HIV vaccine: the prognosis is disappointing

The rake- stepping relay
Boris Zhukov, "Russian Reporter" No. 14-2009

The global cost of creating an HIV vaccine is estimated in the hundreds of billions of dollars. Leading countries periodically report: "We seem to have succeeded ..." Recently, Chinese doctors have begun to search for volunteers to conduct the second stage of clinical trials of the vaccine they developed. 49 people took part in the first stage of the research. The people who received the drug had no undesirable consequences, and the results of the tests were positive – their immune system "remembers" the vaccine administered. Does this mean that a cure for HIV has finally been found?

Reports about the creation of another "AIDS vaccination" sometimes seem like an obsessive nightmare. Years go by, countries and names of development organizations change, but the scheme is still the same: a vaccine against AIDS (more precisely, from its causative agent - HIV, human immunodeficiency virus) has been created, the drug has successfully passed preclinical studies (on cell culture) and the first stage of clinical trials (safety assessment on a limited number of healthy volunteers), the developers solemnly announce the beginning of the second phase of testing – checking the actual protective effect of the vaccine…

Usually nothing is reported about its further fate – as it was with the vaccine developed by the Indian National Institute for AIDS Research, the Russian drug Vichrepol and many other means of preventing the "plague of the twentieth century". The most conscientious developers, such as the American companies VaxGen and Megsk & Co, honestly publish the results of clinical trials, from which it follows that a promising vaccine either does not affect the risk of HIV infection at all, or even slightly increases it. The world community sighs in disappointment – so that in a few months it will hopefully receive a message about a new miracle drug created by another institute or company in another country.

This simple plot has been repeated so many times that even the most gullible and forgetful reader inevitably has a question: what is going on? Why is a frail, low-contagious and extremely unstable to an unfavorable environment monkey virus turned out to be a stumbling block for all immunologists and pharmacists in the world?

Usually, as an answer to it, one has to read that it is, they say, in the extraordinary variability of HIV. In fact, the scope and pace of this variability is quite common for RNA viruses: the virus of ordinary influenza, for example, changes much faster and stronger. However, vaccines against it have been created for a long time. Of course, they do not provide one hundred percent protection, but there has never been such a thing that vaccination does not affect the probability of infection at all. Not to mention that it increases this probability.

In fact, everything is much simpler and more hopeless. The result of any vaccination is an immune response, which is provided by both antibody proteins floating in the blood and directly by cells of the immune system. It is the latter (or rather, some of them, primarily the so-called T-helpers) that are the target of HIV. At the moment when they lock onto it, a tricky molecular mechanism is triggered and the contents of the viral capsule end up inside the cell. A pre-formed immune response only makes the task easier for the virus.

All this is not news for specialists. Nobel Prize winner David Baltimore said last year that an effective vaccine against HIV infection may never be created. To defeat this disease, new, non–standard ideas are needed - as deep as the ideas of Pasteur and Koch, Mechnikov and Ehrlich were in their time.

But government agencies and private foundations – not to mention commercial companies – are ready to allocate funds not for the development of fundamental ideas, but for the creation of specific drugs in a financially plausible timeframe. And while this is the case, we are doomed to receive an endless series of "encouraging interim results." The essence of their "intermediateness" is clearly stated in an old joke about the technology of obtaining butter from shit: "The product still smells, but it's already smeared."

Portal "Eternal youth" www.vechnayamolodost.ru20.04.2009