AEGiS-CATIE: HIV vaccines: science versus morality?

HIV vaccines: science versus morality?

TreatmentUpdate82 - Vol. 9, No. 8 - pp. 5; October 1997
Sean Hosein

In November of this year, IAPAC (International Association of Physicians in AIDS Care) will release details of its plan to test a live HIV vaccine in humans. The trial is expected to begin in the year 2000. Developed in the USA, the vaccine to be used is a form of HIV-1 that has been severely weakened by the removal of 5 pieces of genetic information. Researchers hope that this vaccine will stimulate protective immunity without causing AIDS.

IAPAC will first test the vaccine in 5 volunteers who "will be closely monitored for 6 months after vaccination." If all 5 remain well, the trial will gradually be expanded. A year later, IAPAC plans to conduct larger studies in developing countries and the USA.

Reaction from researchers

Many leading AIDS researchers praise the courage of the volunteers, but feel it is too dangerous to begin testing live HIV-1 vaccines in people. Experiments with weakened forms of SIV used to make a vaccine have found that some vaccinated monkeys eventually develop AIDS. According to Dr. Robert Gallo, Director of the Institute of Human Virology, "live low-replicating retroviruses almost always cause disease: that's been our experience in all animal systems." He adds, "If those vaccinated do not get disease in 3 years, it will not tell you what will happen in 10 years or 30 years."

Mark Grabowsky, a researcher at the National Institutes of Health, says that the understands what is driving the IAPAC doctors: they "see people die every day." But according to Grabowsky, "IAPAC doctors must take into account that they are creating a product which is going to be given to uninfected people, so safety is paramount....there is just not enough evidence that a live [but weakened] HIV-1 vaccine is safe or effective."

Meanwhile IAPAC stresses that there are now 8500 new cases of HIV every day worldwide. According to one spokesman, it is therefore "wrong to require a vaccine to meet US safety and efficacy standards. It is not a scientific question. It is a moral one."

REFERENCES:

1. McCarthy M. AIDS doctors push for live-vaccine trials. Lancet 11 October 1997.

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