South Africa begins first HIV vaccine trial in seven yearsBMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i6501 (Published 01 December 2016) Cite this as: BMJ 2016;355:i6501
The stalled search for an elusive vaccine against HIV began again on 30 November with the official start of the HVTN 702 trial in South Africa. The vaccine efficacy study will follow 5400 men and women injected over a year with five doses of either a two part vaccine or placebo. Results are due in 2020.
“HIV has taken a devastating toll in South Africa, but now we begin a scientific exploration that could hold great promise for our country,” said Glenda Gray, paediatrician and president of the South African Medical Research Council, which is partly funding the study. “If an HIV vaccine were found to work in South Africa, it could dramatically alter the course of the pandemic,” she said at a press conference in a clinic in Soshanguve township outside Pretoria, one of the research sites.
The study builds on the strongest vaccine candidate tested to date, the RV144 vaccine regimen tested in Thailand in 2009, which was 31% effective at preventing HIV infection over 3.5 years of follow-up.1 It contains two immune stimulating components, Sanofi Pasteur’s ALVAC-HIV, which uses viral vectors, and a protein vaccine supplied by GlaxoSmithKline. Both have been altered in hopes of strengthening response and to target the HIV strain most prevalent in southern Africa. ALVAC-HIV uses a canarypox vector, so the vaccine does not contain any killed or live HIV. The new regimen also involves an additional booster dose in hopes of prolonging protection.
“A safe and effective vaccine could be the final nail in the coffin for HIV,” said Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, another funder of the study. “Even a moderately effective vaccine would significantly decrease the burden of HIV disease over time in countries and populations with high rates of HIV infection, such as South Africa.”
Advances in treatment have slowed the AIDS death rate in South Africa—life expectancy in the country fell to 57.1 years in 2009 but had risen to 62.9 years by 2014. Prevention, however, has proved more difficult, and over 1000 South Africans are still infected every day.