Optimism at AIDS Vaccine Meeting
April 22, 2002 -- Making an AIDS vaccine is the medical equivalent of putting a man on the moon. Now, a rare behind-the-scenes look shows that science is about to make one giant leap for mankind.
The peek into the future comes from a meeting of AIDS vaccine superstars held at Atlanta's Emory University. Reports made at the meeting show that there have been huge leaps forward.
"We do have more reason for optimism than we have had in a long time," says Mark Feinberg, MD, PhD, medical director of the newly opened Hope Clinic at the Emory Vaccine Research Center.
Why is it taking so long? Unlike every other disease for which there is a vaccine, HIV infection is chronic. It doesn't just hide quietly like the chickenpox virus. Instead, it keeps making new virus -- and killing immune-system cells -- at a frantic pace.
This means that most of what works with other vaccines doesn't work for HIV. What's needed is nothing less than a leap into the future.
"An AIDS vaccine has been one of the most difficult challenges ever for science and medicine," Feinberg says. "To create an HIV vaccine, we will create a new paradigm for vaccine development. Just as AIDS drug research changed the face of development of new drugs, so will an AIDS vaccine change the face of future vaccines."
This isn't the first time medicine has faced this kind of challenge. In the first half of the 20th century, polio ran roughshod around the globe. Efforts to create a vaccine seemed hopeless.
One of those involved in the struggle to develop a polio vaccine was Neal Nathanson, MD. Nathanson, former director of the Office of AIDS Research at the National Institutes of Health, is vice provost for research at the University of Pennsylvania. He recalls that it was behind-the-scenes work that found there were three types of poliovirus -- the key finding behind the eventual success of the Salk vaccine.
"Now maybe in HIV we have turned the corner and can see a road ahead that is most promising," Nathanson says.
Why are researchers so excited? The answer is that a quiet revolution occurred with the discovery of a way to look at immune cells and tell which part of a virus turns them on. Using this new tool -- developed by John Altman, PhD -- has sped development of a new kind of vaccine.
In the past, most vaccines simply raised antibodies that blocked infection or killed germs. HIV has sophisticated defenses that let it evade normal antibodies. The rare people who never get sick despite longstanding HIV infection tend to have infection-fighting cells in their blood that attack HIV. No one's ever designed a vaccine that helps people make this kind of immune response -- but that's changing.