Wright group

HIV - Pre-exposure prophylaxis and preventive treatment options

Overview:

A/Prof Edwina Wright’s main research focus includes neurological disorders and opportunistic infections of the central nervous system (CNS) in HIV infected individuals.

This includes:

  • Determining the impact of different antiretroviral treatment strategies upon HIV-associated neurocognitive performance

  • Determining the prevalence of HIV-related neurological disorders, nationally and internationally

  • To assess, diagnose and treat HIV related neurological complications.

A/Prof Wright also runs research programs that look at the benefit of pre-exposure prophylaxis in populations at high risk of contracting HIV, as well as looking into the potential positive side-effects of anti-hypertensive treatments in HIV+ positive patients.

For more information on current research programs please see below or visit A/Prof Wright's Burnet Institute web page.

Research Areas:

(1) HIV- Pre-exposure prophylaxis and preventative treatment options

New HIV prevention strategies are necessary in Australia because HIV infection rates continue to rise. The Victorian HIV Pre-Exposure Prophylaxis Demonstration Project, or PrEP, aims to demonstrate that PrEP can be implemented feasibly, safely and effectively in the Victorian context through an accessible program targeted at the populations at highest risk of HIV acquisition.

This is an exciting project that will involve clinical, social and epidemiological research in the area of HIV prevention.

For more information please visit the PrEP web page.

(2) Does treating HIV+ patients for hypertension also improve CD4+ T cell counts and immune function?

Hypertension is associated with increased risk for cardiac and cerebrovascular disease and occurs in up to 20% of HIV+ patients.

The Australian National Heart Foundation Guidelines recommend that hypertension should be treated with ACE inhibitors, Angiotensin II Receptor Antagonists, calcium channel blockers, or low dose thiazide diuretics.

During HIV infection, lymph node fibrosis destroys the architecture of lymph nodes and hence reduces the capacity for antigen presentation and development and proliferation of naive CD4 cells.

A recent feasibility study of the use of lisinopril (an ACE inhibitor) in virologically suppressed HIV+ patients showed that the lisinopril was well tolerated and was associated with a small but significant fall in diastolic blood pressure and a reduction in inflammatory cytokines.

Our study will review treated, virologically suppressed HIV+ patients who have commenced anti-hypertensive treatment in the past 5 years to determine whether treatment with ACE inhibitors or other anti-hypertensive agents is associated with a significant increase in CD4+ cells counts and other measures of immune function.

(3) Strategies for HIV prevention, management of acute and chronic HIV infection Group

Overview

The main research directions include neurological disorders and opportunistic infections of the central nervous system (CNS) in HIV infected individuals and is keen to identify and monitor neurological disease in HIV infected individuals in Australia and developing countries.

Objectives

  • To determine the impact of different antiretroviral treatment strategies upon HIV-associated neurocognitive performance
  • To determine the prevalence of HIV-related neurological disorders, nationally and internationally
  • To assess, diagnose and treat HIV related neurological complications.

Highlights

The Group heads the Australian National NeuroAIDS Brain and Tissue Bank Project which enrolls HIV positive people who have agreed to undergo annual neurological evaluations and to donate their brains at the time of death. This national resource will serve as a future research repository for Australian and international researchers working in the field of neuroAIDS.

Publications

A full list of publications can be found at Google Scholar or Pure research output

Updated Prep Guidelines 2019

Other links

Monash Lens Profile

Burnet Institute Profile

ResearchGate

Victoria HIV Service

HIV and AIDS & Sexual Health 2020 conference

In the media

HIV: A prescription for prevention

Ending the stigma this World AIDS Day

Purple Pen Podcast - HIV Pre-exposure Prophylaxis

Five promising steps forward in HIV science