Welcome to New Center for AIDS Research at Emory Core Leadership

Welcome to New Center for AIDS Research at Emory Core Leadership

Please join the CFAR Co-Directors, Ann Chahroudi, Carlos del Rio, and Colleen Kelley, in congratulating newly named CFAR Core Directors and Associate Directors! They join Kimbi Hagen, Bob Lyles, Kirk Easley, Igho Ofotokun, Vince Marconi, Paul Johnson, John Altman, Hannah Cooper, Patrick Sullivan, Natalie Crawford, Aaron Siegler, Guido Silvestri, Vandy Vanderford, Colleen Kraft, and Maud Mavigner who continue as Core leaders.

The CFAR Leadership and Emeriti Directors evaluated candidates to select the leadership for the Cores, and they invite you to review the attached document that includes brief bios for each of them. These individuals were selected based on their outstanding contributions to HIV Science, leadership experience and potential, and commitment to mentoring and supporting the next generation of HIV researchers.

We are grateful to each of them for their commitment to the CFAR, and we look forward to working together to ensure that we meet the needs of CFAR Members and strive to achieve the CFAR mission: to contribute to ending the HIV epidemic by accelerating the highest caliber translational research — fostering team science, equity, and multidirectional stakeholder engagement.

Developmental Core

Rama Amara, PhD

Co‐Director, Developmental Core

Drenna Waldrop, PhD

Co‐Director, Developmental Core

Kimbi Hagen, EdD

Associate Director, Developmental Core

Clinical Research Core

Vincent Marconi, MD

Co‐Director, Clinical Research Core

Igho Ofotokun, MD, MSc

Co-Director, Clinical Research Core

Andres Camacho‐Gonzalez, MD, MSc

Associate Director, Clinical Research Core

Anandi Sheth, MD, MSc

Associate Director, Clinical Research Core

Biostatistics and Bioinformatics Core

Robert H. Lyles, PhD

Director, Biostatistics and Bioinformatics Core

Kirk A. Easley, MS, MApStat

Associate Director, Biostatics and Bioinformatics Core

David Benkeser, PhD, MPH

Associate Director, Biostatistics and Bioinformatics Core

Yijuan Hu, PhD

Associate Director, Biostatistics and Bioinformatics Core

Prevention and Implementation Sciences Core

Hannah Cooper, ScD

Co-Director, Prevention and Implementation Sciences Core

Patrick Sullivan, DVM, PhD

Co-Director, Prevention and Implementation Sciences Core

Natalie Crawford, MPH, PhD

Associate Director, Prevention and Implementation Sciences Core

Jessica Sales, PhD, MA

Associate Director, Prevention and Implementation Sciences Core

Aaron Siegler, PhD, MHS

Associate Director, Prevention and Implementation Sciences Core

Systems Immunology Core

R. Paul Johnson, MD

Director, Systems Immunology Core

John Altman, PhD

Associate Director, System Immunology Core

Steven Bosinger, PhD

Associate Director, Systems Immunology Core

Rafick-Pierre Sékaly, PhD

Associate Director, Systems Immunology Core

Virology & Molecular Biomarkers Core

Guido Silvestri, MD

Director, Virology and Molecular Biomarkers Core

Deanna Kulpa, PhD

Associate Director, Virology & Molecular Biomarkers Core

Thomas H. Vanderford, PhD

Director, Translational Virology Unit

Colleen S. Kraft, MD, MSc

Director, Clinical Virology Unit

Maud Mavigner, PhD

Director, Viral Reservoirs Unit

download .pdf with all director bios >

LEEP more effectively clears high-risk HPV in HIV+ women

LEEP more effectively clears high-risk HPV in HIV+ women

Featured article in Emory Report
By Shannon McCaffrey | Woodruff Health Sciences Center | Aug. 25, 2021

A new study published in JAMA Oncology by Winship Cancer Institute of Emory University’s Michael H. Chung, MD, MPH, and colleagues, finds that loop electrosurgical procedure (LEEP) is more effective than cryotherapy in clearing high-risk human papillomavirus (hrHPV) in women living with HIV. Chung is a professor of infectious diseases at Emory University School of Medicine, and a professor of global health and epidemiology at Rollins School of Public Health.

