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Why Is It So Hard to Get an HIV Vaccine?

Why Is It So Hard to Get an HIV Vaccine?

Since the outbreak of the COVID-19 epidemic, several effective vaccines have been created at breakneck speed. However, more than 40 years after Michael Gottlieb, MD, a University of Rochester graduate, first named AIDS, there is still no effective vaccine.

Scientists at the University of Rochester Medical Center (URMC) specializing in HIV were involved in the research on the COVID-19 vaccine during the epidemic and are now turning the important data and knowledge gained during those two years to HIV research.

So why has the COVID-19 vaccine been developed so quickly, while the HIV vaccine has taken scientists so many years? Dr. Steve Dewhurst said that the two viruses are completely different. “HIV is like a much harder nut to crack, and the biggest difference between it and SARS-CoV-2 is the number of variants of a single strain of HIV. In an untreated patient, HIV will replicate and mutate for years in a way that SARS-CoV-2 does not. HIV generates new mutations incredibly quickly.”

Dr. Michael Keefer added, “HIV has thousands of variants, and the Greek alphabet is completely inadequate to name them.”

That said, two factors are critical for the rapid development of an effective COVID-19 vaccine. One is from the investment aspect—a basic investment in structure-based antigen design and RNA vaccine technology that can be immediately used for COVID-19 vaccine development. Barney Graham, M.D., associate director of the Center for Vaccine Research at the National Institute of Infectious Diseases (NIAID), developed structure-based vaccine designs during HIV vaccine development, and his work on respiratory syncytial virus (RSV) paved the way for RNA vaccines. The second factor is the significant global resources devoted to COVID-19 vaccine discovery, which has allowed researchers to evaluate a large number of vaccine options very quickly. And both of these advances can now be applied to HIV research.

Dewhurst, professor of microbiology and immunology, and Keefer, professor of infectious disease medicine, have been studying AIDS for more than 30 years. They noted that the COVID-19 vaccine was developed based on more than 20 years of research on vaccines for HIV and other infectious diseases. Now, they are turning the tide and using the knowledge gained from the development of the COVID-19 vaccine to help HIV research.

“It’s kind of like a renaissance where we’re starting from scratch, and the blueprint we’re drawing is an mRNA vaccine,” Keefer said. “The COVID-19 vaccine provides us with a lot of safety data that we can use, and our understanding of vaccine development has increased.”

The AIDS crisis has claimed millions of lives since the epidemic began in the 1980s, and it is estimated that 38 million people in the world are currently infected with HIV. There is no cure for AIDS, but it can be managed through prevention and treatment. Unfortunately, not everyone has access to these drugs and not everyone is tolerant. The ultimate goal remains to develop a vaccine to prevent HIV infection in the first place.

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