EPIICAL at the 23rd International AIDS Conference


The 23rd International AIDS Conference take virtually place from today to July 10th. Attendants have the possibility to engage with the latest HIV science, advocacy and knowledge and also to hear about recent data on COVID-19 and HIV during the Virtual COVID-19 Conference that will be held on July 10th-11th.

EPIICAL Project will contribute to the conference with two posters presenting data related to the immune-response in early-treated HIV-infected children.

  • De Rossi A, Dalzini A, Ballin G, et al. The size of HIV reservoir is associated with telomere shortening and immunosenescence in early ART-treated HIV-infected children. Oral presentation
  • Ruggiero A, Cotugno N, Domínguez-Rodríguez S,  Zicari S, Rinaldi S, Zangari P, Tagarro A, Foster C, De Rossi A, Nastouli E, Luzuriaga K, Giaquinto C, Rossi P, Pawha S, Palma P, on behalf of the EPIICAL consortium. Aging B-cells (ABC) and anti-Env humoral responses are associated with T-bet expression in B-cells of perinatally HIV infected children (PHIV) treated within 24 months of life (the CARMA cohort). Poster
  • Domínguez-Rodríguez S, Tagarro A, Serna Pascual M, Otwombe K, Violari A, Fernández S, Nhampossa T, Lain M,  Vaz P , Behuhuma NO, Danaviah S, Dobbels E, Barnabas S, Cotugno N, Zangari P, Palma P, Oletto A,  Nardone A, Nastouli E, Spyer M, Kuhn L, Rossi P, Giaquinto C, Rojo P on behalf of EPIICAL consortium. A Machine Learning Approach for Predicting Probability of Death or Disease Progression in an Early-Treated Pediatric African cohort. Poster

Congratulation to all authors!

New publications from EPIICAL Consortium

Just published – data on T & B cell memory and T cell function in early-treated children in the Journal of Immunology and AIDS.
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 the immune response and the amount of HIV virus, in children with HIV who are treated at an early stage. This is to outline treatment strategies to help find a cure for HIV.

Congratulations to all the authors!

Human Rights Day


Today we celebrate Human Rights Day. Percentage of HIV-infected children receiving antiretroviral therapy is still very low in low and-middle income countries, as reported by UNICEF.

EPIICAL is the world’s largest consortium dedicated to science of HIV remission. It represents a community made of people affected by HIV, healthcare workers, scientists, Independent Scientific Advisors and pharma representatives, all working together to develop and apply data to inform novel therapeutic strategies in perinatally HIV-infected children to reach HIV remission. Let’s hear from the voice of Dr. Almoustapha Maiga, virologist at University of Bamako, Mali, how can EPIICAL impact in children’s life in developing countries. #StandUp4HumanRights

Earth study enrols 150 patients!

The Earth study has enrolled its 150th patient in Bamako, Mali. A huge congratulations to Bamako and all sites involved in the Earth study.

The Earth study – Cohort of Early Anti-Retroviral Treatment in HIV-perinatally infected Children – is a prospective multicenter, low-interventional study of HIV+ perinatally infected children on sustained suppressive antiretroviral therapy started before 3 months of age.

The Earth study’s primary aim is to engage in care and monitor clinical, virological and immunological features of early treated children in limited-resource settings. This is, ultimately, in order to identify potential participants in proof-of-concept trials directed towards a HIV cure.

With 150 patients enrolled into the study, we are now one step closer to achieving our aim of improving HIV care.

The Earth study is firmly nested in the goals of EPIICAL (early treated perinatally HIV infected individuals: improving children’s actual life), which is the world’s largest consortium dedicated to science of HIV remission. The EPIICAL consortium represents a community made of people affected by HIV, healthcare workers, scientists, researchers, Independent Scientific Advisors and pharma representatives, all working together to develop and apply data to inform novel therapeutic strategies in perinatally HIV-infected children to reach HIV remission.

A massive thank you to all enrolling sites!

But we’re not stopping there…. we are now focusing on reaching our new target of 300 patients.

