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Nature Reviews. Immunology Apr 2002The twenty-first century has begun with considerable success for new AIDS vaccines in macaque models. A common feature of these vaccines is their ability to induce... (Review)
Review
The twenty-first century has begun with considerable success for new AIDS vaccines in macaque models. A common feature of these vaccines is their ability to induce high-frequency CD8+ T-cell responses that control, rather than prevent, infection with HIV. The new vaccines, which include DNA vaccines and live viral vectors, are based on technologies that have been developed since the start of the AIDS epidemic. The ultimate promise of these vaccines will be realized only when efficacy trials in humans are conducted.
Topics: AIDS Vaccines; Acquired Immunodeficiency Syndrome; Animals; CD8-Positive T-Lymphocytes; Clinical Trials as Topic; Drug Design; Forecasting; Genetic Vectors; HIV-1; Humans; Macaca; Vaccines, DNA
PubMed: 12001995
DOI: 10.1038/nri776 -
Lancet (London, England) Jul 2018
Topics: AIDS Vaccines; HIV Infections; Humans
PubMed: 30047374
DOI: 10.1016/S0140-6736(18)31548-4 -
Nature Medicine Mar 2002
Topics: AIDS Vaccines; Animals; CD4-Positive T-Lymphocytes; Clinical Trials as Topic; Disease Models, Animal; Drug Evaluation, Preclinical; HIV Infections; HIV-1; Humans; Macaca mulatta; Simian Acquired Immunodeficiency Syndrome; Simian Immunodeficiency Virus; Time Factors
PubMed: 11875482
DOI: 10.1038/nm0302-207 -
Medical Microbiology and Immunology Aug 2005Since only a limited number of vaccines can be tested for efficacy in phase 3 studies in humans, a filter is needed allowing selection of the most promising ones.... (Review)
Review
Since only a limited number of vaccines can be tested for efficacy in phase 3 studies in humans, a filter is needed allowing selection of the most promising ones. Although differences between HIV infection in humans and simian immunodeficiency virus infection in nonhuman primates (NHP) might limit the predictive value of these models, comparative efficacy studies in NHPs could facilitate ranking of vaccine candidates. While various forms of protein vaccines failed to induce consistent protection, live-attenuated vaccines, DNA vaccines and viral vector vaccines provided various levels of protection in NHPs. However, variability in the experimental models limits the conclusions that can be drawn with respect to the relative efficacy of vaccines not tested in the same experiment. Therefore, better standardization is an urgent necessity in order to exploit the full potential of nonhuman primate models in AIDS vaccine development.
Topics: AIDS Vaccines; Animals; Disease Models, Animal; HIV Infections; Humans; Primates; Vaccines, Attenuated; Vaccines, Synthetic
PubMed: 15843997
DOI: 10.1007/s00430-005-0238-5 -
JAMA Mar 1999
Topics: AIDS Vaccines; Humans; National Institutes of Health (U.S.); Randomized Controlled Trials as Topic; Uganda; United States
PubMed: 10094615
DOI: No ID Found -
Current Opinion in HIV and AIDS Nov 2016Only four HIV-1 vaccine concepts have been tested in six efficacy trials with no product licensed to date. Several scientific and programmatic lessons can be learned... (Review)
Review
PURPOSE OF REVIEW
Only four HIV-1 vaccine concepts have been tested in six efficacy trials with no product licensed to date. Several scientific and programmatic lessons can be learned from these studies generating new hypotheses and guiding future steps.
RECENT FINDINGS
RV144 [ALVAC-HIV (canarypox vector) and AIDSVAX B/E (bivalent gp120 HIV-1 subtype B and CRF01_AE)] remains the only efficacy trial that demonstrated a modest vaccine efficacy, which led to the identification of immune correlates of risk. Progress on subtype-specific, ALVAC (canarypox vector) and gp120 vaccine prime-boost approaches has been slow, but we are finally close to the launch of an efficacy study in Africa in 2016. The quest of a globally effective HIV-1 vaccine has led to the development of new approaches. Efficacy studies of combinations of Adenovirus type 26 (Ad26)/Modified Vaccinia Ankara (MVA)/gp140 vaccines with mosaic designs will enter efficacy studies mid-2017 and cytomegalovirus (CMV)-vectored vaccines begin Phase I studies at the same time. Future HIV-1 vaccine efficacy trials face practical challenges as effective nonvaccine prevention programs are projected to decrease HIV-1 incidence.
SUMMARY
An HIV-1 vaccine is urgently needed. Increased industry involvement, mobilization of resources, expansion of a robust pipeline of new concepts, and robust preclinical challenge studies will be essential to accelerate efficacy testing of next generation HIV-1 vaccine candidates.
