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COVID vaccine developments boost UAB scientists' search for elusive HIV vaccine

A nurse prepares to administer a COVID-19 vaccine. mRNA technology in the vaccines as helped move along trial for a similar HIV vaccine. (Stephen Quinn |
A nurse prepares to administer a COVID-19 vaccine. mRNA technology in the vaccines as helped move along trial for a similar HIV vaccine. (Stephen Quinn |
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Kendall Lawson and his colleagues at AIDS Alabama can't help but imagine what their job might be like if HIV was an illness which could simply be vaccinated against.

"There's probably not a day that goes by that we don't have some type of discussion about that."

Advancements in testing and treatment mean the virus which launched a global epidemic more than 40 years ago is not the death sentence it was once feared to be, particularly in developed nations.

"The surgeon general at the time optimistically said we'd develop a vaccine in two years," recalled UAB Dr. Paul Goepfert, director for the Alabama Vaccine Research Clinic. "The thing is we didn't know what we know now about HIV and what a difficult target it is."

The medical world spent the last three years working to learn as much as possible about a different albeit deadly opponent, COVID-19. One bright spot among scientists during the pandemic has been the emergence of mRNA vaccines, which can be developed more effectively. The hope is these new advancements can help them find the target which has eluded scientists studying HIV for more than four decades.

The primary hypothesis of the study, HVTN 302 is that mRNA vaccines will be safe and well-tolerated among HIV-negative people and will elicit neutralizing antibodies.

Goepfert explained the process in a release published by UAB when the study was first announced: "The experimental vaccines carry mRNA, a piece of genetic code, delivered with instructions for making proteins in the same way that the mRNA vaccines against COVID-19 instruct the body’s cells to make the SARS-CoV-2 spike protein. These instructions show human muscle cells how to make small portions of proteins that resemble parts of HIV but are not the actual virus. People cannot contract HIV from the vaccines. Once immune cells have used the instructions, the mRNA is quickly broken down, and does not stay in the body.

The investigational vaccines are not expected to provide protection from HIV infection, yet the knowledge gained from this study will aid in the future development of an HIV vaccine regimen. Researchers hope to learn whether the immune system will respond to the experimental vaccines by making antibodies and T cells that could fight HIV if a person is ever exposed to the virus in the future. The trial will also clarify whether the immune response to an mRNA vaccine is equal to or better than the response to a protein-based vaccine, while helping define the potentials of using mRNA to increase the pace of developing an HIV vaccine."

READ: Moderna to make mRNA HIV vaccine in partnership with AIDS initiative

50 people will take part in the nationwide study. Goepfert estimates it would be five years at best before a vaccine could be even possible, if the study reveals the findings as hoped for. History shows the odds will be against them. Eight potential vaccines reached efficacy trial stage since the AIDS epidemic began, only one showed marginal effectiveness. Just last month, Janssen Pharmaceuticals announced the only vaccine in advanced global trials had failed.

Lawson, who serves as clinic coordinator, knows the impact of HIV and preventing AIDS is significant on Alabamians as they manage their treatment.

"Cost is a big deal. It is very expensive. If you were paying out of pocket for the medication, you're looking at starting out approximately at about $4,000 a month just for that prescription."

AIDS Alabama uses grants, state funding and insurance where it's available to ensure nobody pays out of pocket for treatment.

READ: Study identifies virulent HIV variant unrecognized for years

Approximately 1.2 million people in the U.S. have been infected with HIV. 13% of them don't even know they're infected. The highest rate of new diagnoses are in the South where Lawson said the virus carries a stigma and many misconceptions.

"Each positive diagnosis that I've given has been to heterosexual people. I've yet to have to deliver the news to someone is gay," said Lawson, "It surprised me honestly."

The work is made even more significant when one considers how far the world has come. An estimated 80 million people have died since HIV was first declared an epidemic in 1981.

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"I always joke which is going to come first if any: Are we going to cure HIV or are we going to develop a vaccine? Because they're both very high bars but that doesn't mean we should not as a culture, as a society we should not shy away from hard things to do."

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