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AIDS Vaccine: Challenges and Opportunities

   Joe DeCapua 15 July 2010

   At  the  18^th  International  AIDS Conference in Vienna, a new report
   outlines    the    challenges   and   opportunities   facing   vaccine
   researchers.   The  report  â  The  Road  to Prevention â is called a
   scientific strategic plan to help end the epidemic.

   The  Global  HIV  Vaccine  Enterprise  â  an  alliance  of independent
   organizations  â  issued  the report Sunday.  Executive Director Alan
   Bernstein says, âThe report is a preview of the strategic plan for the
   Enterprise,  which  is going to be released in September at the annual
   AIDS vaccine conference in Atlanta, Georgia.  It outlines some of the
   key  challenges facing the field and suggests to some extent some ways
   forward.   If  weâre going to stop this epidemic, we need to define a
   clear road to prevention.â

   Working in combination with other prevention efforts

   âThere  are  other  strategies  in  play.   Things like microbicides,
   pre-exposure prophylaxis, treatment as prevention, circumcision.  But
   we  certainly  know  for  other infectious diseases, from polio to HPV
   (Human Papillomavirus), that the best way to stop a virus and probably
   the cheapest is with a vaccine,â he says.

   A  microbicide  can  be a vaginal cream, gel or suppository that kills
   the  AIDS  virus.  Pre-exposure prophylaxis would use anti-retroviral
   drugs  as a preventive measure, instead of treatment later on when the
   immune system starts to fail.

Global HIV Vaccine Enterprise

   Alan Bernstein, Executive Director, Global HIV Vaccine Enterprise

   There  are  several  major challenges to a vaccine.  One is the virus
   itself, which Bernstein calls âclever.â

   âIt  has this ability to mutate and alter itself very quickly and very
   profoundly.  You know, flu changes, letâs say, once a season.  So we
   have  a  year  to  tool  up to make a vaccine and itâs relatively easy
   actually  to  make  a  vaccine against flu.  But even then it changes
   once a year.  HIV changes daily even within one infected individual,â
   he says.

   Another big challenge is money

   âItâs  difficult at the moment to raise money for any kind of research
   given  the  current economic situation globally, including HIV vaccine
   research.  But itâs very frustrating at the moment because on the one
   hand  I  think we all should be worried that this epidemic is reaching
   crisis  proportions.   The  new money for treatment that UNAIDS calls
   for  today  is  not readily available.  And yet, more and more people
   are getting infected,â he says.

   Scientists  know  HIV  has  a  weakness.  But they must find a way to
   exploit it.

   Bernstein says, âEvery living thing must have an Achillesâ heel.  The
   virus  canât change everything about it and still be viable - still be
   able to grow inside ourselves.â

   Scientists  recently  announced they had uncovered naturally occurring
   anti-bodies  in  some  HIV positive people that prevent the virus from
   entering  cells.   The  finding  presents  an opportunity for vaccine
   research.  The trick now is to find a vaccine that will help anyoneâs
   immune system produce such antibodies.

Global HIV Vaccine Enterprise

   Global   HIV   Vaccine  Enterprise  report  released  at  Vienna  AIDS
   conference

   Another important development occurred late last year, when a clinical
   trial  in  Thailand  showed  that  a  human vaccine is possible.  The
   vaccine  candidate  cut  the risk of infection among participants, but
   the results were not high enough to go to market.

   âTrials  are expensive,â he says, âThey cost roughly a hundred million
   dollars  each.   And  we need to do, put simply, a lot more trials if
   weâre  going to get a vaccine.  And I think the optimism in the field
   right  now  has  given  the  whole  field  kind of a new momentum.  I
   wouldnât  have  said  this  a year ago.  But I think itâs clear weâre
   into a new era in this field.  And I must say itâs frustrating not to
   have the funds to actually move through that door pretty boldly.

   The  head  of  the Global HIV Vaccine Enterprise wonât predict when an
   effective  AIDS  vaccine  will  be  available.   Even  if a promising
   candidate were found today, a clinical trial would take at least three
   years.

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