May 16th, 2012
HIV discussion turns to prevention strategies
By Anthony S. Fauci, M.D.
There is a growing consensus that we can significantly curtail the HIV/AIDS pandemic by implementing scientifically proven HIV prevention strategies, such as voluntary, medically supervised adult male circumcision, prevention of mother-to-child transmission and treatment as prevention. With 2.7 million new HIV infections in 2010 alone, however, it is likely that controlling and ultimately ending the HIV/AIDS pandemic will require a vaccine as well.
Last month, a detailed analysis of specimens from the first HIV vaccine clinical trial to show a modest protective effect yielded important clues about how the vaccine might have worked. These clues suggest directions for improving upon the original vaccine regimen to confer a broader, more potent and longer-lasting effect. Meanwhile, several other NIAID sponsored HIV vaccine clinical trials are under way.
Preclinical animal model studies of HIV infection have recently uncovered valuable leads toward designing a preventive HIV vaccine. Scientists have demonstrated that a vaccine can prevent a virulent monkey version of HIV infection and have shown a correlation between this protection and the presence of specific antibodies to the virus.
Scientists are discovering and studying HIV neutralizing antibodies that shield cells in the lab against infection with a wide array of HIV strains collected from infected people worldwide. Researchers are analyzing the structure of these antibodies and using this information to design new molecules to elicit the antibodies through vaccination. In related experiments, injecting these antibodies directly into monkeys has prevented infection from a monkey version of HIV.
All of these advances reinforce our confidence that one day we will succeed at creating a safe, highly effective vaccine to prevent HIV infection.
Vaccines historically have been the single most important tool for controlling epidemics. With an ongoing commitment to HIV vaccine research, we have the potential to radically change the trajectory of the HIV/AIDS pandemic.
Anthony S. Fauci, M.D., is Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, MD.