The ACTG 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. 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.
“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 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 epidemic, 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 Co-Chair of the ACTG’s Global CAB, Estere Mutero, 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 (ART) decreases morbidity and mortality in people with AIDS; published in NEJM in 1997
- ACTG 5221: Rapid initiation of 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’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.”