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An HIV Vaccine, the Other Game-Changer

Posted by Jeffrey T. Safrit, Ph.D., Director of Clinical and Basic Research
Los Angeles, California
May 18, 2011


Last week, a new HIV study was released that has been called a game-changer for the global AIDS fight. This NIH-funded clinical trial (HPTN 052) confirmed something that we in the pediatric AIDS field have long observed.

An HIV vaccine could set the stage for a lifetime of immunity
against HIV for Lungile's daughter and other children around
the world. (Photo: EGPAF/James Pursey)
Using antiretroviral drugs to treat an HIV-infected person is a very effective way to prevent HIV transmission to another person.

This is the same principle that has made prevention of mother-to-child transmission (PMTCT) so effective. With the full complement of medicines and services, we’ve been able to reduce the risk of a mother passing on HIV to her baby to less than two percent.

Today, on HIV Vaccine Awareness Day, we’re reminded of another potential game-changer for ending the AIDS pandemic. But for now, the science of an HIV vaccine is still beyond our grasp.

An HIV vaccine is vitally important for infants and young children, as well as adults. Even though PMTCT is so effective, more than 1,000 children are infected every day, the majority in resource-poor countries. In these regions, access to antiretroviral drugs and HIV transmission through breast milk remain a problem.

While implementation of new WHO guidelines on infant feeding and use of ARVs during breastfeeding will reduce the risk of HIV transmission through breast milk, a successful HIV vaccine would provide the best opportunity for prevention of infection.

Even better, it would possibly set the stage for a lifetime of immunity to the virus.

As the Foundation’s Vice President of Research Dr. Laura Guay has noted, despite the potential benefits, children have been largely excluded from HIV vaccine research. There have been more than 190 HIV vaccine trials completed, and less than two percent of those have included children.

Once a vaccine candidate has been determined to be safe for adults, children should also be prioritized for clinical trials. Otherwise, this particularly vulnerable population will be left behind as advances occur.

While there have been setbacks over the past few years in HIV vaccine research, the 2009 Thai trial offered a glimmer of hope, showing a 30% efficacy in preventing HIV infection. Our scientific efforts must continue to build on these past attempts – even the unsuccessful ones teach us new things.

Yesterday at the World Health Organization in Geneva, Bill Gates called for this to be the “decade of vaccines,” to protect against diseases such as polio, meningitis, and pneumonia.

Let’s include an HIV vaccine to that list, and commit to the resources and research to make it happen.

Jeffrey T. Safrit, Ph.D, is the Director of Clinical and Basic Research for the Foundation, based in Los Angeles.
 

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