Trial puts SA at epicentre of HIV/Aids research

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South Africa is about to become the epicentre of HIV vaccine research with the start of a trial that will inject people with powerful antibodies already proven to neutralise most strains of the virus. Health-e News reports that an Aids vaccine trial that will infuse people with antibodies known to neutralise 85% of HIV strains will begin in southern Africa, the US and South America within months. “We are entering the most exciting period, an golden era of HIV prevention research that has taken us 30 years to get to,” said SA Medical Research Council president Dr Glenda Gray, announcing the trial.

The vaccine will inject people with “broadly neutralising antibodies” (bNA) that have been isolated by the US National Institutes of Health, based on decades of research on HIV-infected people who have been able to hold the virus is check. As HIV mutates so fast, scientists have pinned their hopes on bNAs that are able to neutralise a large number of strains at a time, rather than one or two strains. “Most vaccines try to educate the body to produce an immune response (and develop antibodies], but in this trial you will be given the neutralising antibodies right away,” said Dr Larry Corey of the HIV Vaccine Trials Network (HVTN).

The vaccine will be tested on gay men in the US and South America from November, and women in sub-Saharan Africa from January. At least seven South African trial sites will be involved, and HIV negative women aged between 18 and 30 will be recruited.

The trial participants – about 3,900 globally – will each get a half-hour intravenous infusion via a drip with the special antibodies every two months for 20 months. “We are very optimistic. These neutralising antibodies have been able to prevent the infection of almost every virus. But we have learnt never to underestimate your pathogen,” Corey is quoted in the report as saying. Malawi, Zimbabwe, Zambia and Tanzania are also involved in the trial, which Corey described as a “large world-wide collaboration”. Results will become available in late 2018.

Alongside the neutralising antibody trial, South Africans are currently testing another vaccine that aims to stimulate the body to fight HIV. This trial is a continuation of the 2009 Thailand trial (called RV144), the only vaccine ever to have elicited any immune response in trialists. After a year, it had protected 60% of those involved against HIV but the protective effect had halved by 3.5 years.

The Thai vaccine has been re-engineered to use the type of HIV most common in southern Africa (Clade C), and this has been tested on South Africans. A large-scale trial of the vaccine is due to start next year. Trial participants will get an initial vaccine, then a vaccine boost after 12 months to see whether this can maintain the body’s immune response. “It might mean that people need to get a yearly booster shot,” said Gray, adding that the efficacy of the measles vaccine also waned over time.

“South Africa is the centre of gravity as far as HIV prevention work is concerned,” added Correy. “The Thai vaccine has been partly effective in stimulating the body’s CD4 T cells to fight against HIV, while the second is using the latest research on broadly neutralising antibodies. We are bringing both of these approaches to South Africa, which will make South Africa the epicentre of HIV vaccine development. ”

Health-e News material

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