World AIDS Day 2019


“The mission is remission. We believe that an HIV remission/cure is attainable.”

Today we celebrate World AIDS Day: this year theme is “Communities make the difference”.

In the recent EPIICAL 3rd General Assembly, Carlo Giaquinto and Paolo Rossi, EPIICAL coordinators, stated that “Working together to deliver good science is the way”.

EPIICAL (Early treated perinatally HIV infected individuals: improving children’s actual life) is the world’s largest consortium dedicated to science of HIV remission. It represents a community made of people affected by HIV; healthcare workers, scientists, Independent Scientific Advisors and pharma representatives, all working together to develop and apply data to inform novel therapeutic strategies in perinatally HIV-infected children to reach HIV remission.

How is EPIICAL doing this?

EPIICAL is developing a predictive platform, using existing and new data, to inform treatment strategies that can lead to HIV remission. Unique in EPIICAL are the cohorts of vertically infected European and African children that are providing a deep insight on viral reservoir and immune response characteristics of early treated children. Vertically infected children represent the ideal population to test novel therapeutic strategies towards HIV remission, thanks to their small viral reservoir and their well resilient immune system.

Why are we confident that EPIICAL can achieve HIV remission?

Data presented at the 3rd EPIICAL General Assembly show that a mix of different immunotherapeutic strategies seems to be the most promising way to allow for an ART-free HIV remission. HIV therapeutic DNA-vaccine (the focus of HURRICANE study) will be an important component of this mix. The HURRICANE study is the only ongoing study on HIV-vertically infected children, evaluating therapeutic vaccine effects on the child’s viral reservoir and immune response.

Critical to the EPIICAL project is the contribution of social science. Thinking about how and why people feel, think and act can improve protocol design, inform interventions, support voluntary choice in clinical interventions, and finally improve health and wellbeing outcomes for children and their mothers enrolled into studies.

What next for EPIICAL?

One of the key achievements of EPIICAL, over the last 4 years, has been the development of the strong and passionate international network collaboration. As EPIICAL progresses over the next 4 years, it will design interventions based on the learning so far.  The next appointment is in March 2020 for CROI, during which 8 EPIICAL abstracts will be presented.

Indeed EPIICAL is working to meet the new challenges of HIV community! #WorldAIDSDay

Universal Children’s Day

Today, November 20th, is Universal Children’s Day. This year,  we are celebrating in Cape Town, South Africa, where the EPIICAL 3rd General Assembly is being hosted. Universal Children’s Day is dedicated to the rights of the child, with one key aspect being the right for every child to access the highest standard of health. However, at the end of 2018, there were 37.9 million people living with HIV worldwide and, among them, 1.7 million are children aged less the 15 years.

The Early treated Perinatally HIV Infected Individuals (EPIICAL) is the world’s largest consortium dedicated to science of HIV remission, consisting of well-known scientists and clinicians working in HIV and pediatrics, from 26 institutions worldwide.

EPIICAL is strongly committed to fighting the HIV paediatric epidemic. Unique to the EPIICAL study are the cohorts of HIV-infected children who are treated early, and will be studied to develop strategies to develop treatment for HIV remission in HIV-infected children.
The knowledge gained from the consortium’s work has the potential to transform the lives of HIV-infected children worldwide, as well as potential applicability for the treatment of HIV in adults, particularly those who initiate early anti-retroviral therapy.

EPIICAL publication on Journal of AIDS: treat early, suppress fast!


Treat early, suppress fast!

In a new paper just published online in Journal of AIDS, EPIICAL researchers investigated the association between the timing of antiretroviral therapy (ART) initiation and time-to suppression​ among HIV-infected infants who initiated​ ART within the first 28 days of life.

The study showed as children treated within 7 days of life have a faster​ time to viral suppression, which may result in a favorable ​impact on the viral reservoir.

These data strongly support the potential benefits of starting ART within 7 days of birth even in comparison to​ starting from 8 to 28 days after birth.

The young investigators: A ‘day in the lab’

With Nicola Cotugno

Why are you involved in the EPIICAL project and what’s your role?

