Why HIV vaccine still evades us 40 years on, according to resident GP Dr Zak

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Why does an HIV vaccine still evade us 40 years on, asks Dr Zak
Why does an HIV vaccine still evade us 40 years on, asks Dr Zak

THE Human Immunodeficiency Virus (HIV) was first identified in 1983, with the connection between it and the development of Acquired Immunodeficiency Syndrome (AIDS) established in 1984.

Despite the promise at the time of a vaccine within two to three years, almost four decades later that goal has not yet been reached.

In this time there have been almost 80 million cases of AIDS identified worldwide, with almost 40 million deaths.

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It remains a disease that strikes fear into the hearts of most, and if not identified or treated, remains a death sentence.

In the intervening years, massive strides have been made in treatment. Highly active antiretroviral therapy (HAART) was introduced in 1996. At the time, the life expectancy of a 20-year-old with HIV was ten years. Today, if medicines are commenced early enough, that 20-year-old can hope to reach 70 and are more likely to die from a non-HIV illness.

Despite this success, a vaccine still remains the holy grail. HAART and its subsequent incarnations remain a vastly expensive medication. A good outcome relies on getting tested early enough and adhering to a lifelong treatment regime.

You may wonder why the development of an HIV vaccine has taken so long given the success of the COVID immunisations, which were rolled out in record-breaking time. This is the exception to the rule. Most vaccines are in development for at least five to ten years.

Daily Echo:
Daily Echo:

Several aspects have made vaccine development difficult. Firstly, there is no state of natural immunity after HIV. The only people to have been cured of HIV received stem cell transplants.

Unlike other viruses that may be shed after a matter of weeks, HIV remains in the body lifelong.

Every time HIV replicates it changes itself slightly. In an untreated individual, there may be thousands of different variants of HIV, and worldwide hundreds of thousands of different subtypes of HIV.

Daily Echo:
Daily Echo:

Researchers have never given up despite these hurdles. Since 1984 there have been over 250 trials, with more than 20 ongoing.

The largest trial, conducted in Thailand, with 16,000 study participants, developed a vaccine with around 30% success rate, too low to be acceptable.

Most experts in the field agree that a working vaccine that can be rolled out to all remains at least five or ten years away.

Perhaps the biggest challenge to HIV remains the stigma attached to the condition.

The best way of preventing any sexually transmitted disease is to practice safe sex. If you are worried that you may be at risk of HIV, early testing is vital. If treatment is started soon after a positive result, the picture is far brighter. There are many support groups available.

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