Lessons Learned from HIV Vaccine Clinical Efficacy Trials

Abstract

The past few years have witnessed many promising advances in HIV prevention strategies involving pre-exposure prophylaxis approaches. Some may now wonder whether an HIV vaccine is still needed, and whether developing one is even possible. The partial efficacy reported in the RV144 trial and the encouraging results of the accompanying immune correlates analysis suggest that an effective HIV vaccine is achievable. These successes have provided a large impetus and guidance for conducting more HIV vaccine trials. A key lesson learned from RV144 is that assessment of HIV acquisition is now a feasible and valuable primary objective for HIV preventive vaccine trials. In this article we review how RV144 and other HIV vaccine efficacy trials have instructed the field and highlight some of the HIV vaccine concepts in clinical development. After a long and significant investment, HIV vaccine clinical research is paying off in the form of valuable lessons that, if applied effectively, will accelerate the path toward a safe and effective vaccine. Together with other HIV prevention approaches, preventive and therapeutic HIV vaccines will be invaluable tools in bringing the epidemic to an end.

Efficacy Trials and Progress of HIV Vaccines

“…This research is also effective in phase 2 experiments of monoclonal antibody i.e. humanized anit-CD4, Ibalizumab which in combination with the effective therapy of patients which are infected with HIV [92,93]. In the research center of Diamond AIDS and foundation of Melinda and Bill Gates, Ibalizumab is under safety assessment in healthy uninfected HIV-I Adults during phase I trial experiment.…”

“…For preventing new HIV infections from occurring, several preventive measures are applied, but these preventive measures have some shortcomings, e.g. although condom use and sterile needles have a strong impact, but they possess insufficient adherence and access that limit their impact [3]. Other preventive measures, including male circumcision, pre-prophylaxis (PreP) and Antiretroviral therapy (ART) [4][5][6] have encountered the same problems of limited access and adherence.…”

“…Vaccination does not involve such problems so it is preferred over other preventive measures. Also, vaccination possesses the ability to eradicate the virus, because of this ability it has been the major goal to develop an HIV vaccine to prevent new infections from occurring [3]. In the past 33 years of the HIV pandemic, there has been monumental progress in the clinical management of HIV disease.…”

“…Because in immune system cytotoxic T-lymphocytes play a significant role in controlling the levels of virus during the natural infection of HIV. So, targeting CTLs has also been a preference for research and development of HIV vaccine [3]. The development of an HIV vaccine is a difficult challenge because of lengthy, time consuming and expensive clinical trials for testing HIV candidate vaccines.…”

“…The development of an HIV vaccine is a difficult challenge because of lengthy, time consuming and expensive clinical trials for testing HIV candidate vaccines. In spite of the difficult and enormous challenge, the recent success provides a way forward towards the development of vaccine against HIV [3] (Table 1). …”