Recent news stories reveal incredible promise on the groundbreaking of an HIV vaccine, so I sat down with Dr. Gerard Zurawski, researched and director of the Center for Biotechnology at the Baylor Institute for Immunology Research for a quick Q&A.
Q: Do you think it’s possible that an HIV vaccine (preventive or therapeutic) could be developed soon? And if yes, when?
Yes, it is now very clear that a small subset of HIV-infected individuals can control their HIV infection without medication or vaccination and that the mechanism is based on their own immune response.
The current best preventative vaccine, studied in a 2009 Thai trial, showed for the first time that vaccines can help prevent infection – however, with only a vaccine efficacy of 25 percent.
Improved vaccines are being tested, and there is good reason for hope of success in both preventative and therapeutic vaccines, but this is likely five to 10 years out.
Q: What do you think is the most promising HIV vaccine research that you’ve seen in recent years?
Some new cytomegalovirus (CMV) viral vector-based vaccines have demonstrated remarkable efficacy in monkey models; however, these vaccines have potential safety issues in humans.
Q: As an immunologist, can you compare your first years to today’s times? What has changed on the HIV front?
What has changes is the fundamental understanding of the way the human immune system functions, along with increasing sophistication in the speed and resolution in measuring immune responses. On the HIV front there is the spectacular success of multiple-drug therapy (highly active antiretroviral therapy, or HAART) in controlling HIV infection.
Q: What do you think has been the biggest breakthrough in HIV prevention, treatment and research?
Clearly, the development of multiple-drug therapy (HAART) for controlling HIV infection is the biggest breakthrough.
Q: What do you see happening or what do you look forward to in the future of HIV treatment?
Multiple-drug therapy (HAART), while very effective at controlling HIV infection and prolonging life expectancy of infected individuals, is not the complete answer for treatment. There is increasing evidence that these drugs, which control HIV very well, do not full restore immune function, and therefore patients on long-term therapy are more likely than uninfected people to develop autoimmune diseases as well as cancers.
Q: What do you think is the single most important thing people should know about this disease?
Do not assume that the new HIV drug therapies are the complete answer. Full eradication of HIV infection and full restoration of immune function are not yet attainable.
Q: In your opinion, is there an area of HIV treatment, prevention or research that is overlooked, but has huge potential?
HIV is so important that it is difficult to imagine that anything is overlooked. However, it is clear that new vaccine approaches, including Baylor’s own DC-targeting vaccines, have a huge potential for both prevention and therapy of this disease.