By
Ronald Baker, PhD
As
a result of the recent
failure of a Merck-sponsored HIV vaccine trial, studies of experimental HIV
vaccines conducted by the National Institute of Allergy and Infectious Diseases
(NIAID), part of the U.S. National Institutes of Health (NIH), will be significantly
curtailed, according to an article published by Bloomberg.com.
In September
2007, Merck and NIAID's HIV Vaccine Trials Network (HVTN) halted
a large clinical trial of the experimental V520 (MRKAd5) HIV vaccine after
it failed to prevent HIV infection and did not delay HIV disease progression in
study participants. In fact, the vaccine candidate may
have increased the risk of acquiring HIV for some study subjects.
At
the 15th Conference on Retroviruses and
Opportunistic Infections (CROI 2008) last month in Boston, Ronald Desrosiers
of Harvard Medical School and Neal Nathanson of the University of Pennsylvania
Medical Center presented pessimistic overviews of vaccine research to date, with
Dr. Desrosiers suggesting that the NIH program had "lost its way" and
that current vaccine approaches were likely to fail.
In the wake of these
developments, the AIDS Healthcare
Foundation (AHF) called for all HIV vaccine research to be halted immediately.
"To control AIDS, funding must be invested in strategies that work: effective
prevention efforts, routine testing and universal access to treatment -- and not
spent on expensive vaccine research that over 20 years has yielded little of promise
other than discovering how not to make an AIDS vaccine," according to an
AHF statement.
NIAID hosted a meeting with HIV researchers on March 25
in Bethesda, Maryland, to re-evaluate the agency's $497 million HIV vaccine research
program. Following is a summary of an article on the meeting by Lawrence Altman
published in The New York Times.
Rethinking
a Vaccine for AIDS
Researchers
need to go back to the drawing board to find an effective vaccine for HIV, AIDS
experts said at a NIAID-sponsored meeting on March 25, 2008.
NIAID director
Anthony Fauci, the top U.S. official responsible for government-funded AIDS research,
told meeting attendees that "more fundamental knowledge is needed about HIV"
before a successful vaccine can be developed.
Dr. Fauci also said his
office would "reevaluate the use of the $1.5 billion the NIAID now spends
on AIDS research," and would find the money to achieve the goal of a safe
and effective AIDS vaccine.
"Everything is on the table," he
said. "There is not an immediate solution to the problem." He recognized
that the research program will "have to justify what we are doing" and
determine what actions to take following discussions in smaller meetings with
AIDS researchers.
Dr. Fauci strongly rejected the AHF proposal, stating,
"Under no circumstances will we stop AIDS vaccine research."
Several
researchers at the meeting agreed with the sentiment expressed by James Hoxie
of the University of Pennsylvania, who stated, "We are not close to having
a vaccine" and "there is a tremendous need for innovation" in developing
one.
Other experts said that NIAID should support more vaccine studies
using animal models of human HIV, and they urged increased cooperation between
scientists who work on animal models and those studying experimental HIV vaccines
in humans.
There was widespread support for a proposal to support younger
AIDS researchers to replace those who are continuing to work past retirement age.
To this end, Dr. Fauci said NIAID would "immediately" make cuts in current
HIV vaccine research projects and provide $10-15 million to fund 30 new grants
to "scientists who propose novel ideas."
To view a web cast
of the meeting, go to:
www.macrovolt.com/live/dgi_032508.
3/28/08
Sources
LK
Altman. Rethinking Is Urged on a Vaccine for AIDS. The New York Times (online
edition). March 26, 2008.
J Lauerman. Merck
AIDS Vaccine Failure May Doom Promising Study (Update3). Bloomberg.com. March
26, 2008.
H Khanlou and M Weinstein. Enough Is Enough. AIDS
Healthcare Foundation Statement. March 23, 2008.
D. Brown. Vaccine
Failure Is Setback in AIDS Fight. Washington Post. March 21, 2008.
FDA-approved
Treatments
