Re­searcher: HIV vac­cine needed to end epi­demic

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“The DNA prime is sort of like pour­ing water down a pump, where you pour a lit­tle bit of the pump down the well to prime it. It’s the lit­tle bit that al­lows your body to rec­og­nize the virus and fight it,” Robin­son said.

Robin­son’s vac­cine started Phase II hu­man tri­als in Jan­uary 2009 and in­volves 225 par­tic­i­pants at sites in the United States, in­clud­ing Emory Univer­sity’s Hope Clinic, and South Amer­ica.

The next stage, sched­uled to start in 2014 and last three years, would ex­am­ine high risk pop­u­la­tions, which would in­clude gay men.

Robin­son’s team is also mov­ing for­ward with a sep­a­rate trial to test if the vac­cine can con­trol the in­fec­tion in those who have al­ready been ex­posed.

“For peo­ple who are pos­i­tive al­ready, we have a ther­a­peu­tic ap­pli­ca­tion that we are work­ing on, and we have a very small open la­bel trial go­ing on,” Robin­son said. “In that trial we have sev­eral peo­ple who have re­cently un­der­gone se­ro­con­ver­sion. They go on drugs within 18 months of their in­fec­tions, and they have to have the virus well con­trolled and then we give them the vac­cine.”

‘Crafty virus’ still kills mil­lions

HIV re­search has seen un­par­al­leled ex­pan- sion in the years since Merck made the re­sults of the Thai­land trial pub­lic.

“What we ex­pect to see now, be­tween now and the end of the decade, [is] a se­ries of hu­man ef­fi­cacy tri­als that are build­ing on the [Thai­land] sto­ries, that are build­ing on the bet­ter vec­tors that have ad­vanced into clin­i­cal tri­als,” Koff said.

Re­searchers rou­tinely build on each other’s re­sults and fail­ures. Robin­son’s vac­cine is dif­fer­ent from other pre­vi­ous vac­cines be­cause it in­cludes a macrophage colony stim­u­lat­ing fac­tor, which helps ac­ti­vate the im­mune sys­tem.

“They’re the ones that will see the virus-like par­ti­cles and take that to the B-Cells and the Tcells to ini­ti­ate the im­mune re­sponse,” Robin­son said.

That vac­cine uses tech­niques that have not been tested be­fore, and more new stud­ies are pub­lished nearly monthly.

In Oc­to­ber, the Cen­tre for the AIDS Pro­gramme of Re­search in South Africa re­ported find­ing two new vul­ner­a­bil­i­ties in the HIV protein coat. In Novem­ber a Cana­dian re­search team an­nounced suc­cess­fully clear­ing Phase I hu­man test­ing with a virus that uses dead HIV virus.

“There have been a se­ries of vec­tors of vac­cine can­di­dates, some are weak­ened forms of viruses, some of them are dif­fer­ent forms of boosts, some unique col­lec­tions of an­ti­bod­ies… there are a num­ber of stud­ies that are about to go into tri­als that — just based upon the re­sults in the pri­mate stud­ies — look to have a bet­ter chance at be­ing more ef­fec­tive then the stud­ies that have come be­fore them,” Koff said.

While there are more stud­ies us­ing newly dis­cov­ered tech­niques in the hopes of find­ing an ef­fec­tive cure, re­searchers are leery of set­ting time­lines, or mak­ing overly op­ti­mistic pre­dic­tions.

Even if Robin­son’s vac­cine proves to be highly ef­fec­tive it would be years be­fore it is avail­able to the pub­lic.

“For the pre­ven­tive vac­cine? I really think we’re go­ing to have it, but I think it’s go­ing to take at least five years, and then it’s go­ing to be years be­fore we can a make a prod­uct that we can man­u­fac­ture that your doc­tor can give you,” Robin­son said.

Koff is of­ten asked if HIV could ever be fully erad­i­cated like small pox and said he doesn’t know the an­swer.

“I don’t know if we know enough to fully an­swer that,” he said. “The re­al­ity is that we need a vac­cine first. We have a lot of other tools in the tool box about HIV preven­tion, but with­out a vac­cine it’s un­likely that we’re really go­ing to be able to end the epi­demic.

“I want to em­pha­size that, be­cause ev­ery day you hear sto­ries about … ed­u­ca­tion, con­dom use, cir­cum­ci­sion,” Koff added. “But even with all of those we still have over 7,000 HIV in­fec­tions ev­ery day, and sev­eral mil­lion deaths from AIDS ev­ery year. The virus is crafty enough that it con­tin­ues to find ways above and be­yond our cur­rent preven­tion meth­ods.”

Dr. Har­riet Robin­son is re­search­ing an HIV vac­cine that she hopes could not only keep peo­ple from be­ing in­fected, but re­duce the vi­ral load in peo­ple who are al­ready HIV pos­i­tive. (Photo courtesy GeoVax)

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