Can­di­date vac­cine could give TB the nee­dle

The Sunday Independent - - METRO - LER­ATO DIALE Ler­ato.Diale@inl.co.za

A CAN­DI­DATE tu­ber­cu­lo­sis (TB) vac­cine study has re­newed hope among re­searchers, with UCT ex­perts de­scrib­ing the re­sults as “ground-break­ing”.

This as TB re­mains the num­ber one killer dis­ease in South Africa, ac­cord­ing to Statis­tics SA’s lat­est “Mor­tal­ity and Cause of Death” re­port re­leased ear­lier this year.

The M72/AS01E Vac­cine study, pub­lished in the New Eng­land Jour­nal of Medicine, has yielded ground­break­ing re­sults which show that the vac­cine has an ef­fi­cacy of about 50%.

The in­ves­ti­ga­tional vac­cine was tested on HIV neg­a­tive adults with la­tent TB.

Pro­fes­sor Mark Hather­ill, di­rec­tor of the SA Tu­ber­cu­lo­sis Ini­tia­tive at UCT, de­scribed the find­ings as con­vinc­ing. “This is par­tic­u­larly ground­break­ing be­cause these re­sults showed for the first time that it’s pos­si­ble for a new vac­cine to pro­tect peo­ple who are al­ready in­fected with TB, from pro­gress­ing from a state of in­fec­tion to a state of dis­ease, and that had never been shown be­fore.”

Ex­plain­ing the sig­nif­i­cance of the study’s find­ings, Hather­ill said the study had an ef­fi­cacy of around 50%.

“We al­ready have a TB vac­cine called BCG which is given to all ba­bies at birth. BCG is par­tially ef­fec­tive at pro­tect­ing ba­bies and small chil­dren from the most se­vere forms of TB, but it doesn’t do much for pro­tect­ing chil­dren against lung TB, and by the time chil­dren get to ado­les­cence that pro­tec­tion has waned,” he said.

Hather­ill said if adults were not ef­fec­tively pro­tected against TB, this was prob­lem­atic as the rate of in­fec­tion in­creased grad­u­ally.

“If we are look­ing at a strat­egy to have an im­pact in pro­tect­ing these adults, we have to look for ways to pro­tect adults who are al­ready in­fected.

“It’s vi­tally im­por­tant that we find a new vac­cine that can pro­tect adults who are not only the vic­tims of the epi­demic but are the driv­ers of the epi­demic,” he said.

Mean­while, ex­perts say it’s vi­tal that a new vac­cine is de­vel­oped as South Africa can­not af­ford to treat it­self out of the epi­demic.

The study en­rolled more than 3 500 par­tic­i­pants across 11 sites in south­ern and east Africa, in­clud­ing Kenya, Zam­bia and South Africa.

Ac­cord­ing to re­searchers, half of the par­tic­i­pants were given the can­di­date vac­cine while the other half were given a placebo vac­cine.

In the par­tic­i­pants who re­ceived the in­ves­ti­ga­tional vac­cine, there were 10 cases of TB and in those who re­ceived the placebo, there were 22 cases of TB.

This rep­re­sents 54% ef­fi­cacy, Hather­ill ex­plained.

Hon­orary pro­fes­sor and di­rec­tor at the Well­come Cen­tre for In­fec­tious Dis­eases Re­search in Africa at UCT, Robert Wilkin­son, de­scribed the re­sults as in­trigu­ing and over­all highly en­cour­ag­ing.

“It was a proof-of-con­cept study of a new tu­ber­cu­lo­sis vac­cine given to adults al­ready thought to be in­fected. Over­all it re­duced the risk of tu­ber­cu­lo­sis by around 50%.”

Wilkin­son said fund­ing for TB re­search was “highly nec­es­sary”.

“Tu­ber­cu­lo­sis re­search is poorly funded by com­par­i­son with re­search on many other dis­eases.”

Wilkin­son’s state­ment comes amid grow­ing calls for more fund­ing for TB re­search and de­vel­op­ment.

“It’s vi­tally im­por­tant that there is much more fund­ing di­rected to­wards TB pre­ven­tion. It’s ob­vi­ously im­por­tant for TB pa­tients that bet­ter di­ag­nos­tics and treat­ments are sought, but in or­der to con­trol this epi­demic we need bet­ter tools for pre­ven­tion and vac­cines are the most ef­fec­tive tools for pre­ven­tion,” said Hather­ill.

Asked when the vac­cine would be ready, Wilkin­son said: “The fi­nal fol­low-ups are late this year. Although the trial find­ings are en­cour­ag­ing, many fur­ther tri­als show­ing sim­i­lar ef­fi­cacy would be nec­es­sary be­fore the prod­uct could be li­censed”.

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