Professional Documents
Culture Documents
Hours
Days
Weeks
Zhu et. Al. Science, 1993; Derdeyn et. al., Science, 2004; Keele et. al.,
PNAS, 2008; Salazar et. al., J. Virol., 2008; Haaland et. al., PLoS Path.,
2009; Abrahams et. al., J. Virol., 2009;
Overview
B cell Macrophage
Membrane or envelope
Matrix proteins
Nucleus (genes)
(e.g., Env, Gag, Pol, nef, Tat)
Preclinical
Discovery Research & Clinical Research
Development
How many molecules does it take
to develop an approved drug?
Vaccine-induced immune
responses have to be unusually
quick and smart to combat HIV
Viral vaccine strategies
Why do we think an HIV vaccine
may be possible?
HVTN 505
enrollment
begins
First HIV
vaccine Results of
trial opens Phase III
Phase II Step
Thai Trial
and Phambili
(RV144)
studies halted
Vaccine and Counseling & Risk Reduction Tools Placebo and Counseling & Risk Reduction Tools
New vaccine
strategies
Fundamental
research
Developing a vaccine—a long road
HIV prevention research:
guiding principles
Multiple strategies needed to assemble a
well-rounded “prevention toolkit.”
No one prevention strategy will be 100%
effective, appropriate to or accepted by
everyone.
Multiple prevention strategies must be
evaluated in different populations,
domestically and globally, to determine
the best combinations for a given
population.
Future considerations for
prevention technologies
■ Is it licensed? ■ Is it acceptable?
■ What is the level of ■ Do people use it as
efficacy? indicated?
■ Is it only proven for ■ Can it be used in
certain modes of combination with other
transmission? prevention
■ In what populations has approaches?
it been tested? ■ Is use associated with
■ How much does it cost? decreased use of other
prevention
approaches?
ARV protection Immunological protection
Can they be
combined?
How might new prevention
options work together?
39
BACKUP SLIDES
Vaccine-induced seropositivity
HIV vaccines are designed to provoke immune
responses – this includes antibody production.
Standard tests for HIV detect antibodies, not virus.
Study participants who receive HIV vaccines will
often test positive (seropositive) on these standard
tests but it doesn’t mean they are HIV-infected.
Frequency varies by immunogen—can be >80%
Durability: Potentially >10 years
We refer to this as Vaccine-Induced SeroPositivity,
or VISP.
Isn’t VISP just a “false positive?”
NO.
If an HIV test is designed to look for
antibodies to HIV, then the test has done
exactly what it was supposed to, and got an
accurate result.
What may be false is the interpretation of the
results
We want to get away from saying “false
positive” so that we do not undermine public
confidence in HIV testing.
Issues related to VISP
Several factors may affect study participants who have VISP: