Past, Present and Future of HIV Vaccine Development

Contributed by Allison Adams, Class of 2019

Since 1984, the Human Immunodeficiency Virus (HIV) has been identified to be the cause of AIDS. At that time, Margaret Heckler, the U.S. HHS Secretary, was confident that there would be an effective vaccine ready for testing within the upcoming years. By 1987, the National Institute of Health (NIH) held the first HIV vaccine clinical trial testing the protein called gp160. The trials were quickly diminished however, due to the lack of scientific advancements at the time. The following year, the National Institute of Allergy and Infectious Diseases started enrollment in Phase I clinical trials and was able to launch Phase II in 1992 that included patients with a high-risk behavioral past who were not yet infected.  By 1993, NIAID combined forces with HIVNET and began striving to start Phase III trials (2).

aidsWhile the progress on this front continued, in 1998, VaxGen Inc. began conducting the world’s first Phase III clinical trials with their product, AIDSVAX. Unfortunately, the results gathered in 2004 were dismal; no efficacy for prevention was detected. By 2009, there were promising results from a Phase III trial on a combination vaccine being conducted in Thailand known as the RV144 using gp120. In those results, four out of ten HIV infections were prevented that would have otherwise happened. While this just 31% efficacious, it left scientists under the impression that there were further opportunities for this vaccine (2).

Continuous studies were made and by 2012, scientists were beginning to use samples from RV144 to try and get a better understanding on what type of immune response that might be needed for an effective vaccine. Building upon these analyses, a Phase I/II study began in 2015 on the vaccine called HVTN 100 (1). This study is to continue on until January 2017 and has already been approved for Phase III efficacy trials (HVTN 702 modified from HVTN 100) based on the interim results from July of 2016.

The latest modification in the vaccine, an adjuvant called MF59, has been added in order to increase the vaccine’s strength as well as the protein involved to match the most common strain of HIV located in South Africa, where the efficacy trials will be taking place (3). HVTN 702 is also known as ALVAC-HIV and is scheduled to start in November 2016.

If these trials can produce results at least 50% efficacious, HVTN 702 will become a licensed preventative HIV vaccine. With the technological advancements that have been made in the past fifty years, the world is teetering on the verge of success in creating a vaccine that will have the capability to prevent a multitude of HIV infections each year (3).

References

  1. (2016). Avac.org. Retrieved 26 September 2016, from http://www.avac.org/trial/hvtn-100
  2. History of HIV Vaccine Research | NIH: National Institute of Allergy and Infectious Diseases. (2016). Niaid.nih.gov. Retrieved 26 September 2016, from https://www.niaid.nih.gov/diseases-conditions/hiv-vaccine-research-history
  3. HVTN 702 is a “Go” Uhambo continues. (2016). Hvtn.org. Retrieved 26 September 2016, from http://www.hvtn.org/en/community/community-compass/current-issue/cc-current-article2.html

 

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