The study drew upon data for 354 HIV-infected women recruited from the Coptic Hope Center for Infectious Diseases in Nairobi, Kenya—which Chung cofounded. It set out to determine which modality is more effective at clearing hrHPV, and whether persistent hrHPV is associated with recurrent cervical cancer.

Half the women were randomly assigned to receive cryotherapy and the other half to receive LEEP.

The women were followed every six months for two years with hrHPV cervical swab and Pap tests. Persistent hrHPV detection was associated with a substantially greater risk of recurrent cervical cancer even after controlling for immune status, HIV viral suppression, and type of intervention. Over the 24 months, significantly more women treated with LEEP cleared the hrHPV than those treated with cryotherapy. LEEP was also better at preventing recurrent cervical cancer.

“Our study showed that when treating pre-cancerous cervical lesions in HIV-infected women, LEEP should be the preferred option instead of cryotherapy,” said Chung. “In addition, HPV testing for HIV-infected women is reasonable to do to determine whether the treatment has been successful and can be done as early as 6 months after the intervention.”

HPV is the most common sexually transmitted infection. It is associated with cervical cancer in women and genital warts in both women and men. Women living with HIV who also have certain types of cancer-causing HPV are at higher risk of developing cervical cancer, one of the illnesses that define advanced untreated HIV disease, or AIDS.

Cervical cancer is the fourth most frequently diagnosed cancer among women worldwide, and the most common cause of cancer death among women in sub-Saharan Africa. Women living with HIV have a higher rate of hrHPV than the general population, and are more likely to have persistent hrHPV infection leading to cervical intraepithelial neoplasia (CIN), abnormal growth of cells on the surface of the cervix that can potentially lead to cervical cancer.

It’s helpful to understand hrHPV and HIV coinfection to determine the usefulness of hrHPV testing to prevent cervical cancer among women living with HIV. The World Health Organization (WHO) and many national guidelines recommend testing for hrHPV as a primary cervical cancer screening tool in both high-income, middle- and low-income countries. Testing for hrHPV also is used to screen for recurrent disease after treatment for precancerous cervical lesions, and to help define the frequency and duration of follow-up.

Women in high-income countries with CIN grade 2 and higher are often treated with LEEP, which excises the lesions and surrounding tissue. In low- and middle-income countries, inexpensive and less technically complex cryotherapy is used to freeze the area around the lesion. Neither approach completely treats CIN or clears hrHPV infection, particularly for HIV-positive women. This is why it was important to compare LEEP and cryotherapy outcomes, and to determine whether one or the other is most effective at clearing cervical hrHPV infection, as well as whether persistent hrHPV is associated with recurrent CIN.

“Current clinical practice to treat pre-cancerous cervical lesions in LMIC’s [low- and middle-income countries] largely rests on using cryotherapy,” said Chung, “which is easier and less expensive to administer than LEEP. Clinical practice in LMIC should try to prioritize LEEP over cryotherapy when treating HIV-infected women to achieve the best clinical outcomes.”

Grant support was provided by the President’s Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention under cooperative agreements GH002036 and GH002001.

Other collaborators involved in this study are from the University of Washington, Seattle; Ghent University, Ghent, Belgium; International Agency for Research on Cancer/World Health Organization, Lyon, France; Kenya Medical Research Institute, Nairobi, Kenya; Centers for Disease Control and Prevention, Atlanta; Coptic Hospital, Nairobi, Kenya; and Aga Khan University, Nairobi, Kenya.

