Andrea L. Cox, MD, PhD

Dr. Cox earned an MD from the Johns Hopkins School of Medicine. She completed a residency and a fellowship in infectious diseases at Johns Hopkins and earned a PhD in chemistry from the University of Virginia.

Her laboratory investigates the host immune response to viral infection, particularly hepatitis C virus (HCV), including the role of the immune response in clearance of HCV upon exposure to this virus. They study the humoral and cellular immune responses to HCV from the earliest phases of infection through years
following infection, allowing assessment of the response irrespective of the outcome of infection. They are characterizing the mechanisms of protective immunity against HCV infection in order to improve HCV vaccine design. A significant barrier to the development of an HCV vaccine is that HCV is a highly diverse virus.

The laboratory is developing an HCV vaccine that may overcome this diversity and stimulate an effective immune response. Despite ongoing viremia with sequence evolution in those chronically infected with HCV, we have shown that in the majority of individuals, the CD8+ T cell responses generated early in HCV
infection decline in peripheral blood and are not replaced with new responses.

The results suggest that the development of HCV-specific T cell clones is arrested during the first year of infection. They are currently investigating the molecular phenotypes associated with this loss of functional activity and are characterizing differences between the functional and molecular phenotype of lymphocytes
recognizing epitopes that undergo substitution and those recognizing epitopes that do not. Identifying the molecules associated with decreased function might provide targets for blockade, enhancing immunogenicity of a vaccine or serving as novel immunotherapeutic agents themselves. Thus, the overall goal of the program includes understanding immune system failure to clear HCV infection in order to overcome the mechanisms of immune evasion that limit HCV vaccine efficacy.