viral load (VL), this difference became more attenuated over time (2012–2016). This was true overall and among those with the greatest number of STIs [age 18–34, men who have sex with men (MSM)]. This likely reflects gains in population-wide virologic control through improved antiretroviral therapy and access to care, which helps mitigate the risk of HIV transmission.



Outcomes of Dual Versus Triple Antiretroviral Drug Regimens Among Virally Suppressed Adults in the DC Cohort

March 2022

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37 Reads

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1 Citation

AIDS Research and Human Retroviruses

This study explored virological outcomes of two-drug (2DRs) and three-drug (3DRs) antiretroviral regimens in adults with HIV in the DC Cohort. We analyzed 310 treatment-experienced adults with sustained HIV RNA ≤50 copies/mL at baseline, 53 of whom switched to 2DRs and 257 continued 3DRs. Adults on 2DRs and 3DRs had similar demographics (median age 53.3 years, 76.8% cisgender male, 76.1% Black). Adults on 2DRs had more participants with ≥2 comorbidities (62.3% vs. 42.8%, p = .019), had a longer time since HIV diagnosis (median years 20.4 vs. 13.2, p = .017), and received the regimen of interest for a shorter duration (median years 1.3 vs. 3.3, p < .001) compared with adults on 3DRs. Adults receiving 2DRs had a higher, although nonsignificant, risk for virological failure (two consecutive HIV RNA ≥50 copies/mL) at 24 months follow-up than adults on 3DRs (6.7% vs. 1.7%, respectively; p = .10). Future analysis of the effectiveness of 2DRs is needed.



Setting AIDS 2025 targets—Functional components
Ending AIDS as a public health threat by 2030: Time to reset targets for 2025

June 2021

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122 Reads

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43 Citations

Paul De Lay and co-authors introduce a Collection on the design of targets for ending the AIDS epidemic.


Figure 3: The HCAAP model HCAAP=HIV Cure Africa Acceleration Partnership. NGOs=non-governmental organisations. TPP=target product profile. PLHIV=people living with HIV.
The case for an HIV cure and how to get there

November 2020

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388 Reads

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82 Citations

The Lancet HIV

In light of the increasing global burden of new HIV infections, growing financial requirements, and shifting funding landscape, the global health community must accelerate the development and delivery of an HIV cure to complement existing prevention modalities. An effective curative intervention could prevent new infections, overcome the limitations of antiretroviral treatment, combat stigma and discrimination, and provide a sustainable financial solution for pandemic control. We propose steps to plan for an HIV cure now, including defining a target product profile and establishing the HIV Cure Africa Acceleration Partnership (HCAAP), a multidisciplinary public-private partnership that will catalyse and promote HIV cure research through diverse stakeholder engagement. HCAAP will convene stakeholders, including people living with HIV, at an early stage to accelerate the design, social acceptability, and rapid adoption of HIV-cure products.





Citations (30)


... 26 Investment in research and development has accelerated vaccine creation and improved HIV treatments. 27 Integration of health services has enhanced resilience, while a focus on preparedness ensures readiness for future health emergencies. These lessons aim to improve global health outcomes and create robust systems capable of addressing complex public health challenges. ...

Reference:

Comparative Analysis of Virology and Pathogenesis of SARS-CoV-2 and HIV Infections: Implications for Public Health and Treatment Strategies
Forty years of investment in HIV research: progress towards ending the HIV pandemic and preparation for future pandemics

... Their perspectives, experiences, and needs can provide valuable insights and contribute to more effective research and product development strategies. In doing so, it will be important to ensure that an HIV vaccine is developed and integrated into existing and future effective prevention strategies [37]. ...

Fitting a vaccine into the HIV prevention landscape

... The study's prediction for the AIDS incidence in Shandong Province from 2023 to 2030 reveals an increasing trend, with an expected incidence of 6.33 in 2030. Despite the United Nations Sustainable Development Goals aiming to end the AIDS epidemic by 2030 25 . the prediction suggests that AIDS in Shandong Province continues to exhibit an increasing trend, highlighting a significant gap from the 2030 target. ...

