HIV/AIDS is often called the “forgotten epidemic”. After all, according to the Center for Disease Control, between 2010 and 2014, “the estimated number of annual new HIV infections declined 10%.” The peak of this pandemic happened several decades ago.
However, this progress does not negate the fact that millions of people are still suffering. In fact, approximately 36.7 million people were living with HIV worldwide in 2016. And in that same year, 1.8 million people became newly infected. One sobering way of looking at this statistic is that approximately 4,932 people become newly infected with HIV each day. This translates into 205 newly infected people each hour!
The Search for a HIV/AIDS Vaccine
During the 9th IAS Conference on HIV Science in Paris, France, Dr. Anthrony S. Fauci, director of the National Institute of Allergy and Infectious Disease (NIAID), stressed the importance of a HIV/AIDS vaccine in order to bring an essential end to this pandemic.
The development of a vaccine is critical to ending this pandemic because although major strides in the treatment of HIV/AIDS, not enough people have access to or are actively taking this treatment.
“Accordingly, if both of these treatment and prevention modalities were effectively implemented throughout the world, the HIV/AIDS pandemic would end,” Dr. Fauci explained. However, this goal is somewhat unrealistic and unattainable, making a vaccine the only feasible solution to ending this pandemic. He added, “Although an estimated 19.5 million of the estimated 36.7 million HIV-infected people globally are receiving anti-HIV therapy (an extraordinary accomplishment), more than 17 million people are not receiving therapy. This leaves a substantial treatment gap.”
Additionally, ending HIV/AIDS with treatment would not be economically feasible. According to the doctor, the to funds necessary to pull off such a considerable feat add up “to at least $350 billion”.
He concluded his presentation by saying, “That then allows me to come to a conclusion that we will actually need an HIV vaccine to achieve—and I want to underscore a very important word—a durable end to the HIV pandemic.”
This is precisely what many laboratories are attempting around the world.
Several New Studies Committed to Finding a HIV/AIDS Vaccine
37 years ago, Margaret Heckler, Secretary of Health and Human Services under President Ronald Reagen, announced to reporters at a press conference that a vaccine for AIDS would be ready for testing within the timespan of two years. Fast-forward to the present and we are still without an effective HIV/AIDS vaccine.
In fact, scientists have largely given up on a vaccine that would act similarly to other vaccines that we take. As Dr. Fauci explained, it is incredibly difficult for the human immune system to “mount a protective response against HIV”. Therefore, scientists are not searching for a vaccine that 100% effective, but rather decreases risk by at least 50%.
Research in Thailand
A recent study conducted in Thailand decreased the risk of infection by 31%, but that figure was not enough to justify licensure of a vaccine. Several other studies happening around the globe are aiming to find that elusive vaccine that can reduce risk by at least 50%.
Research in Paris
In Paris, the National Institutes of Health and the pharmaceutical company Sanofi are engineering a “three-pronged” antibody that attaches to three different places on the HIV virus and attacks it from all three sides. This “trispecific” antibody should obstruct HIV, which is a constantly mutating virus, and create obstacles that even it cannot circumvent.
Rowena Johnston, director of research at The Foundation for AIDS Research (amfAR), said, “This is very impressive and really very exciting for people who are looking for ways to prevent HIV acquisition.”
Research in Seattle
Another study being conducted at a non-profit in Seattle called the Center For Infectious Disease Research is answering the call for the importance of a HIV/AIDS vaccine. Bridget Fisher, a postdoctoral research scientist at the non-profit explains, “The public perception of HIV is changing, but the disease itself is still here. It’s still infecting people: 1.7 million people get infected every single year [globally]. And it’s still killing people.”
Fisher and her team have developed an orally-administered vaccine, which has entered pre-clinical trails. This particular vaccine appears promising because it covers the many different strains of the HIV virus.
The study will take approximately five years to complete. Therefore, if successful, the HIV/AIDS vaccine may take more than a decade to be accessible to the public.
Research in London
A research team led by Professor Robin Shattock at Imperial College in London is also trying to break through the seemingly impossible barricade leading to a HIV vaccine.
Professor Shattock and her team are planning on testing a medication that would be administered at puberty, which would offer years of protection.
“With this particular trial, what we are hoping for is to be able to get antibodies to the right place at the right time. It would be an important step if we showed that,” Professor Shattock explained.
Like the vaccine in Seattle, this medication is orally administered. The US pharmaceutical company PaxVax has manufactured the pills, which does not contain any of the HIV virus. Instead, they contain a small amount of adenovirus 4, which has been specifically engineered to exhibit the HIV protein.
Professor Shattock described the process: “Participants will swallow this tablet. The virus will replicate to a minor extent in the gut and then die off, but we hope that will give us antibodies in mucosal surfaces in the vagina and rectum, the sites that HIV would normally enter.”
After administering the vaccine, monitoring will take place to see if this vaccine is effectively targeting areas on the body most at risk. “We will measure the level of antibodies that are made in response to the vaccine. We will measure these in the blood and the rectum and vagina to show that they are induced. We will test against HIV in the lab, and look at whether these antibodies neutralise the virus.”
If successful, this would not solve the search for the HIV vaccine, but would lead scientists one step closer to developing one. Professor Shattock and her team are hoping to progress the collective understanding of how this virus works and help people prevent infection.
“A vaccine would be much better, but we are still a long way from developing a vaccine that can do that… We are just trying to solve one part of the puzzle, which is how to get the antibodies to the right place at the right time.”