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Will we ever have an AIDS vaccine?

6th May 2011

Writing in The Telegraph, Michael Day asks if there will ever be a vaccine for AIDS.

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Almost three decades after the HIV virus was identified, the search for a vaccine is perhaps the most urgent project in modern medicine.

Progress remains slow, leaving researchers to lobby for an “adaptive” design for clinical trials of potential vaccines, where rather than wait for the final results scientists begin looking for signs of effectiveness immediately.

It may be a controversial approach but with 2.2 million new infections around the world in 2009 – with a majority in sub-Saharan Africa – it is an appealing argument.

Combination treatment has seen death rates fall but the medicines are expensive, and lifelong compliance with the complex therapy is challenging to maintain. There is also the constant threat of some strains of HIV becoming resistant to the drugs.

While vaccines are appealing, of the three major vaccines tested in humans, the first, VaxGen gp120, showed no protective effect; another called Step was actually shown to increase the risk of infection in some categories of volunteer; while the most promising called RV144 reduced infections in a relatively low-risk Thai population by 31%.

It has been hailed as a proof of concept and that a vaccine could prevent HIV infection to some degree.

Researchers, writing in the journal Science Translational Medicine, say it strengthens their argument for quicker, more flexible clinical trials to be adopted to accelerate its development.

With quicker recruitment of volunteers and earlier decision-making, scientists say it will be possible to focus on useful vaccines and simultaneously learn more about the immune system changes that indicate a vaccine is having an effect.

 

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