GUEST AUTHOR: Nick Kolev

Dr. Gaurav Gaiha, MD, DPhil, has been awarded a prestigious Avant-Garde Award for HIV and Substance Use Disorder Research from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH). This award is part of the NIH Director’s Pioneer Award mechanism which supports individual scientists of exceptional creativity who propose high-impact research that will open new areas of HIV research and/or lead to new avenues for prevention and treatment of HIV among people who use drugs.

Gaiha received this award for his project “Harnessing Highly Networked HLA-E-Restricted CTL Epitopes to Achieve a Broadly Effective HIV Cure,” which aims to create a universal T cell vaccine for HIV.

HLA molecules are involved in presenting small pieces of viruses and other pathogens to T cells (or immune cells), allowing them to clear viral infections. However, there are many possible HLA molecules across the human population, making it difficult to create a “one-size-fits-all” vaccine. Gaiha’s project seeks to overcome the challenges of HLA diversity in the human population by utilizing a non-classical HLA molecule – known as HLA-E – for which there are only two major variants.

Gaiha also plans to specifically incorporate regions of the virus that are difficult to mutate. These regions are ideal to target as they are critically important to viral protein structure and therefore struggle to evolve and develop resistance before the T cells can eliminate them. This would allow an HIV vaccine to work both durably and universally.

While the development of this vaccine would be broadly applicable to the general population, it could be particularly beneficial for patients with substance use disorder.

“If we could develop an effective and broadly useful T cell vaccine, we believe it could be a remarkable aid to this community,” Gaiha said.

According to the UNAIDS 2022 Fact Sheet, the risk of acquiring HIV is 35 times higher among people who inject drugs than adults who do not inject drugs — a correlation higher than any other risk factor.

Gaiha also noted that the Avant-Garde Award offers substantial flexibility in proposed ideas towards a high-risk/high-reward goal, a strategy that differs from most traditional funding mechanisms.

“I greatly appreciate the flexibility to take an unconventional approach towards this problem, which is a highly unique opportunity,” Gaiha said.

Gaiha is a prinicipal investigator at the Ragon Institute, assistant professor of medicine at Harvard Medical School, and attending physician in the Division of Gastroenterology at Massachusetts General Hospital.

His lab’s work is focused on the development of novel T cell-based vaccines for HIV and other infectious diseases by eliciting responses that target specific regions within viruses that are resistant to mutation and thus easier to target on a broad scale.

“I am honored to received this generous funding, which will enable our team to approach the goal of a functional HIV cure for HIV-positive individuals with substance use disorder and broadly for the HIV-positive population,” he said.

The NIDA is the lead federal agency supporting scientific research on drug use and addiction. It is one of the 27 institutes comprising the NIH, the nation’s medical research agency.