US Leads Effort to Build on Success in HIV Vaccine Science

Nelson L. MichaelWhen the HIV epidemic first emerged in the 1980s, the U.S. government immediately recognized the threat the disease could pose to U.S. and Allied Service Members. In this age of global deployments, HIV not only continues to pose a threat to Service Members, but it can also compromise the stability of a nation where the disease is prevalent and endanger worldwide security.

Early in the epidemic, the U.S. military emerged as a leader in the field of HIV research when its researchers developed the first HIV disease staging system, published evidence of the then-controversial notion that HIV could be transmitted heterosexually, described over half of the circulating variants of HIV, and developed the criteria for Western blot positivity—the first supplemental confirmatory test for HIV.

Fast-forward to 2009; the U.S. Army announced the results of RV144, the first HIV vaccine regimen to show some ability to protect people against this devastating disease. This landmark study showed a vaccine efficacy of 31.2% at the end of the study at 42 months, but interestingly there was a higher early protective effect of 60% 12 months into the study.

For the last two years, the U.S. Military HIV Research Program at the Walter Reed Army Institute of Research (WRAIR) has been part of a public private partnership called the P5, which is building on this success to advance and ultimately license similar vaccine candidates that have the potential to achieve a broad public health impact. The collaborators are planning future efficacy studies using an improved vaccine regimen with an extra vaccine boost at 12 months to improve and prolong the level of protection seen in the RV144 study.

This progress in vaccine science was enabled by strong collaborative leadership from the WRAIR and the U.S. National Institutes of Allergy and Infectious Diseases (NIAID), along with partners from the Thai and U.S. governments, private companies, non-profit organizations and more than 16,000 volunteers. By leveraging resources and capabilities, we have been able to achieve together what no one organization or country could do alone.

As we approach the AIDS 2012Exit Disclaimer conference, HIV scientists and global leaders are talking about the end of AIDS. Recently, great advances have been made in preventing HIV through the use of new strategies such as adult male circumcision in Africa and AIDS therapeutics as prophylaxis. However, these new prevention strategies have their limitations, and it will take a combination of prevention methods, including a vaccine, to truly end the pandemic. The U.S. military—working with U.S. and international collaborators—vigorously pursues this goal to protect U.S. troops and the global community so that we may one day achieve an AIDS-free generation.

Editor's Note: For information on the US Government's activities at the conference, please visit USG@AIDS2012.