I became interested in HIV-related immunology after receiving my degree in Medicine and when, as a medical student, I began following vertically HIV infected children at the Bambino Gesù Children’s Hospital in Rome. During my residency in Pediatrics, back in 2013, I observed the first baby steps made by EPIICAL, stemming from the ideas of Paolo Palma, Paolo Rossi and Carlo Giaquinto. I immediately sensed that EPIICAL was a great opportunity to pursue my passion for Immunology Research in order to contribute to future possible strategies aimed at improving the quality of life of HIV infected children. Since then, I have been working within the Immunological Platform through the active collaboration between the Miami Center for AIDS Research (CFAR) and OPBG. Through ongoing projects and during my postdoctoral fellowship experience in Miami in 2014 and 2015 we were able build preliminary analysis to support the EPIICAL experimental plan. Today, in the 4th and last year of the project, I am now actively involved in the research and clinical activities of the Immunological Platform for the EPIICAL studies (CARMA, EARTH and HVRRICANE) through scientific discussions, SOPs validation and data dissemination.

How has your participation in EPIICAL helped prepare your career for this role in the Project?

I believe that my current research is strongly influenced by the concepts and approaches pursued by the EPIICAL consortium. Moreover, I feel that this project, more than any other in which I have participated, has given young researchers like me the opportunity to share work experiences with great scientists and top-level physicians in the field of pediatric HIV from all over the world. On the other hand, however, EPIICAL is a broad and extremely diverse consortium which aims to merge knowledge from different fields. I now feel that this complexity has greatly helped my personal growth and adaptability in future collaborative projects.

Tell us about your typical day in the lab!

There is no perfect day in the lab. But the fact that you are surrounded by young, ambitious and valuable young researchers certainly makes it better. The research group has grown incredibly since the beginning of this experience, and I am now lucky enough to follow two PhD students who are involved in HIV projects. Accordingly, the day in the lab is spent between bench work, data analysis and discussion through the weekly based data club and journal club.

The main activities of the lab work are FACS analysis, FACS sorting and multiplexed gene expression analysis. But we all have the same impression: the best is yet to come!

Which are the main results of your Work Package (Immunological Platform)?

In the last few years we have been focusing on humoral and cell immunity in early treated HIV infected children. Indeed, we recently showed how HIV serology profiles may be crucial to predict the size of viral reservoirs in vertically HIV infected children. In addition, we produced gene expression data on HIV specific B cells after in vitro stimulation in early treated patients. We believe that this data may inform future immune therapeutic strategies able to improve HIV specific responses. Indeed, sorted gp140+ B cells from these patients were analyzed for gene expression and BCR sequence. Toll Like Receptor pathways proved to be downregulated in seronegative early treated children, suggesting that targeting such molecules may improve the HIV specific immune response in these children. On the T cell side, our work showed early treated children present a functional advantage compared with late treated patients in terms of intracellular cytokine production upon in vitro stimulation (data produced by Miami CFAR). In line with this, RNA Seq (data produced at Case Western University) also pointed to specific differences between early and late treated patients. This evidence further suggests that the timing of ART initiation is a pivotal characteristic in clinical studies aiming at remission.

These differences and the selective advantage in the memory NK compartment was also recently showed by our group at the EPIICAL general assembly held in Madrid in November 2018.

What will be the next milestones of the Immunological Platform?

We are all very excited about the upcoming enrollment and experiments for the HVRRICANE project. Indeed, for the first time, this study will test the ability of a HIV DNA vaccination together with a TLR4 agonist to reduce viral reservoir in HIV infected/early treated patients. We will test how the vaccination induces HIV specific T and B cell immunity and its ability to induce neutralizing Ab as well as Ab dependent Cytotoxic activity.

The other EPIICAL projects, CARMA and EARTH, are also moving fast. In 2019 we will produce the final results for CARMA and also start receiving the EARTH samples from the African sites. Needless to say, plenty of work and excitement still in the pipeline.

What advice would you offer to current young researchers?

Follow your passion, don’t let setbacks discourage your research, be determined …and try to do something EPIICAL!!!