"COULD AN HIV VACCINE REALLY BE ON THE HORIZON?"

Background Information

There are two categories of HIV vaccines currently being researched in clinical trials. One type of the HIV vaccines is "preventive" and vaccines designed to prevent HIV infection from occurring in uninfected HIV-negative individuals. The other HIV vaccines currently being researched are vaccine trials for those that have been infected with HIV and are "therapeutic" vaccines being developed with the ultimate goal of HIV eradication but today are designed to control HIV infection in HIV-positive individuals.

As there are numerous HIV vaccines currently being researched in clinical trials, one might ask: "Could an HIV vaccine really be on the horizon?" Despite the current global recession, the Obama Administration's American Recovery and Reinvestment Act of 2009 provides a 34 percent increase to the budget in two-year stimulus funds of the National Institutes of Health (NIH), one of the 11 operating divisions of the U.S. Department of Health & Human Services (HHS) and the agency that funds grants, cooperative agreements, and contracts to researchers that perform preventive and therapeutic vaccine clinical trials, among many others.

The Preventive HIV-Vaccine Trials

AIDSinfo, also an HHS project that offers federally approved information on HIV/AIDS clinical research, provides that with regard to the preventive HIV vaccine clinical trials for HIV-negative individuals, there are 14 studies that are currently active and recruiting patients across the United States, however the number rises to 118 studies if the option to select trials that are no longer recruiting patients. Out of all of the preventive HIV vaccine clinical trials for HIV-negative individuals, there are 78 trials that are now closed or "completed."

Today, of all of the preventive HIV vaccines being researched, the vaccines can be broken down into three categories and in no specific order:

1. DNA vaccines that inject DNA containing HIV genes into the body where cells take up the DNA and use it to produce HIV proteins that trigger an immune response;

2. Component, protein or sub-unit vaccines that contain individual pieces of synthetic HIV made in a laboratory through genetic engineering which are thought to provoke an immune response upon introduction to the body (although potentially too weak to protect against an actual HIV infection); and

3. Recombinant vector vaccines made of weakened or carrier types of non-HIV virus that is used to deliver incomplete copies of HIV genes into the body thereby provoking an immune response.

Of the three categories listed, the vaccines may be tested individually, or, in a "prime-boost vaccination strategy" where one category of preventive HIV vaccine is then followed by a later dose of a second category of preventive HIV vaccine. Since none of these vaccines contain any real HIV or complete copies of HIV genes, the HIV Vaccine Trials Network (an international group of scientists and educators that work closely with the National Institutes of Allergic and Infectious Diseases, an agency of the NIH) states that the preventive HIV vaccines cannot cause HIV or AIDS.

The Therapeutic HIV-Vaccine Trials

With respect to therapeutic AIDS vaccines for HIV-positive individuals, 5 studies are found at the AIDSinfowebsite that are currently active and recruiting patients, which number grows to 48 studies when including those studies that are no longer recruiting patients. Out of all of the therapeutic AIDS vaccine clinical trials for HIV-positive individuals, there are 33 trials listed as closed or "completed."

Conclusion

To date, neither an approved vaccine that prevents HIV, nor an approved therapeutic vaccine that assists HIV management thereby prolonging disease progression, has been developed. "Could an HIV vaccine really be on the horizon?" How this question may finally be answered is through the definition of "horizon" and its symbolism. Hopes for an HIV vaccine could very well be on that "apparent intersection of the earth and the sky as seen by an observer," the "horizon." It is that place that can always be seen. It is that place that one always hope to reach. Lastly, the horizon is also that place that even upon a lifelong journey, it just can't quite be reached. The alternative to not making that journey, however, is eminent doom.

Learn more about this author, John Huetteman.
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