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HIV Vaccine $$, ADAP & Hepatitis
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Reported by Jules Levin
Finding a vaccine for HIV is a wonderful goal. Recently, there was a controversy surrounding the fact that the NIH is providing $119 million for a vaccine study in Thailand for which leading researchers feel is a wasteful study. They feel that the vaccine candidates being studied in this trial have already proven themselves to be ineffective. Below, you will see an article in the Wall Street Journal quoting a highly respected vaccine researcher, Ron Desrosiers, who also questions the current candidates for HIV vaccines and strategies for developing a vaccine for HIV. My concern is the inadequate funding and attention being paid to providing access to HIV and Hepatitis C care and treatments we know work and save lives.
We already have HIV treatments that we know work in stopping HIV dead in its tracks in infected individuals and therefore prevents death & improves health in people infected with HIV. In addition, HCV and HCV/HIV coinfection is treatable. HIV accelerates hepatitis C disease progression at least 2 times faster than hepatitis C progression in HCV monoinfected individuals. But, access to care and treatment for HCV/HIV coinfected individuals is limited, the Federal government and responsible Federal agencies are not providing adequate funding for testing & counseling, care, and treatment for hepatitis C and for HCV/HIV coinfection. ADAPs are underfunded. ADAP advocates have requested over several hundred million dollars in the past few years to support adequate provision of life-saving HIV treatments. But the proposed increase from government for ADAP is $35 million. ADAPS are increasing closing for new enrollment and are not offering Fuzeon to all patients who need it. In addition, very few ADAPs provide HCV treatment—pegylated interferon plus ribavirin.
Funding HIV vaccine research is important but should we neglect access to care and treatment for individuals infected with HIV and HCV? A reassessment and reordering of priorities is in order. Should we provide support to vaccine research? YES. Should we provide adequate funding to support full access to HIV and HCV treatments and care, and HCV testing & counseling? YES.
Key Vaccine Researcher Criticizes Current Vaccine Strategies
It's Back to Basics After Setbacks For AIDS Vaccine
By MARILYN CHASE
Staff Reporter of THE WALL STREET JOURNAL
SAN FRANCISCO -- In the wake of setbacks in AIDS-vaccine trials, scientists made a plea for vaccine researchers to go back to their labs and settle basic science questions about the complex interplay between the AIDS virus and the human immune system.
"There's ample evidence to indicate that development of an effective vaccine against HIV-1 will be extremely difficult," said Ron Desrosiers, a professor at Harvard Medical School, speaking at the 11th Annual Retrovirus conference here Tuesday evening. "Most promising candidates stand little chance of success."
Dr. Desrosiers, who pioneered the use of live-virus vaccines in monkeys, said current vaccine models are doomed to fail as a result of the clever "escape strategies" mounted by the human immunodeficiency virus to evade destruction by the human immune system.
These escape strategies include frequent mutation, an ability to resist neutralizing antibodies and the ability to play hide and seek with the immune system by integrating into the human cell, and then switching to a latent (or silent) phase, before reactivating to pump out copies of itself.
These tricks, Dr. Desrosiers said, mean that "a vaccine must generate superior response to the natural immune response" in order to prevent AIDS.
So far, vaccine researchers have focused on getting more products into their pipelines, and on planning large-scale trials, rather than basic science.
Lawrence Corey, a Seattle researcher who heads the HIV Vaccine Trials Network, defended the process of vaccine research but conceded, "We need to do experiments in a helluva lot quicker way."
Since the human immune system is so poor at containing HIV, the classic vaccine strategy of simply mimicking the immune system "is not the best way," said Dennis Burton, a professor at Scripps Research Institute in La Jolla, Calif. Still, Dr. Burton said he is keen to target gp41, the fusion protein of the AIDS virus, which hides and dodges the immune system by presenting a decoy version of itself.
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