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HIV vaccine research: crisis of faith?

HIV/AIDS researchers are despondent over the waning prospects of ever creating an effective vaccine against the virus, according to a linkurl:survey;http://www.independent.co.uk/news/science/the-independents-hiv-survey-the-questions-and-answers-814936.html conducted by British newspaper __The Independent__. But can it really be all that bad? "Most scientists involved in Aids research believe that a vaccine against HIV is further away than ever and some have admitted that effective immunisation

By | April 24, 2008

HIV/AIDS researchers are despondent over the waning prospects of ever creating an effective vaccine against the virus, according to a linkurl:survey;http://www.independent.co.uk/news/science/the-independents-hiv-survey-the-questions-and-answers-814936.html conducted by British newspaper __The Independent__. But can it really be all that bad? "Most scientists involved in Aids research believe that a vaccine against HIV is further away than ever and some have admitted that effective immunisation against the virus may never be possible," __The Independent__ linkurl:article,;http://www.independent.co.uk/news/science/is-it-time-to-give-up-the-search-for-an-aids-vaccine-814737.html which ran today (Apr 24), began. The trouble is that __The Independent__ polled only "35 leading Aids scientists in Britain and the United States" - not an especially large sample. The interpretation of their results also seems somewhat selective to this reader. The debate concerning the search for an HIV vaccine swirls around the recent linkurl:failure;http://www.the-scientist.com/blog/display/53633/ of major clinical vaccine trials, and a subsequent NIH linkurl:summit,;http://www.the-scientist.com/blog/display/54488/ where the research community decided to ratchet back its clinical research and focus more on the basic science underlying the disease. __The Independent__ article gives some statistics characterizing scientist responses from the survey: "...just two were now more optimistic about the prospects for an HIV vaccine than they were a year ago; only four said they were more optimistic now than they were five years ago." "Nearly two thirds believed that an HIV vaccine will not be developed within the next 10 years and some of them said that it may take at least 20 more years of research before a vaccine can be used to protect people either from infection or the onset of Aids." And - though the story doesn't define "substantial minority" and the survey doesn't specifically ask whether a vaccine could be developed at all - "A substantial minority of the scientists admitted that an HIV vaccine may never be developed." A look at the survey responses, a link to which __The Independent__ provided, reveals a slightly different story. The majority of scientists responding to the question, "Are you more or less optimistic about the prospects of an HIV vaccine compared to a year ago?" answered that they were neither more nor less optimistic about an HIV vaccine than they were a year ago. Similarly, the majority of respondents answered that they disagreed with the assertion that "money being spent on developing an HIV vaccine would be better spent on education and prevention." __The Independent__ posted some edited comments from scientists who participated in their survey. Respondents included linkurl:Guido Silvestri;http://www.med.upenn.edu/camb/faculty/gt/silvestri.html of University of Pennsylvania School of Medicine, who wrote, "We need more basic science to understand how HIV and the immune system interact, and particularly more studies of in vivo SIV infection in non-human primates." Silvestri also wrote that an effective HIV vaccine was "greater than 20 years" from being a reality. linkurl:Seth Berkley,;http://www.the-scientist.com/news/20040713/03/ president of the International AIDS Vaccine Initiative, also weighed in, writing: "While scientists don't know how long it will take to develop an AIDS vaccine, we do know that a vaccine is the only way to end a major viral epidemic. And there is scientific evidence to support the belief that an AIDS vaccine is possible." Some responses posted by __The Independent__ did voice doubt over the promise of an HIV vaccine. "Perhaps we will never have a true preventative vaccine," wrote linkurl:Samuel McConkey,;http://www.rcsi.ie/index.jsp?nID=774&pID=503 a researcher at the Royal College of Surgeons in Ireland's Department of International Health and Tropical Medicine. "One HIV infection does not prevent further infection: what I am saying is that there is no infection-acquired immunity. This is different from malaria, and most other infections for which there is a vaccine at present." A torrent of public linkurl:comments;http://blogs.independent.co.uk/openhouse/2008/04/have-your-sa-11.html#comments appeared on __The Independent__'s Web site in response to the article. Some posters voiced a denial of HIV's existence or the virus's ability to cause AIDS, while others posted screeds on morality, abstinence or homosexuality. Still others lent their support to the search for an HIV vaccine. What do you think about the future of an HIV vaccine? How about __The Independent__'s survey? Let us know in a comment.
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Comments

Avatar of: Ellen Hunt

Ellen Hunt

Posts: 199

April 28, 2008

I do not think an HIV vaccine that is significantly better than placebo will exist in 20 years. Prevention is everything.
Avatar of: ROULETTE W SMITH

