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(MENAFN – The Conversation) There are an estimated 5,000 new cases of HIV transmission each day. About 70% of the 37 million people living with HIV in the world are in sub-Saharan Africa. Of the 1.8 million new HIV transmissions worldwide in 2017, 800 million occurred in eastern and southern Africa. New and effective prevention strategies are essential to reduce HIV transmission.
So what will it take to reduce HIV transmission? Prevention.
That's why researchers around the world are working hard to find a safe and effective vaccine. This requires extensive testing, starting with the labs and then the animal testing. Then come the crucial human clinical trials. A number of them are running on different sites in 12 countries on four continents.
These trials are being conducted under the auspices of the HIV vaccine trial network. The network currently manages 49 clinical trial sites in nine countries and 18 ongoing trials, four of which are efficacy trials. Three trials are of particular interest as they are already in progress since 2016 and are expected to be completed by the end of 2021.
The first is known as anti-antibody mediated prevention studies. It is a matter of checking whether a largely neutralizing antibody can prevent the acquisition of HIV in humans. The second, called Uhambo, is testing an experimental HIV vaccine regimen. And the third, Imbokodo, is testing an experimental regimen designed to provide protection against various strains of HIV worldwide.
These studies involve thousands of people around the world, including those most affected by HIV. If any of them succeeds, that is to say if the tested drugs prove to be safe and effective for human use, the fight that will last for 30 years to put an end to the HIV / AIDS epidemic will be a huge step forward.
It has been incredibly difficult to make an HIV vaccine. Among the obstacles to overcome are the genetic diversity of HIV, which is superior to any other pathogen, the absence of good animal model, the absence of natural cure for man and the complexity of the structure or envelope of the virus.
The search for antibodies
Antibody-based prevention studies enrolled 4,625 participants from the United States, Brazil, Peru, Switzerland, Tanzania, Zimbabwe, Botswana, South Africa, Kenya, Malawi. and Mozambique.
These trials began in May 2016 and should be completed by the end of 2021. The clinical trials are designed to test whether a large-scale neutralizing antibody (VRC01) administered intravenously can prevent the acquisition of HIV.
A largely neutralizing antibody is an antibody that has been shown to neutralize or inactivate HIV in nonclinical experiments. Study participants receive intravenous infusions of high-speed neutralizing antibody VRC01 every eight weeks.
This is the most advanced clinical trial on the effectiveness of a largely neutralizing antibody in preventing HIV infection in humans. These studies can potentially clarify the level of neutralization that a means of HIV prevention or an HIV-based HIV prevention method must achieve and maintain to provide lasting protection.
Vaccine
The Uhambo trial is currently underway in South Africa and aims to recruit 5,400 seronegative and HIV-positive men and women aged 18 to 35 years. This clinical trial involves a new version of the only HIV vaccine candidate ever shown to provide some protection against the virus. This vaccine candidate was investigated in the 2003 to 2006 clinical trial RV144 in Thailand, conducted by the US Military HIV Research Program and the Ministry of Health of the United States. Thailand.
The Thai trial yielded significant results in 2009, when it was found for the first time that a vaccine could confer – albeit modest – protection against HIV.
The Uhambo treatment regimen aims to provide greater and longer-lasting protection than the RV144 regimen and has been adapted to the predominant HIV subtype in southern Africa.
Immune responses
Imbokodostudy (Imbokodo means "rock" in isiZulu) is officially known as HVTN 705 / HPX2008. It is conducted in over 2600 HIV-positive and HIV-negative women in South Africa, Malawi, Mozambique, Zambia and Zimbabwe aged 18 to 35 years.
The vaccine regimen tested in this trial is based on "mosaic" immunogens. These are components of vaccines derived from HIV strains from different parts of the world. This approach has been designed to induce immune responses against a wide variety of HIV strains around the world.
Way forward
Our scientific background is remarkable.
But there is still some way to go before knowing the impact of these tests. The three essays support major advances over the last two decades. We hope that from these three areas of exploration will emerge a clarity that will bring the world closer to solving what is needed to protect against HIV.
If one of the vaccines or antibodies is effective, a huge explosion of scientific research will then be triggered to improve, adapt and, more importantly, bring a new form of HIV prevention to the population.
- Public health
HIV
Kenya
South Africa
Zimbabwe
Malawi
botswana
HIV vaccine
HIV / AIDS
Tanzania
mozambique
Global Perspectives
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