EPIICAL insight

For more on the EPIICAL project, watch our insights videos.

In the year of COVID-19 vaccines, why do we still not have a cure for HIV?

What is the effect of HIV infection on the human body?

How do current therapies tackle HIV?

Why do we need EPIICAL and what is its mission?

HIV infection still requires lifelong therapy, but lifelong therapy leads to side effects which affect vital human organs, such as the heart, kidneys and bones. Side effects are also one of the key reasons that HIV sufferers do not continue their therapy. The EPIICAL project is working to solve this by obtaining remission of HIV infection in patients, without the need for continuous treatment. Find out more in this video from Pablo Rojo, one of the principal investigators of EPIICAL.

Why haven’t we been able to eradicate HIV yet?

Antiretrovirals are only effective against infected CD4 cells in people where HIV is actively replicating. In some cases, when the HIV virus enters the human CD4 cell, the HIV virus does not actively produce new copies of itself – instead its DNA remains within the cell. This produces latent HIV infected CD4 cells, and this is called a viral reservoir. Merlin Robb, Deputy Director for Clinical Research for the U.S. Military HIV Research Program, explains the HIV viral reservoir in more detail.

How is EPIICAL achieving its mission?

Antiretroviral treatment, if started at an early stage, is able to reduce the amount of HIV virus in a child’s body. EPIICAL is studying the characteristics of immune response and the amount of HIV virus in children with HIV who are treated at an early stage, in Europe and South Africa. This will help EPIICAL to understand and outline treatment strategies that can help stop the need for long-life ART.

Paolo Palma provides an insight to the HVRRICANE study: another step towards HIV remission. HVRRICANE aims to test the efficacy of a therapeutic vaccine in reducing the amount of virus in the blood of infected children

What is important for EPIICAL to consider while conducting research in low- and middle-income settings?

When working in a low-resource setting, patients and study team face a lot of problems. Wilma Orange and Ronelle Arendse, two nurses from @StellenboschUni involved in EPIICAL, enlighten challenges that children and families face every day, and the difficulties their team encounters while working with patients

How is EPIICAL working to overcome these challenges?

One strand of the work of EPIICAL is to study and understand families and patient’s adherence to treatment, once they agreed to be enrolled into a clinical trial.
Holly Peay, (PhD, RTI International) explains how EPIICAL is doing this and how it can improve the way clinical trials are carried out with children and families in the future.