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Early HIV vaccine results lead to major trial: researchers
by Staff Writers
Durban, South Africa (AFP) July 19, 2016


Researchers warn of no quick HIV cure
Durban, South Africa (AFP) July 19, 2016 - Researchers on Tuesday praised progress made towards developing an HIV cure, but said it was impossible to tell when or even if a cure for the devastating epidemic would be found.

Some 18,000 delegates from around the world have converged on the coastal city of Durban for the 21st International AIDS Conference where the latest advances in research are being presented.

Last week, scientists unveiled an aggressive strategy to develop an outright cure, but many of those in Durban warned it was still a young field of research.

"A true cure is an aspirational goal," said principal author of the strategy Professor Sharon Lewin.

She said remission -- the ability of a patient to stop taking anti-retroviral treatment and remain healthy -- was the intermediate goal.

"We don't know when we will have a cure and if we will have a cure," said Nobel Medicine laureate Francoise Barre-Sinoussi, who in 1983 helped identify the human immunodeficiency virus (HIV) that causes AIDS.

"We really believe that we will be able to have sustainable remission," she said.

"That's not to say a cure is impossible, it's just to say to have a real cure is very, very hard."

In 2004, AIDS deaths peaked at more than two million.

Last year, the toll was around 1.2 million lives -- a decline attributed in large part to the success of anti-retroviral drugs, which reduce the symptoms of people carrying the virus.

Scientists increasingly understand how HIV remains barricaded in tissues -- such as the lymph nodes and the gut -- after being beaten back by anti-retroviral therapy, the standard drug cocktail given to HIV patients.

"We still need a lot more basic research about where and why virus persists and how to harness immune response to eliminate it," said Lewin.

Research has also found starting therapy early limits the ability of the virus to establish a stronghold.

But less than half of an estimated 37 million people worldwide living with HIV receive therapy.

Over $200 million was invested in cure research last year, up from just $88 million invested in 2012.

"That trend needs to continue," said Barre-Sinoussi.

Promising results from an early safety trial with a potential HIV vaccine have paved the way for a major new study, researchers announced at the International AIDS Conference in Durban on Tuesday.

An 18-month trial with a candidate vaccine dubbed HVTN100 drew on 252 participants at six sites in South Africa, one of the countries hardest-hit by an epidemic that has claimed more than 30 million lives worldwide since the 1980s.

The participants fell within a low-risk category for contracting the sexually-transmitted virus, the researchers said.

The trial cleared a key hurdle in the long, three-phase process to test new drugs. In this early phase, the main point is to assess safety, not efficacy.

"We wanted to see if this vaccine candidate is safe in a South African population and if it is tolerable," Kathy Mngadi, principal investigator at one of the research sites, explained to AFP.

The team also looked for antibodies signalling that the body's immune system was responding to the vaccine.

The trial built on the foundations laid by a groundbreaking trial conducted in Thailand in 2009, which yielded the world's first partially effective vaccine, dubbed RV144.

While hailed as a breakthrough, the effect of the Thai course decreased with time, dropping from 60 percent after one year to 31.2 percent after three-and-a-half years.

"RV144 set us on this journey of hope, but also showed us what we still need to learn and accomplish in this field," said Fatima Laher, co-chair of the HVTN100 trial.

- Next step -

All the study criteria "were met unequivocally and, in many instances, the HVTN100 outcomes exceeded both our own criteria," added trial protocol chair Linda-Gail Bekker.

The next phase of the trial, dubbed HVTN702, will kick off in November with the recruitment of 5,400 South African men and women aged between 18 to 25 at high risk of contracting HIV.

People are divided into risk categories through criteria that includes their sexual activity.

"We hope to have results in five years, and it is going to be a very exciting five years for all of us because it is the result of many, many years of hard work," said Glenda Gray, HVTN Africa programme director.

A fully effective vaccine is still a long way off, she cautioned.

But recent studies have shown that even a partially effective blocker could have a huge impact if rolled out on a large scale.

Some two-and-a-half million people are still becoming infected with HIV every year, according to a new study published on Tuesday, even as drugs have slashed the death rate and virus-carriers live ever longer on anti-retroviral treatment.

While the quest for a cure continues, many view a vaccine as the best hope for stemming new infections.

Larry Corey, principal investigator for the HIV Vaccine Trials Network, a publicly-funded international project, said vaccines were barely mentioned the last time the conference was held in Durban some 16 years ago.

"It's really gratifying now to see how far we've come scientifically," he said.

Last year, billionaire and philanthropist Bill Gates, who spends millions of dollars on AIDS drug development, said he hoped for an HIV vaccine within a decade, as a cure seems less likely.


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