Alfred Health is a leader in HIV research, with a national and international profile encompassing basic science, clinical research and translational research.
As a statewide service we have a wide-ranging research profile from HIV cure research to the emerging health comorbidities seen in people living with HIV.
We collaborate with a wide range of research partners from people living with HIV, community agencies and peak organisations, national and international research institutes, government and industry.
Innovative research award
Associate Professor Julian Elliott, an HIV physician at The Alfred and a researcher at Monash University and Cochrane Australia received the prestigious Commonwealth Health Minister’s Award for Excellence in Health and Medical Research in 2017. This annual award recognises the top-ranked Career Development Fellowship (CDF) applicant through the National Health and Medical Research Council (NHMRC).
Using this funding, A/Prof Elliott and his team will be able to continue their innovative work developing new systems to analyse and simplify medical research. This includes online platforms, artificial intelligence and the ‘citizen science’ website – where members of the public help process research articles. A/Prof Elliott’s work focuses on making sure the findings of research translate into action and improved health, using new technologies and ways of collaborating to make that easier.
Research in comorbidity and effects of antiretroviral treatment (ART)
People with HIV are living longer and are experiencing greater comorbidity associated with either antiretroviral treatments (ART) or chronic immune activation and inflammation secondary to HIV infection itself.
The HIV Service has a very active research program evaluating risks for health comorbidities as well as prevention.
Prof Jenny Hoy leads an international study investigating the contribution of HIV and ART on bone loss and fractures (NIH funded) and comparing the effect on bone of switching the offending ART drug or treating with an osteoporosis drug in those with low bone mass (NHMRC funded).
Dr Janine Trevillyan performed two important clinical trials associated with cardiovascular disease and risks.
Research in HIV cure
Research into HIV cure continued through 2015 with strong partnerships between Alfred Department of Infectious Diseases (Dr. James McMahon, Dr. Julian Elliott, Prof. Jenny Hoy), the Doherty Institute, University of Melbourne and international collaborations in the United States and Europe. This included a collaborative study with the University of California, San Francisco, funded by the NIH and American Foundation for AIDS Research, which demonstrated that disulfiram, a drug used to treat alcohol addiction, can activate latent HIV (Elliott JH et al, Lancet HIV 2015).
In addition, collaboration has been established with the Department of Haematology at Alfred Health to undertake leucophoresis on participants with stably treated HIV to obtain large numbers of latently infected CD4 T-cells.
This work will continue to inform new strategies to eliminate HIV latency and improve our understanding of HIV pathogenesis.
A/Prof Edwina Wright successfully established a Pre-Exposure Prophylaxis (PrEP) demonstration project in 2015 and is currently leading the PrEPX Study which is a larger Victorian study to provide PrEP to 2,600 Victorians at risk of HIV infection.
Dr James McMahon established a clinical network of providers of HIV care in Victoria, treating over 80% of people living with HIV to focus on treatment as prevention. This work established estimates of patient retention in HIV care as well as tracing and re-engaging patients lost to care (McMahon JH et al., Plos One 2015).
PhD student Nick Medland also systematically reviewed the cascades of HIV Care globally, making recommendations for optimal methods to assess the cascade (Medland et al. JIAS 2015).
Dr Elliott, head of the department’s Clinical Research Unit, also led a collaboration of world-leading researchers to describe the opportunities of ‘big data’ in evidence-based medicine (Elliott JH et al, Nature 2015).
Clinical Research Unit (CRU)
The Clinical Research Unit is a key part of the HIV research profile and is one of the largest of its kind in Australia with over 40 active protocols. The CRU conducts research in the field of HIV with multiple observational studies in HIV medicine and has a strong focus on HIV cure related research.
The CRU has also led clinical trials examining how medications can reverse HIV from its latent state and is focused on strategies to activate HIV from latency in the setting of antiretroviral therapy. Approaches to assess the extent and distribution of persistent HIV and to manipulate the immune system to control HIV without the need for antiretroviral therapy are also being assessed.
The success of the department in HIV cure research is underpinned by our close collaboration and partnership with The Doherty Institute for Infection and Immunity.