Is there an AIDS vaccine? Trump may think it exists, but here's a look at the actual status of the vaccine
Currently, people living with HIV have access to life-saving treatment with HIV medicines, called antiretroviral therapy or ART. However, a cure or vaccine for AIDS is currently not available
President Donald Trump incorrectly said on Tuesday, June 16, that there is a vaccine for AIDS. He said that the same scientific expertise that created a vaccine for AIDS will be able to deliver a vaccine for Covid-19 by the end of the year.
"Before the end of the year, I predict we will have a very successful vaccine, therapeutic and cure. We are making tremendous progress. I deal with these incredible scientists, doctors, very very closely. I have great respect for their minds. They have come up with many other cures and therapeutics over the years. These are the people, the best, the smartest, the most brilliant anywhere, and they’ve come up with the AIDS vaccine. They've come up with — or the AIDS, and, as you know, there's various things and now various companies are involved. But the therapeutic for AIDS. AIDS was a death sentence, and now people live a life with a pill. It's an incredible thing,” Trump said from the White House Rose Garden.
HIV continues to be a major global public health issue, having claimed more than 32 million lives so far, according to the WHO. In 2018, 37,832 people were diagnosed with HIV infection in the US and approximately 1.7 million people became newly infected with HIV worldwide.
A vaccine, also called a "shot" or "immunization", is a substance that teaches your body's immune system to recognize and defend against harmful viruses or bacteria. HIV was first identified in 1984. Back then, the US Department of Health & Human Services Secretary Margaret Heckler declared that an AIDS vaccine will be ready for testing within two years. Since then, several clinical trials have been conducted, and some are ongoing. But despite tremendous research and development over the years, there is currently no vaccine available that will prevent HIV infection or treat those who have it. However, scientists are working to develop one. Developing an HIV vaccine is challenging as HIV mutates rapidly and has unique ways of evading the immune system, say experts.
The National Institutes of Health (NIH) is investing in multiple approaches to prevent HIV, including a safe and effective preventive HIV vaccine. "These research efforts include two late-stage, multinational vaccine clinical trials called Imbokodo and Mosaico. Other NIH-supported research aims to deliver additional HIV prevention options that are safe, effective and desirable to diverse populations and scalable worldwide to help end the global pandemic," says the Department of Health & Human Services.
The NIH announced plans last year to conduct a Phase 3 HIV vaccine efficacy trial at multiple clinical research sites in North America, South America and Europe. The trial, called HPX3002/HVTN 706 or Mosaico, will assess whether an investigational vaccine regimen designed to induce immune responses against a variety of global HIV strains can safely and effectively prevent HIV acquisition among men who have sex with men and transgender people. A complementary study in women called HPX2008/HVTN 705 or Imbokodo that launched in 2017 in five southern African countries is ongoing.
According to a page on the history of HIV vaccine research by the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, the last update is for 2017 when the agency and its partners launched "Imbokodo or HVTN 705/HPX2008, a Phase 2b proof-of-concept study evaluating the safety and efficacy of an experimental regimen based on a 'mosaic' vaccine designed to induce immune responses against a wide variety of global HIV strains."
On February 3, 2020, NIH issued a statement stating that the NIAID, has stopped the administration of vaccinations in its HVTN 702 clinical trial of an investigational HIV vaccine. The Phase 2b/3 study, named HVTN 702 or Uhambo, began in 2016. “This action was taken because an independent data and safety monitoring board (DSMB) found during an interim review that the regimen did not prevent HIV. Importantly, the DSMB did not express any concern regarding participant safety," it says. NIAID Director Anthony S Fauci, said, "Research continues on other approaches to a safe and effective HIV vaccine, which I still believe can be achieved."
The United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) also joined forces in establishing the new HIV Vaccine Initiative (HVI) to boost HIV/AIDS vaccine efforts. The aim is to accelerate the availability of a safe, effective and affordable HIV vaccine by building international consensus, on assays to evaluate the safety and immunogenicity of vaccine candidates; endpoints to determine clinical efficacy; standards for vaccine evaluation and quality control; clinical trial design, clinical development plans, and regulatory pathways; target product profiles; and research ethics and community participation in biomedical HIV prevention trials.
"Building the capacity of regulatory agencies in disease endemic countries to evaluate HIV vaccine-related submissions for clinical studies and eventually licensure, and supporting HIV high burden countries to define a national strategy for the evaluation of, and access to new HIV vaccines," are its other goals.
Currently, people living with HIV have access to life-saving treatment with HIV medicines, called antiretroviral therapy or ART. If taken as prescribed, HIV medicine reduces the amount of HIV in the body (viral load) to a very low level, which keeps the immune system working and prevents illness. The standard antiretroviral therapy (ART) consists of the combination of antiretroviral (ARV) drugs to maximally suppress the HIV and stop the progression of HIV disease. ART also prevents the onward transmission of HIV. According to experts, huge reductions have been seen in rates of death and infections when use is made of a potent ARV regimen, particularly in the early stages of the disease.
There are also drugs, such as Truvada and Descovy, that a person can take every day if they are at higher risk of catching HIV. This is considered pre-exposure prophylaxis (or PrEP) against HIV infections. "Pre-exposure prophylaxis (or PrEP) is a way for people who do not have HIV but who are at very high risk of getting HIV to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection," says the CDC.
When taken daily, PrEP is effective in preventing HIV. However, these drugs are expensive and PrEP is much less effective if it is not taken consistently. "Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74% when taken daily. PrEP is much less effective if it is not taken consistently," says the CDC.