Photo:  Michael H. Chung, MD, MPH co-founded the Coptic Hope Center for Infectious Diseases in Nairobi, Kenya, from which 354 HIV-infected women were recruited for the study. Photo: Paul Brown, University of Washington

NIH awards Emory and partners $27.6M for pediatric HIV cure research

NIH awards Emory and partners $27.6M for pediatric HIV cure research

Featured article in Emory Report
By Jill Wu | Woodruff Health Sciences Center | Aug. 20, 2021

Emory University and the Yerkes National Primate Research Center will share with the Johns Hopkins University School of Medicine in a five-year, $27.6 million award from the National Institutes of Health (NIH) to accelerate the search for a cure for HIV in children and adolescents.

The Pediatric Adolescent Virus Elimination (PAVE) Collaboratory is using a multidisciplinary, multicultural and iterative approach to study pediatric HIV. The $5.7 million annual grant is part of the Martin Delaney Collaboratories (MDC) for HIV Cure Research program.

Co-principal investigator Ann Chahroudi, MD, PhD, is an infectious disease specialist at Children’s Healthcare of Atlanta, director of the Center for Childhood Infections and Vaccines and associate professor of pediatrics, Emory University School of Medicine. She is also a researcher with the Yerkes Microbiology and Immunology Division. The co-lead is Deborah Persaud, MD, a virologist and professor at the Johns Hopkins University School of Medicine. PAVE will collaborate with 36 U.S. and internationally based co-investigators.

Around the globe, an estimated 1.7 million children under age 15 are living with HIV, and there are about five million adolescents and young adults aged 15-25 who have HIV. Additionally, about 150,000 children a year are born infected with HIV.

“Despite remarkable advances in the prevention and treatment of HIV, it remains an epidemic for millions of children and adolescents who live with the virus every day,” says Chahroudi. “The mission of our collaboratory is more than treating HIV in children, it’s to find a cure, which will improve millions of lives worldwide.”

The PAVE Collaboratory aims to identify and harness the unique immunovirological features of HIV infection in children and adolescents. Working with pediatric nonhuman primate models, PAVE team members will conduct preclinical safety and effectiveness research studies of novel treatments. The collaboratory will also focus on developing procedures, tools and techniques, including imaging, specifically for infants, children and adolescents.

Ann Chahroudi

Lessons from 40 years of HIV/AIDS

Lessons from 40 years of HIV/AIDS

Featured article in Emory Report
By Martha McKenzie | Emory Report | June 1, 2021

Forty years ago, on June 5, 1981, the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report (MMWR) carried a report of five otherwise healthy gay men in Los Angeles who suffered from a rare form of pneumonia. Two had died.

James Curran, an epidemiologist in the CDC’s Sexually Transmitted Disease Control Division at the time, was asked to review the report before it was published. That was his first glimpse at the disease that would roil the world and define his career: acquired immunodeficiency syndrome (AIDS).

Soon after the report was published, Curran, now dean of Emory University’s Rollins School of Public Health, was asked to chair a task force organized to investigate the cause of this unusual outbreak. He was detailed to the investigative team for 90 days. The assignment lasted 15 years.

The task force’s first order of business was to establish a case definition, determine how the disease spread, and develop prevention recommendations.

“In those early days it was all boots-on-the-ground surveillance,” says Curran. “We tried to identify and follow everyone who fit the description, which soon included other opportunistic infections and a rare cancer called Kaposi’s sarcoma in addition to Pneumocystis pneumonia. We were trying to answer questions like, did these cases only occur in gay men? Were they limited to California and New York? Were they always fatal?”

Within weeks, Curran’s team confirmed more than 25 additional cases. The case definition the team put together based on their discoveries was adopted worldwide, allowing early and consistent recognition of the global AIDS epidemic.

It took two years for the cause of AIDS — a novel retrovirus eventually named human immunodeficiency virus (HIV) — to be identified.

Since then, vast progress has been made in diagnosis, prevention and treatment. Drugs developed at Emory — Emtriva and Epivir — are among the most widely used to suppress viral loads in infected people. The development of pre-exposure prophylaxis (PrEP) offered HIV-negative people effective protection from contracting the virus. Over the decades, AIDS went from being a death sentence to a chronic, life-long condition that could be managed with the correct medications.

