May 18th, 2011
10:56 PM ET

On HIV Vaccine Awareness Day, the search continues

May 18 is HIV Vaccine Awareness Day. It's a day to remember the thousands of volunteers, health care professionals, advocates, scientists and community members who work tirelessly on a safe, effective vaccine. But 30 years into the epidemic that has claimed the lives of more than half a million Americans, there is still no vaccine. That's not to say there haven't been a number of promising clinical trials.

The National Institutes of Health says it continues to move toward that goal. Dr. Anthony Fauci, director at the National Institute of Allergy and Infectious Diseases, says he is optimistic there will be one and says a trial of 16,000 people in Thailand in 2009 proves a safe and effective vaccine is possible. In that trial the vaccine was well tolerated and was 31% effective in preventing HIV infection.

"Many of the best minds in HIV vaccine science are examining blood samples and data from the Thai trial to learn how the vaccine candidate prevented HIV infections and to consider how it could be modified to be more effective."

Fauci says the challenge is that most vaccines against viral diseases–like measles, influenza and polio–stimulate antibodies that control the virus. This prevents illness and eventually gets rid of the virus. With HIV, the virus has multiple ways of evading the body's immune defenses.

"HIV rapidly mutates and an infected person's immune system generally cannot keep up with all of the ever-changing variants of the virus in his or her body. In addition, within days of infection, HIV begins to destroy critical immune cells that normally protect against the virus; this attack on the body's defenses is relatively unique among pathogens," Fauci said. "HIV inserts itself into the DNA of human cells where it can remain undetected by the immune system. These challenges have made it extremely difficult to design a vaccine that prevents an infection from establishing itself in the body."

Mitchell Warren, executive director of AVAC-Global Advocacy for HIV Prevention, an organization committed to the global delivery of AIDS vaccines, says recent breakthroughs have provided important clues that will lead to a safe, effective vaccine.

"HIV is a one of the toughest enemies ever, and the scientific challenges it poses have kept researchers puzzling over ways to defeat this virus for decades now. The good news, though, is that we are closer now than we have ever been to finding a safe and effective vaccine. The results of the RV144 trial that took place in Thailand proved in 2009 that an AIDS vaccine is possible and gave new clues and renewed hope to the fight," said Warren. "We've also seen tremendous breakthroughs in antiretroviral-based prevention interventions. Thirty years since the disease was identified, science is presenting us with new knowledge and, more importantly, new opportunities. We now have a combination of new and emerging HIV treatment and prevention options, including vaccines, that allow us talk honestly about an end of AIDS in our lifetimes."

Daniel Montoya, executive director for the National Minority AIDS Council, says minorities are underrepresented in HIV vaccine trials and that has to change.

"In order for any search for and HIV vaccine to be successful, those communities who bear the largest burden of infection need to be represented in trials., Montoya said. "Huge strides are being made in HIV/AIDS research every day, and we must ensure that the vaccine trials receive both adequate funding and appropriate minority representation. Thirty years into the epidemic, it is our best hope of finally bringing it to an end."

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