SPEND MONEY. SAVE LIVES

TWO x TWO for AIDS and Art 2021 auction highlights. Photograph by Kevin Tachman. A spectacular TWO x TWO evening. Photograph by Exploredinary. Kevin Robert Frost. Courtesy of amfAR.

Monies raised during TWO x TWO benefit AIDS research through amfAR.

INTERVIEW BY ANDREW MCINNES

Kevin Robert Frost joined the staff of amfAR, The Foundation for AIDS Research, in 1994 and was appointed chief executive officer in 2007. Here Kevin discusses amfAR’s goals and priorities and explains how amfAR invests the funds it raises through renowned fundraising galas such as TWO x TWO for AIDS and Art.

Andrew McInness (AM): What are amfAR’s current research priorities? Kevin Robert Frost (KRF): We’re laser focused on developing a cure for HIV that’s safe, affordable, and accessible to the 38 million people worldwide who are living with HIV. We’re pursuing a range of promising strategies, including various types of cell and gene therapies, immunotherapy, and pharmacologic approaches. At the amfAR Institute for HIV Cure Research in San Francisco, researchers are in the midst of a complex HIV cure trial that involves a combination of agents. Right now, the big scientific challenge is the persistent reservoir of virus that’s able to evade attack by antiHIV drugs and the immune system. Unfortunately, HIV is a very complex and wily virus, and finding a way to eliminate this reservoir has proven extremely difficult. But if we can achieve it, we could be well on our way to a cure. AM: Will you summarize some of the recent grants amfAR has awarded? KRF: In July we awarded $1.6 million to five research teams working on various cure strategies. Three teams are investigating gene therapy approaches, including the use of CAR T cells—cells that have been genetically engineered to target and kill HIVinfected cells. This approach has been used successfully and quite dramatically in the treatment of certain types of cancer, and there is some optimism that it can be adapted to cure HIV. But the biggest grant was awarded to a team at Massachusetts General Hospital that’s investigating the possibility that some people on long-term treatment may have cleared the virus without knowing it. This could potentially change the game for people who today assume they’ll be on treatment for life. We expect our board of trustees to approve a new round of grants when it meets later this month. AM: Have there been major advances or breakthroughs lately? KRF: This year alone there have been two new cases of a cure, bringing the number of confirmed cases to five. All have resulted from stem cell transplantation—a high-risk and costly procedure that’s only an option for a very small number of individuals with both HIV and certain types of cancer. These cases have confirmed the central importance of a genetic mutation common to all of the stem cell donors that makes them resistant to HIV. Now we have to find a way to exploit or replicate this mutation, called CCR5 delta32, in a way that’s far less invasive and more widely applicable. AM: Did amfAR have any involvement in research on COVID-19? KRF: At the start of the outbreak, many HIV researchers pivoted immediately to COVID-19. Their expertise in virology, immunology, and other specialties would prove critical to characterizing this novel virus and developing vaccines and therapeutics. As an infectious disease organization with years of experience, we quickly launched the amfAR Fund to Fight COVID-19 to support the research effort. Through the fund we awarded a number of grants investigating areas such as COVID-associated kidney disease, antibodies, and the intersection between HIV and COVID-19. At the same time, our policy team led the way, through its research and analysis, in highlighting the stark racial disparities in the COVID response. AM: What other work is amfAR supporting? KRF: We’re very interested in the phenomenon of elite control, i.e. the small number of people who are able to keep their HIV in check in the absence of treatment. What is it about their immune systems that makes this possible? Our researchers are working hard to figure this out so that perhaps we can replicate this powerful immune response in other—maybe all—people living with HIV. AM: What are your hopes for the next couple of years? KRF: First and foremost, we want to see rapid progress towards a cure. To a large extent, a cure for HIV is now a problem of technology. We have a pretty good understanding of the scientific questions that stand in the way of a cure. We need to develop and refine the tools needed to answer these questions. Scientific progress is typically incremental, but we’re working towards, and hoping for, major breakthroughs that could truly bring a cure within our grasp. P