In 1995 Curran left the CDC to become the dean of the Rollins School of Health, but he continued working in AIDS as co-director of the Emory Center for AIDS Research (CFAR). On the 40th anniversary of the first published account of AIDS, he reflects on the progress that has been made and what lies ahead.

“We’ve come so very far, yet there are about 38 million people worldwide living with HIV,” says Curran. “It’s a silent disease, so there are many more than 100,000 people in the U.S. who are infected but don’t know it. We’ve been able to reduce mortality and slow the transmission rate, but current therapy is not curative and must be continued for life. We can’t talk about totally eliminating AIDS until we’ve developed a vaccine and curative therapy. These remain important priorities for our current CFAR scientists.”

Still, the history of AIDS offers positive lessons. Though the beginning of epidemic was characterized by fear and homophobia, with President Ronald Reagan refusing to speak publicly about AIDS for nearly six years, a commitment to fight the disease prevailed. The George W. Bush administration established the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to bring relief, including heavily discounted drugs, to Africa and Asia, which suffered disproportionately.

“That global philanthropic commitment has saved tens of millions of lives,” says Curran.

Governments would do well to heed this lesson, especially in the face of wealthier nations hoarding COVID-19 vaccines.

“One thing AIDS taught us, and subsequently Ebola and Zika: Pathogens do not respect national boundaries,” says Curran. “If we want to keep ourselves safe, we have to keep everyone safe.”

Soon after the CDC reported the first cases of what would come to be known as AIDS, epidemiologist James Curran, shown here at the CDC in 1985, was asked to chair a task force to investigate the cause. Curran became dean of Emory’s Rollins School of Public Health in 1995. Photo by Steve Ringman/San Francisco Chronicle via Getty Images.

Emory-developed COVID-19 vaccine safe, effective in animal models

Emory-developed COVID-19 vaccine safe, effective in animal models

Featured article in Emory Report
By Lisa Newbern | Woodruff Health Sciences Center | February 4, 2021

Researchers at Yerkes National Primate Research Center and Emory Vaccine Center have developed a COVID-19 vaccine that has proven safe and effective in mice and monkeys. The results were published online Thursday, Feb. 4 in Immunity.

The Emory COVID-19 vaccine induces protective immunity via the platform of modified vaccinia Ankara (MVA), a harmless version of a poxvirus that is well-known for its use in HIV/AIDS vaccines. Like the Moderna and Pfizer vaccines, the MVA COVID-19 vaccine induces strong neutralizing antibodies, which support the immune system’s ability to fight infections. The MVA COVID-19 vaccine also induces killer CD8 T cells, providing a multi-pronged approach to halting SARS-CoV-2.

In addition, Emory researchers say the vaccine is easily adaptable to address disease variants and can be used in combination with existing vaccines to improve their ability to combat variants and has the potential to be equally effective with a single dose.

Lead researcher Rama Amara, PhD, built the MVA COVID-19 vaccine based on his more than 20 years of experience working with MVA and animal models to develop an HIV/AIDS vaccine. He and his Yerkes-based research team tested two MVA SARS-CoV-2 vaccines in mice. One of them, MVA/S, used the complete spike protein of coronavirus to induce strong neutralizing antibodies and a strong killer CD8 T cell response against SARS-CoV-2.

“Generating neutralizing antibodies is an important component of a successful COVID-19 vaccine because the antibodies can block the virus from entering the body’s cells,” says Amara, who is Charles Howard Candler professor of microbiology and immunology at Emory University School of Medicine and a researcher in Yerkes’ Division of Microbiology and Immunology. “It’s as important to activate CD8 T cells that can clear infected cells, so this allows us to approach halting the virus two ways simultaneously. The CD8 T cells also provide ongoing value because they are key to working against other variants of the virus, especially if antibodies fail.”

