Center for AIDS Research (CFAR) (University-Wide
Interdisciplinary Research Center)
Director: Michael
Saag, MD
Established: 1988
Introduction/Mission Statement
The UAB Center for AIDS Research (CFAR) is
one of the seven original Centers established by NIAID in 1988. It has benefited over the past 20 years from
Institutional leadership that has had the vision to support AIDS research to an
extraordinary level, based on the deeply-held institutional belief that UAB
investigators should play a leading role in combating this global plague.
The HIV pandemic affected Alabama later than
the epicenters of the disease in the U.S., and initially the demographics of
the disease mirrored that reported in the rest of the country. Now, however, in common with a majority of
Southern states, the burden of the disease falls on racial and ethnic minority
populations, on women, and on the medically underserved, particularly in rural
areas – presenting a challenge that is remarkably similar to that of the
developing world.
The need for better treatments, better
behavioral and prevention interventions, as well as an effective vaccine
against HIV drives the research agenda of the UAB CFAR. Institutional commitment, evidenced by
strategic recruitment and provision of research space, resources, and targeted
funding, coupled with the unique interdisciplinary environment of the UAB CFAR
has allowed the HIV/AIDS research program to develop continuously over the last
20 years. This has resulted in sustained
growth of UAB AIDS-related funding increasing from $6 million in 1988 to over
$74.2 million ($20 million NIH awards) in 2006.
The multidisciplinary membership base of the
Center enables the rapid translation of fundamental knowledge about HIV/AIDS
and its related disorders into clinical treatment, prevention programs, and
effective community outreach interventions. The UAB CFAR provides a dynamic environment
for collaborative research within the Institution. Research within the Center encompasses three
major areas: HIV Pathogenesis, Experimental Therapeutics, and HIV Prevention – both
domestically and internationally – with Research Programs in 14 defined
specialties. The UAB CFAR provides
infrastructure, designated research space, 8 research core facilities with
specialized equipment and trained personnel, and access to developmental
research funds to its 152 members and the UAB research community. The Center has played an indispensable role in
UAB’s national reputation in HIV/AIDS research and care (ranked 5th
in the Nation by U.S. News & World Report in 2007). The UAB CFAR has
brought world-class HIV/AIDS treatment, awareness and education to Birmingham,
the surrounding metro area and the state of Alabama.
Building on a Continuously Growing Foundation of Strength
Since its inception, the UAB CFAR has been
particularly successful in fostering collaborative interactions that bridge
basic science and clinical research, as demonstrated by the following list of
‘firsts’. UAB investigators were the
first to:
- Describe the quasispecies
nature of HIV (Nature, 1988)
- Describe the nature of the acute HIV-1
viral syndrome (NEJM, 1991)
- Discover that plasma viral load is a
prognostic marker and clinical disease indicator (Science, 1993)
- Test 8 of the 24 currently approved
anti-HIV drugs in clinical trials (Nature
Med, 1998; NEJM, 1993; others)
- Evaluate triple drug combination
therapy (Nature, 1995)
- Describe the viral dynamics of HIV and
rapid development of drug resistance (Nature,
1995)
- Establish guidelines for the use of
viral load in clinical practice (Nature
Med, 1996)
- Establish proof of concept for a fusion
inhibitor (Nature Med, 1998)
- Establish the zoonotic
origin of HIV-1 (Nature, 2000)
- Describe the role of neutralizing
antibodies in the host immune response to HIV (Nature, 2003)
- Describe the evolving 'glycan shield' mechanism of neutralizing antibody
escape (Nature, 2003)
- Describe HIV envelope neutralization
properties of newly transmitted virus during heterosexual transmission (Science, 2004)
- Demonstrate proof of concept that
selective blocking of the R5 co-receptor is a viable treatment modality (Nature Medicine, 2005)
- Describe novel lamprey (jawless fish)
antibody responses, which possess polyvalent antigenic specificities and
durable structural features, and are usable in HIV vaccine research (Science, 2005)
- Trace the origin of pandemic (HIV-1
group M) and non-pandemic (HIV-1 group N) to distinct communities of wild
chimpanzees in southern Cameroon (Science,
2006)
- Identify HIV-1 group O like viruses in
wild western gorillas (Nature, 2006)
- Discover that Nef-mediated
suppression of T cell activation was lost in the lentiviral
lineage that gave rise to HIV-1 (Cell,
2006)
- Establish broad access to ART in
collaboration with the Zambian government utilizing a clinical algorithm
driven management system and database to assess outcomes (JAMA, 2006)
- Discover a new lineage of effector CD4+ T cells, the T-helper-17 (T(H)17)
lineage, that has features distinct from classical T(H)1 and T(H)2 lineage
and provides adaptive immunity tailored to specific classes of pathogens,
such as extracellular bacteria (Nature,
2006).
