Vaccine Needed to End the HIV / AIDS Pandemic?

HIV pandemic can be ended with or without a vaccine

Successfully implementing today’s treatments and prevention tools could end the HIV/AIDS pandemic, reported Anthony S. Fauci, MD, National Institute of Allergy and Infectious Diseases.

Yet, the pandemic continues.

Although an estimated 19.5 million of the estimated 36.7 million HIV-infected people globally are receiving anti-HIV therapy, more than 17 million people are not receiving therapy.

Most of the major infectious diseases such as smallpox, polio, and yellow fever, have effective vaccines for their control and in some cases, elimination.

So the question arises... ‘when will an HIV vaccine become available?’.

The answer to that question needs to be addressed from both a theoretical and a practical standpoint.

Theoretically, the HIV pandemic can be ended without an HIV vaccine.

Treatment with HIV medicines is called antiretroviral therapy (ART). A person's initial HIV regimen generally includes three HIV medicines from at least two different drug classes.

But, ART doesn't cure HIV.

There are over 30 highly effective anti-HIV drugs are currently available. These medications can suppress the virus such that patients who are treated soon after infection and continue therapy throughout their lifetime can expect to have an almost-normal life expectancy.

Therefore, theoretically, if all of the people living with HIV could be treated, it would be possible to stop HIV the epidemic.

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People who are currently uninfected by HIV, but whose life situation puts them at high risk of HIV infection, can take a single pill containing 2 anti-HIV drugs and decrease the likelihood of acquiring HIV infection.

This Preexposure Prophylaxis (PrEP) can lower the risk of acquiring HIV through sexual activity by more than 90%.

In the USA, it is estimated that approximately 10% of people who could benefit from PrEP are actually receiving it.

From a practical standpoint, ending the HIV/AIDS pandemic without a vaccine is unlikely.

An important question is… ‘how effective the vaccine must be?’

One vaccine tested in a large vaccine trial in Thailand reduced the risk of infection by 31%, a figure inadequate to justify licensure of the vaccine.

Recent advances in HIV vaccine research provide hope that at least a moderately-effective vaccine can be developed.

It is critical to continue accelerating a robust research effort in that direction while aggressively scaling up the implementation of current treatment and prevention tools.

To do anything less would lead to failure, which for HIV is not an option.

Corresponding Author: Anthony S. Fauci, MD, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases.

No conflicts of interest were reported.