Jill Lau
Maintaining momentum: HIV cure research in the COVID era
The COVID-19 pandemic has devastated lives, healthcare systems and economies around the world. Research has not escaped unscathed. Clinical trials have been difficult to maintain during the pandemic. This is due to a combination of halts to non-urgent clinical services and work from home directives. In addition, many people involved in clinical trials shifted focus to COVID-19. HIV cure research slipped down the priority list. But, even in a pandemic, research towards a cure for HIV must continue. Recent papers suggest how HIV cure research can proceed in a global pandemic for the American context. This includes ways to safely restart trials and minimise COVID-19 risks for participants and staff. HIV community advocates and researchers have now adapted these principles for the low COVID-19 context in Australia.
The Australian experience with COVID-19 is unique, with few infections compared to many other countries. We have effectively stopped community transmission. Our few new cases emerge from returned travellers in quarantine. Australians are starting to get vaccinated against SARS-CoV-2, the virus which causes COVID-19. Research activities are slowly returning to pre-pandemic levels. Two new HIV cure clinical trials will begin recruiting this year. For these, it is critical to have trial management plans tailored to settings where COVID-19 case numbers are low.
What has been done to enable safe research in Australia?
In October 2020, an Australian working group developed a COVID-19 Clinical Trial Risk Minimisation Plan. This plan addresses ways to keep trial participants safe. Strategies include telehealth or home study visits to avoid hospital clinics and regular COVID-19 testing. It also includes an infection management plan for dealing with COVID-19 diagnoses. Because of our low COVID-19 transmission rates, the plan would apply if COVID-19 infections cross a specific threshold. The thresholds are based on current government definitions of transmission “hotspots”.
Why is this important?
The most significant part of this process was bringing researchers and community members together. The working group included stakeholders from a range of community and research organisations. These included the National Association of People Living with HIV Australia (NAPWHA), Burnet Institute, Living Positive Victoria, The Peter Doherty Institute for Infection and Immunity, the Alfred Hospital, Monash University and Positive Women Victoria. Community involvement ensured the plan reflected the voices and preferences of people living with HIV. Clinical trial development for HIV cure research must include people living with HIV at all stages. The COVID-19 pandemic should not stop the search for an HIV cure. By prioritising the needs and preferences of people living with HIV, HIV cure research can safely resume.
.png)