Which STDs most require a vaccine?

Issue: February 2019

Cases of STDs have reached record high numbers in the past few years, and the epidemic has shown no signs of slowing down. Infectious Diseases in Children asked several experts — including Wei Li Adeline Koay, MBBS, MSc, an infectious diseases specialist at Children’s National Health System — about some of the STDs that are in greatest need of a vaccine.

Almost 40,000 people are diagnosed with HIV annually in the U.S., with youth and young adults comprising the majority of this number. Although pre-exposure prophylaxis and post-exposure prophylaxis are available to reduce HIV transmission in individuals at high risk for HIV, these medications have side effects and must be taken daily, and it can be challenging to ensure adherence. The long-term impact of ART on the gut microbiome, bone mineral density, mitochondrial DNA, renal function and other organs also is not clear.

Additionally, there is also a growing number of infants born to women living with HIV who fortunately remain uninfected but have been exposed to both HIV and ART. The short- and long-term impact of exposure to maternal HIV and ART is also unknown in these children.

If an HIV vaccine was available like the vaccine against hepatitis B to reduce the transmission of HIV both in the newborn period and adulthood, or like the vaccine against HPV that is given to adolescents and young adults, imagine the impact that this could have on local and international prevention of HIV transmission. Because of the potential for the HIV virus to mutate and hide in the body, both a cure and vaccine for HIV remain elusive but continue to be major priorities in the HIV research community. Several HIV vaccine trials are currently underway, it is hoped with positive results in the next 5 to 10 years.

Disclosure: Koay reports no relevant financial disclosures.

Editor’s note: To read our February cover story on the STD epidemic, click here.