Ending AIDS as a public health threat by 2030: Time to reset targets for 2025

... Additionally, research indicates that a scenario such as PIC is more likely than complete HIV elimination 7,8,10,[31][32][33][34][35][36][37] . This implies that PHIV and key populations will not have a choice between PIC or HIV elimination as a new treatment option. ...

The case for an HIV cure and how to get there

The Lancet HIV

... countries (UK and South Africa), highlighting the need for additional high-quality experimental studies in PLWH. This is particularly important for SARS-CoV-2 vaccines based on adenovirus type-5 (Ad5) platforms, given prior concerns associated with higher risk of HIV acquisition in participants of Ad5 vectored HIV-1 vaccine trials [10]. Although follow-up data from one of these studies did not find increased risk of HIV progression among participants who became HIV-infected, it remains critical to monitor the effects of other Ad-5-based vaccines on HIV infection and progression [11]. ...

Use of adenovirus type-5 vectored vaccines: a cautionary tale
  • Citing Article
  • October 2020

The Lancet

... Similar poor awareness results have been reported in other countries. [19][20][21] In response, various governments have taken steps, such as observance of HIV vaccine awareness day on May 18. [22] However, there is a need to create further awareness through various social media platforms, tele advertisements, and national policies. ...

The search for an HIV vaccine, the journey continues

... Recent estimates indicate that 4 million lives could have been saved if an effective antiviral had been available within 6 months of the start of the pandemic 5 . Moreover, although effective SARS-CoV-2 vaccines were quickly developed, this is not always possible for all viruses, as is the case of HIV-1 6 . Even for SARS-CoV-2, it has taken years for COVID -19 vaccines to reach 20 % of the population in low-income nations 7 . ...

The complex challenges of HIV vaccine development require renewed and expanded global commitment
  • Citing Article
  • December 2019

The Lancet

... [12][13][14][15] As such, both federal and local ending the HIV epidemic (EHE) efforts are increasingly turning to implementation science to accelerate and support intervention uptake and dissemination in the field. [16][17][18][19][20][21] Implementation strategies are the building blocks of effective implementation; they refer to specific methods and techniques designed to enhance adoption, administration, and sustainment of interventions in practice. 22,23 The implementation science field has developed a collection of 73 specific implementation strategies, called the Expert Recommendations for Implementing Change (ERIC) compendium, 24 which have been grouped into 9 thematic clusters. ...

Role of Implementation Science: Linking Fundamental Discovery Science and Innovation Science to Ending the HIV Epidemic at the Community Level
  • Citing Article
  • December 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

... In recent years, the concept of "Undetectable = Untransmittable" (U = U) has emerged as a transformative framework for understanding outcomes. The U = U principle asserts that PLWHA who receive ART and maintain an undetectable viral load-defined as fewer than 200 copies/mL-for at least 6 months cannot sexually transmit the virus to others (Cohen et al., 2016;Eisinger et al., 2019). This concept, supported by robust scientific evidence, has significantly shaped global HIV treatment and prevention strategies (Bavinton et al., 2018;Rodger et al., 2019;Phanuphak et al., 2020). ...

HIV Viral Load and Transmissibility of HIV Infection: Undetectable Equals Untransmittable
  • Citing Article
  • January 2019

JAMA The Journal of the American Medical Association

... [17][18][19][20][21][22][23][24] The US government including the NIH, the Centers for Disease Control, and Health Resources and Services Administration have thus invested significantly in recent years in efforts to End the HIV Epidemic in the United States through implementation science and scaling of evidence-based practice. 9,[25][26][27] Funding for IR both in the United States and internationally has been steadily increasing in recent years. 1 There is often a lengthy delay in evidence generation, although some of this may be field specific. 11,12,[28][29][30] The objective of these analyses was to review the scientific production process and time to dissemination of HIVrelated IR findings. ...

Ending the HIV Epidemic in the United States: Closing the Implementation Gaps
  • Citing Article
  • August 2018

Annals of Internal Medicine