Successful HIV Vaccine Probable

While most of us are consumed with the Avandia vote or diverted by the umpteenth procedure on Dick Cheney's failing heart, Wayne Koff and Seth Berkley of the International AIDS Vaccine Initiative promise the existence of an effective HIV vaccine...in the not-too-distant future. Their perspective on vaccine development, in the context of the upcoming International AIDS Conference in Vienna, is available in this week's NEJM.

The reasons for their enthusiasm:

• Encouraging results from the large vaccine trial (RV144) in Thailand, which was reported last year.
• The prevention or control of infection with simian immunodefiency virus (a monkey correlate of HIV) in preclinical studies by using "new vaccine approaches."
• The identification of "vulnerable" HIV targets by using broadly neutralizing mAbs.

Data from these investigations can and/or will be used to tweak (for lack of a better word) candidate vaccine regimens against HIV. Specifically in the short term, investigators will attempt to define the immune mechanisms that conferred protection in the Thai trial and then create a vaccine regimen (eg, multiple prime and boost shots) to maximize those responses. Koff and Berkley predict follow-up clinical trials to be under way by 2013. (That's sooner that the legislated kick-off of ObamaCare.)

Successful vaccine development will necessitate the cooperation of government, academia, and industry and will demand, of course, lots of money. Koff and Berkley advise that the global financial crisis should not thwart the forward movement of vaccine development at this promising stage. One visible backer is Bill Gates, who recognizes the big hurdles to a successful HIV vaccine and is scheduled to speak at the Conference, says the WSJ Health Blog.