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TheU.S.MilitaryHIVResearchProgram(MHRP)isattheforefrontofthebattleagainstHIVtoprotectU.S.troopsfrominfectionandtoreducetheglobalimpactofthedisease.WhileitsprimaryfocusisdevelopingagloballyeffectiveHIVvaccine,MHRPprovidesHIVpreventionandtreatmentservicesfundedthroughthePresident’sEmergencyPlanforAIDSRelief(PEPFAR)inthecommunitiesinwhichresearchisconducted.

MHRPwasauthorizedbyCongressin1986andhassincebecomealeaderininternationaleffortstocombatHIV.WithsitesinAfrica,AsiaandEurope,theprogram’sgrowthhasbeenachievedthroughthecombinationofstrongvaccinescience,thecarefuldevelopmentofresearchsitesandpartnershipswithkeyresearchinstitutionsinthehostcountriesandtheU.S.,includingNIH/NIAID.

HIVVaccineDevelopmentIn2009,theMHRPannouncedresultsofanArmy-sponsoredclinicaltrialinThailandthatdemonstrated,forthefirsttime,amodestabilitytoprotectagainstHIVinfection,reducingthenumberofinfectionsby31.2percent.Thisstudyofferedthevaccineresearchfieldrenewedhope,andmoreimportantly,itprovidedscientificdirectiontohelpguidefuturevaccinedevelopment.AnewefficacystudybasedonRV144beganinNovember2016inSouthAfrica,ledbytheNIH.Additionally,MHRPplayedakeyroleinanimalstudiesandearlyclinicaltestingofanothernovelvaccinestrategyusingAd26/MVA/proteinvaccinecandidatesaimedatglobalprotectionfromHIV.ThiscollaborationledtoaPhaseIIstudy,whichourpartnersitesinThailandandUgandaparticipatedin,calledtheAPPROACHtrial.

TheAPPROACHstudyshowedpromisingimmuneresponsesandhelpedleadtoanewefficacystudythatHVTNlaunchedin2017calledImbokodo(HVTN705),sponsoredbyJohnson&Johnson.MHRPisactivelyinvolvedinthisefficacystudyasacollaborator.

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• Vaccinedevelopmentandtesting• Threatassessmentand

epidemiology• HIVdiagnostics• Therapeuticsandcureresearch

LeveragingOurExpertiseMHRPhasdevelopedextensivecapabilitiesandinternationalinfrastructurethatisbeingleveragedtocombatotherinfectiousdiseases:• VaccinesforEbola,MERS

andZika• Emerginginfectionssurveillance• HIV/TBandHIV/malaria

co-infectionanddiagnostics

www.hivresearch.org

MHRPResearch

Centeredatthe

WalterReedArmyInstituteofResearch

(WRAIR)

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U.S. MILITARY HIV RESEARCH PROGRAM

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MHRPledthefirst—andonly—HIVvaccinetrialtoshowefficacy(31.2%)inpreventingnewinfections,therebyprovidingcritical

evidencethatasafeandeffectiveHIVvaccineispossible.

Soldier Health – World Health

• FirsttoidentifyheterosexualtransmissionofHIV-1

• CharacterizedmorethanhalfoftheknownHIVgeneticsubtypes

• ConductedthefirstEbolavaccinetrialinAfrica

• Conductedthefirst-in-manMERSvaccinestudy

ForceReadiness

• OverseesallHIV-1testingfortheArmy,andservesastheTri-ServiceHIVReferenceLaboratory

• TrackstheHIVepidemicinactive-dutyforcesandassessestheriskofHIVexposuretodeployedU.S.andalliedforcesoverseas

• Evaluatesrapidtestsandotherdiagnosticstoolstoensurebattlefieldbloodsafety

Contributions

Collaborations

• MHRPcollaboratesextensivelywithU.S.andinternationalagencies,foreigngovernmentsandmilitaries,NGOsandacademicandindustrypartners

www.hivresearch.org

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MHRPresearchersarealsodevelopingandtestingnovelvaccinestrategies,includingnewadjuvantsandimprovedproteinconstructsaimedatsubtypeB,whichiscommonintheAmericas,EuropeandThailand.NewclinicaltrialsitesandpartnershipsareindevelopmentforfutureHIVvaccinestudiesinGermanythatwillfocusonsubtypeB,whichismostrelevanttoU.S.servicemembers.

CommitmenttoCombatHIVPEPFARisthelargestU.S.Governmentinternationalhealthinitiativeinhistory,dedicatedtoprovidingintegratedpreventionandtreatmentinthedevelopingworld.ImplementingPEPFARactivitiesatourresearchsiteshashelpedMHRPbuildstrongandtrustingrelationshipswithinthecommunitieswhereresearchisconductedandprovidesanethicalframeworktoconductHIVclinicalresearch.

OurPEPFARprogramsengagebothcivilianandmilitarypopulationsinsub-SaharanAfrica.MHRPPEPFARprogramshavedevelopedrobustin-countryrelationshipswithCDC,USAID,PeaceCorpsandotherstakeholdersandhavebuiltpowerfulpartnershipswithhost-countrycivilsociety,government,academiaandnon-governmentalorganizations.

TowardsaFunctionalCureTobetterunderstandhowtheimmunesystemrespondsduringtheacute(veryearly)stageofHIVinfectionandexploregeneticchangesinthevirus,MHRPlaunchedtwoinnovativecohortstudiesinThailandandEastAfrica,RV217andRV254.MHRPhasconductedseveralfunctionalcurestudieswithintheseacuteinfectioncohorts.ThesesmallstudiesevaluatestrategiesaimedatinducingHIVremission,suchasHIVvaccinesorantibodyagainstHIV.

InternationalResearchNetworkMHRPiscenteredattheWalterReedArmyInstituteofResearch(WRAIR),acommandwithintheU.S.ArmyMedicalResearchandMaterielCommand.Theprogram’snetworkincludesinternationallaboratoryandclinicalresearchcapabilities.MHRPhaspartnerresearchsitesinTanzania,Kenya,Nigeria,Uganda,Mozambique,GermanyandThailand,andthemainlaboratoriesarelocatedinSilverSpring,Maryland.

MHRPhassupported:

351,762patientscurrentlyonAntiretroviralTherapy(ART)1,051,138womentoreceiveHIVcounselingandtesting226,029malestoobtainmedicalmalecircumcision

September2018