HIV and co-infections
Co-infections with viral or bacterial pathogens cause significant morbidity in patients with HIV. In the case of HIV/HBV co-infection, morbidity and mortality secondary to liver disease is greatly increased compared to those infected with HBV or HIV alone. Mortality remains elevated even after treating both the HIV and HBV virus. The HBV Immunology Lab investigates the mechanism of how HIV can accelerate liver disease in patients co-infected with HBV. They hypothesise that this occurs by combined effects of HIV and HBV on inflammation in the liver. These studies could potentially lead to new treatments for liver disease. In addition they have a long-standing interest in developing novel assays to characterise the immune response to other important HIV co-infections, including cytomegalovirus (CMV) and Cryptococcus.
HIV Latency Reversing Agents
The biggest hurdle in curing HIV infection in an individual is that the virus remains dormant in some populations of cells, hiding from the immune system and the cocktail of antiviral drugs. This is described as HIV latency and poses a major barrier to curing HIV. The Lewin-Cameron Lab’s research focuses on agents that ‘wake up’ dormant HIV hiding in the body and reverse HIV latency. One group of drugs they strongly focus on is histone deacetylase inhibitors (HDACi).
HIV Reservoir Virology
The HIV Reservoir Virology group’s major focus is on unravelling the viral determinants of HIV latency. They use innovative virological techniques to understand how the virus can persist on ART using CD4+ T-cells from HIV-infected individuals on ART. The reservoir virology group also has a major interest in developing assays to better quantify HIV persistence on antiretroviral therapy.
HIV-related immune reconstitution and immune activation
Following antiretroviral therapy, CD4+ T-cells recover but often don’t recover to normal levels and immune activation can persist. Although patients are no longer at risk of AIDS associated illnesses, they are at increased risk of other diseases including cardiovascular disease, neurological disease and malignancy. The Lewin-Cameron lab is interested in determining novel host factors that influence immune reconstitution including genetic factors.
Dendritic cells and immunomodulation in HIV
Dendritic cell-T cell interactions in different tissues are critical in generating T cell immunity and this interaction is important in controlling productive HIV infection and latency in the T cells. The Lewin-Cameron Lab are exploring how different types of dendritic cells can control the establishment, reversal and maintenance of HIV latency. One major interest of this group is the role of immune check points and their blockade in DC-induced HIV latency.
Professor Sharon Lewin is the inaugural Director of the Doherty Institute. She leads a large multi-disciplinary research team that focuses on understanding why HIV persists on treatment and developing clinical trials aimed at ultimately finding a cure for HIV infection and understanding how HIV interacts with other common co-infections, including hepatitis B virus (HBV). She is a consultant infectious diseases physician at the Alfred Hospital in Melbourne and an Australian National Health and Medical Research Council (NHMRC) Practitioner Fellow. She was recently appointed to the NHMRC Council and the Chair of the Health Translation Advisory Committee. Sharon was previously Head, Department of Infectious Diseases, the Alfred Hospital and Monash University (2003 – 2014) and Co-head, Centre for Biomedical Research, Burnet Institute (2010-2014). Sharon was the local co-chair of the 20th International AIDS Conference (AIDS2014) held in Melbourne in July 2014, which was the largest health and development conference ever hosted in Australia. She is on the leadership team of the International AIDS Society’s Strategy Towards an HIV Cure and is Chair of the Australian Government Ministerial Advisory Committee on Blood Borne Viruses and Sexually Transmitted Infections.