Topics: AIDS Vaccines; Clinical Trials as Topic; HIV Infections; Humans; Treatment Outcome
PubMed: 27537673
DOI: 10.1097/COH.0000000000000312 -
Vaccine Jun 2008Human immunodeficiency virus (HIV) has infected 50 million people worldwide and killed 16 million so far, and the epidemic is still spreading with 16,000 new cases of...
Human immunodeficiency virus (HIV) has infected 50 million people worldwide and killed 16 million so far, and the epidemic is still spreading with 16,000 new cases of HIV infection daily and a projection of 100 million infected individuals by the end of the next decade. There is no question that a safe and effective acquired immunodeficiency syndrome (AIDS) vaccine is urgently needed to bring the current AIDS pandemic under control. But, is preventive AIDS vaccine an attainable goal? Unfortunately, the results of many laboratory and clinical studies over the past two decades are not encouraging. We comment on the efficacy, safety and ethics of AIDS vaccine, and the urgent need for a new strategy for AIDS vaccine development.
Topics: AIDS Vaccines; Consumer Product Safety; HIV Envelope Protein gp120; HIV Infections; HIV-1; Humans; Vaccination; Vaccines, Synthetic
PubMed: 18164521
DOI: 10.1016/j.vaccine.2007.11.061 -
AIDS Research and Human Retroviruses Oct 1998Critical misconceptions about vaccine development have arisen in the context of acquired immunodeficiency syndrome (AIDS) vaccine research. These include: the goal of... (Review)
Review
Critical misconceptions about vaccine development have arisen in the context of acquired immunodeficiency syndrome (AIDS) vaccine research. These include: the goal of vaccination; the biological relevance and predictive value of animal models; the meaning of "correlates of protective immunity"; the nature and duration of vaccine-induced immune responses; and the need for multiple, iterative field trials. In this article, lessons from the history of successful vaccine development relevant to these issues are discussed. Clarity about these central issues and adherence to a common vocabulary are important for the process of establishing an appropriate, milestone-driven process for developing safe, effective AIDS vaccines.
Topics: AIDS Vaccines; Animals; Clinical Trials as Topic; Disease Models, Animal; Drug Design; HIV Infections; Humans; Viral Vaccines
PubMed: 9814944
DOI: No ID Found -
African Health Sciences Dec 2001
Review
Topics: AIDS Vaccines; Clinical Trials as Topic; Congresses as Topic; Disease Models, Animal; HIV Infections; HIV Seroprevalence; Human Experimentation; Humans; Prognosis; United States
PubMed: 12830816
DOI: No ID Found -
PloS One 2016The Investment Framework Enhanced (IFE) proposed in 2013 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) explored how maximizing existing interventions and...
BACKGROUND
The Investment Framework Enhanced (IFE) proposed in 2013 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) explored how maximizing existing interventions and adding emerging prevention options, including a vaccine, could further reduce new HIV infections and AIDS-related deaths in low- and middle-income countries (LMICs). This article describes additional modeling which looks more closely at the potential health impact and cost-effectiveness of AIDS vaccination in LMICs as part of UNAIDS IFE.
METHODS
An epidemiological model was used to explore the potential impact of AIDS vaccination in LMICs in combination with other interventions through 2070. Assumptions were based on perspectives from research, vaccination and public health experts, as well as observations from other HIV/AIDS interventions and vaccination programs. Sensitivity analyses varied vaccine efficacy, duration of protection, coverage, and cost.
RESULTS
If UNAIDS IFE goals were fully achieved, new annual HIV infections in LMICs would decline from 2.0 million in 2014 to 550,000 in 2070. A 70% efficacious vaccine introduced in 2027 with three doses, strong uptake and five years of protection would reduce annual new infections by 44% over the first decade, by 65% the first 25 years and by 78% to 122,000 in 2070. Vaccine impact would be much greater if the assumptions in UNAIDS IFE were not fully achieved. An AIDS vaccine would be cost-effective within a wide range of scenarios.
INTERPRETATION
Even a modestly effective vaccine could contribute strongly to a sustainable response to HIV/AIDS and be cost-effective, even with optimistic assumptions about other interventions. Higher efficacy would provide even greater impact and cost-effectiveness, and would support broader access. Vaccine efficacy and cost per regimen are critical in achieving cost-effectiveness, with cost per regimen being particularly critical in low-income countries and at lower efficacy levels.
Topics: AIDS Vaccines; Acquired Immunodeficiency Syndrome; Cost-Benefit Analysis; Humans; Immunization Programs; Models, Theoretical; Poverty; Public Health
PubMed: 26731116
DOI: 10.1371/journal.pone.0146387