Overview of the key roles played by the UAB Center for AIDS Research
The overall goal of the UAB CFAR is to
stimulate and support multidisciplinary basic, behavioral and clinical AIDS
research so as to hasten the development of effective treatments and prevention
strategies for AIDS. The UAB CFAR has
taken a comprehensive, multidisciplinary, institution-wide approach to pursue
this goal of fostering translational research.
The key roles played by the CFAR to achieve this goal include:
- Stimulated
interdisciplinary translational research – The Center has played a critical
role in stimulating interdisciplinary, translational research that bridges
the basic, clinical and behavioral sciences. This is accomplished through the founding
of Interdisciplinary Research Groups (IRGs),
which have been established, for example, in HIV Pathogenesis,
Tuberculosis, Clinical Outcomes, and Metabolic (lipid) Complications of
ARV therapy. This continues to be
the highest priority for the Center.
- Promoted
multidisciplinary AIDS research – The Center has supported and
promoted multidisciplinary AIDS research efforts that would generally not
be possible within the confines of individual laboratories by sponsoring
shared research and clinical core facilities. These activities enabled UAB
investigators to be competitive for Integrated Preclinical/Clinical
AIDS Vaccine Development Program (IPCAVD), Gates Grand Challenges in Global
Health, Center for AIDS Vaccine Immunology (CHAVI) and Gates Global
HIV/AIDS Vaccine Enterprise (GHAVE) awards.
- Created a
unified, coordinated Clinical Trials Unit – The CFAR serves
as the hub for a novel, Center-wide coordinated Clinical Trials Unit (CTU)
that manages all of the HIV/AIDS Clinical Therapeutic, Vaccine, and Microbicide Network efforts. In response to the most recent CTU RFA
from the NIAID, the CFAR facilitated the application, providing
coordinated financial, regulatory, pharmacy, repository, training, and
community advisory board support to each of the three major Network
affiliated sites (ACTG, HVTN, and MTN) funded at UAB.
- Recruited new
investigators – The Center has played a catalytic role in the recruitment of
more than 18 new investigators into HIV/AIDS research both from within UAB
and from outside institutions.
- Mentored
minority and junior faculty – The Center has stimulated the entry
of minority and junior faculty into HIV/AIDS research through a
competitive developmental research grant program that in combination with
mentoring seeks to ensure a productive transition of newly independent
investigators. Among the new
investigators, 17 of 18 have received Developmental Awards through the
CFAR and each of the 3 minority investigators have received awards and
significant contributions to their start up package.
- Fostered
information exchange – The Center fostered interactions and
information exchange by sponsoring research seminars, symposia and
continuing AIDS education programs that are vital to maintaining its cutting
edge in basic, clinical and behavioral research programs. In 2006 alone, the UAB CFAR hosted the
National CFAR Directors meeting, the CFAR Global AIDS Research Coalition,
the CFAR AIDS-Related Malignancy Working Group, the CFAR Social and
Behavioral Science Research Network, the CFAR Network of Integrated
Clinical Systems, and hosted a day-long National CFAR Symposium on UAB’s
campus.
- Facilitated
the creation of a fully functional research unit in Zambia – The CFAR
facilitated the establishment of one of the few multidisciplinary NIAID
Clinical Trials Units in Lusaka, Zambia through scientific consultation,
investment in research infrastructure, and targeted mentoring.
- Leveraged
institutional support – As a chartered University-Wide Interdisciplinary
Research Center, the CFAR has provided a focus and coordination for all
AIDS research activities within the Institution. This has resulted in more than $4.5
million of Institutional support for CFAR programs in the past 5 years.
- Addressed
regional disparities – In response to the disproportionate impact
of HIV on minorities in the Southeastern United States, the UAB CFAR has
created an Outreach Project in the “Black Belt” of Alabama, a 23 county
region of the southern part of the state where the most impoverished
citizens reside, the majority of whom are African-American. Based out of Selma, the Black Belt
initiative is coordinated by Dr. Groesbeck Parham to educate residents in
this region about HIV, encourage HIV testing, and coordinate referral into
care.
For additional information:
Web site: http://www.uabcfar.uab.edu
Administrative Director: Donna Porter, PhD
Email: dcporter@uab.edu
Phone: 205-934-8291
Director: Michael
Saag, MD
Approved by: Donna
Porter, PhD, Administrative Director
Date: April 8, 2008
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