Durable end to the HIV/AIDS pandemic likely will require an HIV vaccine
Durable end to the HIV AIDS pandemic likely will require an HIV vaccine WHAT Despite remarkable gains in the treatment and prevention of HIV infection, development of an effective HIV vaccine likely will be necessary to achieve a durable end
Durable end to the HIV/AIDS pandemic likely will require an HIV vaccine
WHAT
Despite remarkable gains in the treatment and prevention of
HIV infection, development of an effective HIV vaccine likely will be necessary
to achieve a durable end to the HIV/AIDS pandemic, according to a new
commentary from Anthony S. Fauci, MD, director of the National Institute of
Allergy and Infectious Diseases (NIAID), part of the National Institutes of
Health.
Theoretically, effective global implementation of existing
HIV treatment and prevention tools could end the HIV/AIDS pandemic.
Antiretroviral therapy that suppresses HIV both benefits the health of those
living with HIV and prevents viral transmission to their HIV-negative sexual
partners. Additionally, strategies such as pre-exposure prophylaxis (PrEP) can
effectively prevent HIV acquisition among people at high risk for infection.
However, from a practical standpoint, ending the HIV/AIDS
pandemic without a vaccine is unlikely. Despite extraordinary progress in
implementing HIV testing and treatment, substantial gaps remain. Globally, more
than 17 million people living with HIV are not receiving antiretroviral
therapy. This is compounded by the continuing high rate of new infections, an
estimated 1.8 million worldwide in 2016 alone. Modeling studies have suggested
that the wide geographic dispersion of people, especially in certain rural
areas, would make it extremely difficult to reach all those who need HIV
treatment and prevention services. In addition, the economic resources needed
to leverage HIV treatment and prevention across the globe continually increase
as people become newly infected.
Dr. Fauci writes that even a modestly effective HIV vaccine
could substantially slow the pandemic, if deployed alongside current treatment
and prevention efforts. Because the immune system mounts an inadequate
protective response against HIV, an HIV vaccine most likely will not be as
effective as proven vaccines used to control or end global outbreaks, such as
yellow fever and polio vaccines, which are nearly 100 percent effective. According
to modeling studies, if current HIV treatment and prevention efforts are
sustained and an HIV vaccine that is at least 50 percent effective is developed
and deployed, the pandemic could be curbed.
It is critical to continue and accelerate a robust research
effort to develop an HIV vaccine that is at least moderately effective, while
also aggressively scaling up the implementation of current treatment and
prevention tools, Dr. Fauci concludes.
ARTICLE
AS Fauci. An HIV vaccine is essential for ending the HIV/AIDS pandemic. Journal
of the American Medical Association DOI: 10.1001/jama.2017.13505 (2017)