Based on the encouraging study results in mice, Amara’s team advanced the MVA/S COVID-19 vaccine into a study with 10 rhesus monkeys at Yerkes. For five animals, the researchers gave two doses of the vaccine a month apart and then challenged them with SARS-CoV-2. The researchers also challenged a group of five monkeys that received a placebo MVA vaccine, which did not contain any genes from the COVID-19 virus. The virus grew to high levels in the lungs of all five placebo animals by the second day, but was below detection limits in all five MVA/S-vaccinated animals.

“Comparing the virus in vaccine and placebo groups provided clear results the MVA/S vaccine is safe and effective against SARS-CoV-2,” says Amara. “These results are even more promising because the MVA/S-vaccinated animals did not show any signs of inflammation in the lungs such as what medical professional are seeing in humans who have COVID-19.”

Rafi Ahmed, PhD, director of the Emory Vaccine Center, credits Amara for his comprehensive approach:

“Based on decades of research, we know MVA vaccines are safe, effective and can be used in combination with other vaccines, including mRNA vaccines, to enhance the immune system’s response. The Emory MVA COVID-19 vaccine, which builds on the MVA HIV vaccine Dr. Amara co-developed that recently completed phase 2a human clinical trials, scores multiple goals by producing neutralizing antibodies, inducing killer CD8 T cells and preventing lung inflammation. This multi-layered approach to developing a COVID-19 vaccine is well positioned to fight the current strain of SARS-CoV-2 as well as the variants we’re beginning to see.”

“My research team and I as well as the entire Yerkes community are excited to move the Emory MVA COVID-19 vaccine forward,” says Amara. “The world needs multiple COVID-19 vaccines to meet the demand. Our vaccine can stand alone as well as complement the available mRNA versions. It’s a perfect combination of scientific expertise and collaboration, and commitment to improving human health.”

Amar’s team will continue their work on COVID-19 vaccines, with one study focusing on the effectiveness of a single dose of the Emory MVA COVID-19 vaccine. A convenient single dose regimen could prove especially valuable to ensure a high rate of vaccine uptake. Amara received two FastGrant awards to supplement his NIAID grant and expedite this follow-up COVID-19 research.

In a second study, Amara’s team is focusing on inducing broader T cell responses capable of fighting new COVID-19 variants and other human coronaviruses.

“The newly designed vaccines aim to induce T cells against multiple other genes of the virus in addition to targeting the spike protein,” says Amara. “This requires inserting multiple genes of the coronavirus into the vaccine, which can be challenging. MVA, however, is well-suited for this because of its unique capacity to carry extra genes.”

Amara’s research team includes Nandakishore Routhu, PhD (postdoc), Sailaja Gangadhara, PhD (research associate), Narayanaiah Cheedarla, PhD (postdoc), and Venkata Satish Bollimpelli, PhD (postdoc), all four co-lead authors, as well as Ayalensh Shiferaw (research specialist). Amara and his team worked in close collaboration with the laboratories of Mehul Suthar, PhD, and Steve Bosinger, PhD. Suthar is an assistant professor in the Emory SOM Department of Pediatrics and an EVC researcher. Bosinger is an assistant professor in the SOM Department of Pathology & Laboratory Medicine, an EVC researcher as well as a researcher in Yerkes’ Division of Microbiology and Immunology, and director, Yerkes Nonhuman Primate (NHP) Genomics Core.

In addition to the NIAID grant 3R01AI148378-01S1, the MVA vaccine study reported in this release is supported in part by the Yerkes National Primate Research Center base grant P51OD011132 from the NIH Office of the Director, Office of Research Infrastructure Programs.

Grant amounts (direct + indirect):

3R01AI148378-01S1 $582,625/for 2 years

P51OD011132 $10,540,602/yr

Fast grant 1, $250,000

Fast grant 2, $350,000

Note: The amounts listed above are for the full grants. Only a portion of the P51 will support infrastructure needs of the COVID-19 vaccine study reported in this news release.

Rama Amara, PhD