ROULETTE W SMITH

Posts: 10

April 28, 2008

I firmly believe that a vaccine against AIDS is possible, though if and only if there is a fundamental shift in paradigms. In several of my publications dating back to the mid-1980s, I cited a seemingly counterintuitive approach which is taught in ethological studies. My approach recognizes two overlooked issues in vaccine research targeting HIV. First, there always has been confusion regarding fundamental differences between HIV, as a lentivirus, and other retroviruses ? the oncoviruses and spumaviruses. For all practical purposes, it is unlikely that a vaccine can be crafted against HIV, though not AIDS per se. Second, AIDS is a misnomer; not all pathogens become opportunistic in HIV/AIDS. For the most part, only ?nascent? pathogens (including HIV itself ? and recursively) become opportunistic. It should be noted that an underlying logic involving Modus Tollendo Tollens can help clarify many of these issues. That logic also clarifies why the Henle-Koch postulates are irrelevant in HIV/AIDS; to wit, the opportunistic pathogens most often are not HIV.\n\nThe central question for the sciences is how to ?stop? the failed approaches and then to shift paradigms. Having worked in this field since 1979 (even before the first cases of GRIDS / AIDS were reported), I can attest to the challenges of getting investigators and scholars to see a ?bigger picture?. That bigger picture extends beyond the matter of vaccines for AIDS. For example, I had to formulate a theory of autotoxicity, autovirulence and context-specificity to explain high titers of acid-labile α-interferon in HIV/AIDS. The theory (in 1983) also explained the presence of EBV antigens in Kaposi?s sarcoma tissue, despite the subsequent discovery of a KSV8 ? another gamma herpesvirus. KSV8 investigators failed to appreciate the significance of a ~39% overlap in DNA sequences in EBV and KSV8. Most importantly, the theory provided the first concrete model for ?hit-and-run? and ?beneath-the-radar? infections associated with ubiquitous gamma herpesviruses.\n\nThere is one final point which should not go unnoticed. Of the numerous international conferences on HIV/AIDS, I cannot recall any of those conferences wherein issues involving logic, methodology and the philosophy of sciences were encouraged or discussed. As a pun on Immanuel Kant?s ?A Critique of Pure Reason,? I addressed this matter head-on in 1983 at the 7th International Congress of Logic, Methodology and Philosophy of Science [Salzburg, AUSTRIA] 4:358-362. I titled my presentation, ?A Critique of Impure Reasoning in Biological Sciences.? Of course, there were no HIV/ AIDS scholars at the conference!\n\nRoulette Wm. Smith, Ph.D\nInstitute for Postgraduate Interdisciplinary Studies\nP. O. Box 60846\nPalo Alto, CA 94306-0846 USA\nE-Mail: najms@postgraduate-interdisciplinary-studies.org
Avatar of: PRASANTA GHOSH

PRASANTA GHOSH

Posts: 9

April 29, 2008

While presently there is no vaccine against HIV, I believe that hope for the development of a vaccine is not yet lost. If the Merck?s experimental data are analyzed thread bare, one would be hopeful to find that several questions for which solutions can be found can now be addressed. Can we, for example, increase the antibody titer against the env proteins of HIV-I and concomitantly increase the CTL activity further? Is there any vector better than Adeno vector? \n There can also be fall outs from the results of Merck?s trial. Presently, several kinds of highly active antiretroviral drugs are used to treat HIV patients; these drugs control the viral load and bring down viral numbers in the infected patients to the minimum. These synthetic chemical entities are used to combination to attack the virus in more than one of its path- ways, from infection to maturation and spread. The human endeavor has been to attack the virus by producing and deploying newer drugs (synthetics and biologically active substances) that act either by inhibiting attachment and fusion of the virus with the host cell, or inhibit the viral reverse transcriptase as also the agents that inhibit the HIV protease. Some other agents as viral assembly inhibitors and viral maturation inhibitors have also been used and investigated. While there has been some success to reduce the viral load in the infected by using these substances, none of the combinations have been successful as a cure. The combinations suited to individual patients are to be continued till the patients survive.\nMost of the drugs are considerably toxic; the recipients cannot often continue the drug combinations for longer periods. Sooner or later resistance to the used drug regimen develops and if the patients survive, they are to look for newer regimen of drugs for continuing treatment. In the mean time the immune system of the patients gets substantially damaged. In such circumstances, alternative agents that ensure maintaining almost non-detectable levels of HIV viral load in patients are very much needed to prolong their lives. Can we use substances like those of Merck or better ones in conjunction with anti-retroviral drugs in order to prolong the status of almost non-detectable levels of viral load in HIV patients for longer period than what is achievable presently? \nI think, such a regimen holds the potential of being the best bet for prolonging the life of the HIV patients under the existing state of scientific development in HIV globally before an effective but preventive HIV vaccine is discovered.\n
Avatar of: anonymous poster

anonymous poster

Posts: 1

February 25, 2009

All the more reason to focus our resources on making HIV a curable disease for those who are infected. Even if we had a vaccine today, dispensing it to the areas where HIV is most rampant might be difficult. (Can we really expect big drug companies to develop a vaccine and give it to everyone in the poorest countries for litttle or no money?)

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