HIV drugs have vastly improved the quality of life for people living with HIV and AIDS, but they can't yet cure the infection. Someone at high risk for HIV can take a pill to help prevent an infection, but they'll have to take one every day. This method, called PrEP, isn't 100% effective.
That's why researchers are working hard to create an HIV vaccine.
A vaccine prevents or controls a specific infection by training the body's immune system to fight it. Over the years, scientists have made vaccines for diseases including typhoid, measles, polio, influenza, and smallpox. More money has been spent on finding an HIV vaccine than on any other vaccine in history.
Although it's been decades since the discovery of the virus, we still don't have a vaccine for it. Why? Developing one is almost always a long process. The polio virus was first identified in 1908 but it took until 1955 for the first vaccine to be approved!
An HIV vaccine is even more difficult because:
- Many types of HIV exist, and new types keep forming.
- HIV has clever ways of "outwitting" the immune system.
- Scientists still don’t completely understand what parts of the immune system work against HIV.
Despite the complex challenges, many researchers are hopeful about the prospects of an HIV vaccine.
Two Kinds of Vaccines
A preventive vaccine would train your immune system to "recognize" and fight off HIV before the virus causes infection and makes you sick. They would be for people who are HIV-negative. Someday, a vaccine may be able to prevent HIV infection in all, most, or some people.
Because they don't contain any live virus, a preventive vaccine could not give you HIV. But it might prompt your immune system to make antibodies that would show up on a blood test and give you a false positive result.
A therapeutic vaccine would help control infection and delay the progression of the disease. They work by ramping up your immune system to find and kill HIV-infected cells and by preventing or limiting HIV from making copies of itself. They're being tested in people who are already HIV-positive but who have healthy immune systems.
Vaccine Testing and Clinical Trials
First, HIV vaccines are tested in labs and animals. Then, a single HIV vaccine could take years of testing in humans before it would be OK for the public.
A vaccine to prevent HIV typically goes through three phases of clinical trials to test its safety and effectiveness. People in all three phases are supposed to keep practicing safe sex. They're not deliberately exposed to HIV after they've been vaccinated.
Each phase must go well in order to move on to the next one.
- Phase I lasts between 12 and 18 months. Small numbers of healthy, HIV-negative volunteers help researchers test the safety and figure out best doses.
- Phase II can last up to 2 years. Hundreds of healthy, HIV-negative volunteers help researchers to refine dosing and test how well the immune system responds.
- Phase III can last 3 to 4 years with thousands of healthy, HIV-negative volunteers.
mRNA Vaccine Trials for HIV
The International AIDS Vaccine Initiative (IAVI), a nonprofit group, and biotechnology company Moderna launched the phase I human clinical trial with an experimental HIV vaccine made using mRNA technology. It’s the same kind that’s used in COVID-19 vaccines.
People in the study at George Washington University School of Medicine and Health Sciences in Washington, DC, have received the first round of the experimental shots.
The clinical trial will test to see if the mRNA vaccine, when it delivers HIV antigens or proteins to your body, can stimulate your immune system to produce B cells, a type of white blood cell. The B cells are then expected to turn into broadly neutralizing antibodies (bnAbs) that knock out the human immunodeficiency virus (HIV).
The study includes 56 HIV-negative people ages 18 to 50. They were split into four groups and given one or two doses of the experimental vaccine. Some also received a booster.
Certain people don't get infected by HIV, even after they've been exposed to it more than once. Others who do get infected don't seem to be affected for a decade or longer. These examples suggest that some immune systems are able to fight HIV.
In test tube studies, rare antibodies do work against HIV.
Vaccines have successfully protected monkeys against a relative of HIV. Even when the vaccines haven't completely protected the monkeys, they allowed them to live much longer. There are more than 100 vaccines in the works and at least two are currently late stage, multinational vaccine cl9nical trials underway.
Finding out what's working in these cases could provide clues for the development of an HIV vaccine.
NAIAD: "HIV Vaccines Explained: Making HIV Vaccines a Reality," "Many Americans Think an AIDS Vaccine Already Exists," "Monkeys Vaccinated Against SIV Survive Longer After Infection."
AIDSInfo: "Preventive HIV Vaccines," "Therapeutic HIV Vaccines."
Cohen, J. Science, July 1, 2005.
Kahn, P. AIDS Vaccine Handbook: Global Perspectives, 2nd edition. May 2005.
Markel, H. NEJM, Aug. 25, 2005.
CDC: "Vaccine Development."
Iavi.org: “IAVI and Moderna launch trial of HIV vaccine antigens delivered through mRNA technology.”
ClinicalTrials.gov: “A Phase 1 Study to Evaluate the Safety and Immunogenicity of eOD-GT8 60mer mRNA Vaccine (mRNA-1644) and Core-g28v2 60mer mRNA Vaccine (mRNA-1644v2-Core).”