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5 developments in HIV vaccine research over the past year
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In 1984 — the same year that HIV was recognized as the cause of AIDS — then HHS Secretary Margaret Heckler announced that efforts were underway to develop and test an HIV vaccine, according to the NIH.
Three years later, the first clinical trial to assess an HIV vaccine was launched at the NIH. During the trial, the investigational gp160-subunit vaccine showed no signs of serious adverse events, according to the NIH. In time, however, the vaccine, along with many other promising candidates tested over the past 30 years, were found to be ineffective.
Today, numerous HIV vaccine candidates are currently in preclinical and clinical development, according to Anthony S. Fauci, MD, director of the NIH’s National Institute of Allergy and Infectious Diseases.
“There are two major parallel approaches toward an HIV vaccine,” Fauci told Infectious Disease News. “The first is to improve upon and amplify a vaccine that was tested during the RV144 trial in Thailand. The vaccine was 31% effective, which was not good enough for being deployed as a vaccine for use but was good enough for us to begin developing correlates of immunity.”
The second major approach, Fauci said, is to develop immunogens that specifically induce broadly neutralizing antibodies (bNAbs), which have previously shown to prevent most HIV strains from infecting cells, according to the NIH. Although the vaccine examined during RV144 offered some protection against HIV, it was unable to induce these bNAbs, Fauci said.
As the search for a safe and effective vaccine continues, Fauci recognized the important role of study volunteers and investigators.
“Years ago, we started HIV Vaccine Awareness Day to thank the volunteers for their altruism and willingness to participate in this very important endeavor,” he said. “Nothing we do in the form of clinical research would ever be possible without people who volunteer for studies. For that reason, we have a great deal of admiration and gratitude toward them.
“The investigators who devote their careers and lives to HIV vaccine research also need to be commended for their patience and unselfish investment of time. These are not quick-fix studies. Unlike some research, when you know the answer in a year or less, studying a vaccine takes years and years.”
To mark the occasion of HIV Vaccine Awareness Day, held each year on May 18, Infectious Disease News has compiled five stories covering research in HIV vaccine development over the past year:
Efficacy trial under way for Janssen’s HIV vaccine
In December, the NIH and partners announced the start of a large phase 2b trial evaluating the efficacy of Janssen Pharmaceutical’s investigational HIV vaccine.
The vaccine is designed to protect against a wide variety of HIV strains. It is based on “mosaic” immunogens that are created with genes from different subtypes of HIV-1, according to the NIH. Read more.
Vaccine necessary to eliminate global HIV/AIDS pandemic
In an editorial published in JAMA, Fauci further discusses the need for a vaccine to eliminate the spread of HIV. He noted that it will be unlikely to develop an HIV vaccine with 100% efficacy because a protective response against HIV is difficult to achieve. Read more.
HIV vaccine fails to suppress viral load, affect reservoir
An experimental therapeutic HIV vaccine regimen did not suppress the virus in patients whose ART was paused in a study testing the vaccine’s safety and efficacy, according to researchers.
The results suggest that a vaccine capable of controlling HIV viremia without ART remains elusive, the researchers wrote in Science Translational Medicine. Read more.
Janssen’s HIV vaccine shows promise in clinical trial
Janssen Pharmaceuticals’ lead investigational HIV vaccine regimen that targets a wide variety of HIV-1 subtypes was well-tolerated and elicited HIV-1 antibody responses in 100% of healthy volunteers, according to first-in-human clinical data from the APPROACH trial.
The vaccine regimen was one of seven different prime-boost vaccine regimens examined in the phase 1/2a trial. Read more.
HIV vaccine boost generates higher immune response 6 to 8 years later
Boosting Thai participants from the RV144 HIV vaccine trial 6 to 8 years after their initial vaccination generated higher immune responses compared with those seen immediately after RV144; however, these humoral and CD4+ T cell responses were short lived and did not grow after subsequent boosting, according to data published in The Journal of Infectious Diseases.
These results come from a late-boost follow-up study to RV144, known as RV305, which demonstrated 60% efficacy against HIV acquisition at 1 year and 31.2% efficacy at 3.5 years. Read more.
Disclosure: Fauci reports no relevant financial disclosures.