Los Angeles, Calif. - The AIDS Clinical Trials Group (ACTG), the largest global HIV research network, commemorates the 40th anniversary of the initial publication of reports of what came to be known as HIV/AIDS in CDC's Morbidity and Mortality Weekly Report (MMWR) on June 5, 1981. The anniversary coincides with the 2021 Virtual Annual ACTG Network Meeting. ACTG has played a critical role in HIV research for nearly four decades and has done so in close partnership with the HIV community. ACTG research includes landmark studies that have changed the treatment and care of people living with HIV around the world. This year's annual meeting will highlight ACTG research and efforts over the past year, including those to address COVID-19, as well as future research directions.
"What began with a medical report about five men 40 years ago became a worldwide epidemic that has directly and indirectly affected tens of millions of people," said ACTG Chair Judith Currier, M.D., M.Sc., University of California, Los Angeles, who has been part of the ACTG since 1991. "As a group, the ACTG has participated in the evolution of HIV from what was almost always a fatal diagnosis to a chronic and manageable condition. We are truly humbled that our community-engaged research network has significantly contributed to this dramatic progress over the past four decades and to shifting treatment guidelines and paradigms. The annual meeting provides us with an opportunity to reflect on our successes and challenges and plan for the ways that ACTG research can continue to advance the field of HIV."
The ACTG began with 14 AIDS Treatment Evaluation Units which were founded in 1986 and officially became the ACTG a year later. Initial research started with trials of AZT (which became the first treatment approved by the Food and Drug Administration but is rarely used anymore due to toxicity) and therapies for the treatment and prevention of opportunistic infections that caused the deaths of people living with HIV. The ACTG expanded to include international sites in 2002, initially pairing sites in Haiti, Brazil, Peru, and South Africa with mentor sites in the United States. The ACTG now includes 32 international sites among its total 65 sites. Over the years, the ACTG has also expanded its focus to address other diseases, including tuberculosis (TB), hepatitis, and more recently, COVID-19.
"The expansion of the ACTG to include global sites was vital to ensure that our research agenda truly served people living with HIV around the world," said ACTG International Vice Chair Ian Sanne, FCP, FRCP, University of the Witwatersrand Helen Joseph, who has been with the ACTG since 2012. "It has been a remarkable journey of advancements since the ACTG added the initial international sites nearly two decades ago. Particularly impressive is the way that the international sites have informed ACTG's research agenda and the impact of that research on international HIV treatment and care."
The ACTG has partnered with the HIV community from the earliest days of the pandemic, with community members attending ACTG meetings beginning in 1987. By 1990, every ACTG research unit had a community advisory board (CAB) to provide guidance and input into clinical trial protocol development.
"The CABs have always played an important role in the ACTG, including in developing our study protocols," said Estere Mutero, co-chair of the ACTG's Global CAB, who has been part of the ACTG since 2006. "Through its engagement with diverse populations, the ACTG has become a truly global network, facilitating the participation of communities around the world in our studies."
Examples of ACTG studies that have influenced or changed the landscape of HIV, TB, and hepatitis include:
- ACTG 019: Treatment with AZT decreases the rate of progression of HIV; published in the New England Journal of Medicine (NEJM) in 1990
- ACTG 077: Treatment of Toxoplasma Encephalitis with Clindamycin/ Pyrimethamine; in coordination with the French Agency for Research on AIDS and Viral Hepatitis (ANRS); published in NEJM in 1993
- ACTG 081: Prevention of Pneumocystis Pneumonia; published in NEJM in 1995
- ACTG 159: Treatment of Cryptococcal Meningitis; in coordination with the Mycoses Study Group; published in NEJM in 1997
- ACTG 320: Combination antiretroviral therapy decreases morbidity and mortality in people with AIDS; published in NEJM in 1997
- ACTG 5221: Rapid initiation of antiretroviral therapy (ART) in people with TB; published in NEJM in 2012
- ACTG 5175: Single-dose combination ART is safe and effective in resource-limited settings; published in PLoS Medicine in 2012
- ACTG 5208 (OCTANE): Limitations of single-dose NVP and implications for maternal HIV resistance; published in PLoS Medicine in 2012
- ACTG 5257: Benefit of integrase inhibitors for first-line ART; published in Annals of Internal Medicine in 2014
- ACTG 5241 (OPTIONS): Treatment with two to three active agents for salvage ART; published in Annals of Internal Medicine in 2015
- ACTG 5360: Minimal monitoring approach to HCV treatment is safe and successful; presented at AASLD 2020
- ACTG 5349: Shortening the length of TB treatment; published in NEJM in 2021
During the 2021 Virtual Annual ACTG Network Meeting, which is being held from Monday, June 14, through Friday, June 18, ACTG committees provide updates on their research and programming over the past year and plans for the future. Each year, the meeting provides the opportunity for ACTG researchers, staff, and community members from around the world to learn about the broad scope of the ACTG's efforts.
"ACTG's efforts have led to treatment regimens that control HIV and allow many people living with HIV to lead healthy long lives," said ACTG Co-Chair, Joseph J. Eron, M.D., University of North Carolina, who has been part of the ACTG since 1993. "We recognize that there is still much to be done to end the HIV epidemic and the ACTG remains dedicated to the task. We are especially committed to research to find a functional cure and reduce the complications associated with lifelong HIV. And we are proud to continue to move forward with the strong involvement and support of people living with HIV."
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About the ACTG
Founded in 1987, the AIDS Clinical Trials Group (ACTG) was the world's first HIV research network. It is funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), and collaborating NIH Institutes. The ACTG conducts groundbreaking studies to improve the treatment of HIV and its complications, including tuberculosis and viral hepatitis; reduce new infections and HIV-related illness; and advance new approaches to prevent, treat, and ultimately cure HIV in adults and children. ACTG investigators and research units in 15 countries serve as major resources for HIV/AIDS research, treatment, care, and training/education in their communities. ACTG studies have helped establish current paradigms for managing HIV disease, and have informed HIV treatment guidelines, resulting in dramatic decreases in HIV-related mortality worldwide.