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Why don’t we have a Vaccine for HIV-AIDS Yet ?

by Nabjot Kaur

Why don’t we have a Vaccine for HIV-AIDS Yet ?

June 10, 2021

Exactly 40 years ago, a mysterious illness appeared out of nowhere. DR. Michael Gottlieb was vainly trying to treat a man with a persistent fever. The man was suffering from pneumonia, and his mouth was covered with a fungus that made it difficult for him to swallow or eat, followed by another man with similar symptoms. Three more previously healthy young men from Los Angeles soon turned up with a matching set of symptoms. Two out of these five gay men ended up dying as their immune system stopped protecting them, which made Gottlieb concerned. Soon, after that Gottlieb and his colleagues contacted the Centre for Disease Control, who asked them to prepare a report on their findings. On 5 June 1981, their information got published.

The condition today is known as HIV AIDS ( acquired immunodeficiency syndrome ). The report written by Gottlieb and his colleagues became the first official record of HIV AIDS. This disease has killed 33 million people around the world since then.

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years of HIV AIDS

What is HIV, and How Does it Affect Humans?

Not to be confused with these two terms, HIV is the virus, and AIDS is the term used only when the virus severely damages the immune system. HIV AIDS attacks specific cells in the immune system, which are known as T cells or CD4 helper cells. HIV kills these particular cells and makes it harder for the body to fight other illnesses or infections. HIV not just destroys these cells but also uses them to make more copies of the virus using replication machinery. Ignoring HIV can make the smallest of the infections like – fever and cold much more severe.

When a certain amount of CD4 cells are destroyed by this virus and CD4 drops below 200, it states that the person has progressed to full-blown AIDS. 

History of HIV

In 1999 researchers found that HIV is closely related to SIV ( Simian Immunodeficiency Virus ). HIV-1 is very similar to a strain of SIV found in chimpanzees, while HIV-2 is identical to a strain of SIV found in Sooty Mangabeys. The same researchers then conducted another research to find out how SIV could have infected the Chimps. They discovered that chimpanzees had hunted and eaten smaller monkeys (greater spot-nosed monkeys and red-capped Mangabeys), which infected them with SIV.

There’s a “Hunter” theory which is the most commonly accepted theory relating to the spread of HIV from Chimps to Humans. This theory states that SIV got transferred to humans as a result of chimps being eaten and killed. Also, there’s a possibility of chimps’ blood getting into the cuts and wounds of the hunters while hunting them. Researchers proposed that both HIV 1 and HIV 2 got transferred to humans in a similar manner. HIV 2 causes fewer infections and is far rarer than HIV 1. HIV 2 is mainly found in West African countries like Mali, Nigeria and Mauritania.

Gideon-Mendel-on-aids-and-hiv-scoolbuzz
In The Ward, Gideon Mendel started his career-spanning battle against the stigma of HIV/AIDS

Is There Any Cure for HIV AIDS?

Unfortunately, there’s no cure for this virus yet. However, there’s a treatment called ART, aka Antiretroviral Treatment. ART is very effective in controlling HIV, further enhancing the quality of life.

To date, only three people have beaten HIV, while others have to live with it for the rest of their life, until, of course, we could develop a cure.

Like COVID, 19 people were unknowingly infecting their friends, loved ones, and strangers, but COVID 19 has killed more people in less than 18 months compared to HIV. The same doctors who treated HIV at the beginning of their careers are now treating COVID 19.

“You start from ground zero, and then you build the plane as you’re flying it,” Gottlieb said on treating both these diseases in the early days. He also noted that “There was this sense of helplessness, of winging it, of doing the best you can with less than adequate tools and learning as you went.”

Covid-19 got all the attention that a virus and a medical emergency should get, HIV diagnoses took at least five years to develop. HIV AIDS wasn’t even Identified until 1983. HIV still couldn’t get the kind of global attention that COVID 19 gained within a few months, even though it’s as fatal as the new Coronavirus. It’s recorded that at the end of 2018, 37.9 million people were living with HIV worldwide, and in 2018 itself, around 770,000 lost their lives to HIV AIDS. “HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives,” stated an organization.

hiv-blood-tests-many-mutations-scoolbuzz
HIV has evolved an ability to generate and tolerate many mutations in its genetic information.

Why Is There No Cure for HIV Yet?

HIV is a long-lasting infection which is one of the major obstacles in developing a vaccine for HIV AIDS. Also, it completely wears out the immune system, and on top of that, there are numerous deadly variants of HIV. Looking at it from an economic approach, many people can’t even afford the treatment, which becomes a more significant part of the problem.

“For COVID 19 vaccine, the money poured in, which was the right thing to do,” says Susan Zolla-Pazner, an immunologist at the Icahn School of Medicine at Mount Sinai in New York City. That’s not the case for HIV Vaccine research; the funding for HIV comes in 5-year instalments, making it challenging to assign financing effectively.

The speed of HIV at making new copies of itself is unmatchable. It can generate around 10,000 copies in a single day, with each copy carrying at least one unique mutation. To calculate, one person carries countless mutations of HIV, making it much more deadly than other viruses. HIV has inserted its genetic blueprint into the host DNA, creating a hidden reservoir in the T cells. The reservoir makes HIV invisible to the immune system. Once HIV successfully inhibits its new hideout, the immune system and the treatments can’t get the host rid of it.

HIV-AIDS-vaccine-Why-don’t-we-have-one-after-37-years-scoolbuzz
Extracts DNA from samples for further tests at the AIDS Vaccine Design and Development Laboratory

Testing and Vaccination Development

To date on six clinical trials of the potential vaccine have been conducted on people. Out of these, only one vaccine known as RV144 was proved successful at preventing HIV infection. Under this, participants were given six shots in total. Out of these six shots, four shots contained a canarypox virus that carries the genetic instructions for select HIV proteins and can’t replicate in cells. This makes the cells develop viral proteins and create an immune response against them. The remaining two shots contained HIV protein fragments which are vital for the virus to enter the cells. The trial option aims to make the participants develop a robust immune response and protect them against subtypes of HIV. This vaccine strategy successfully lowered the risk of HIV Infection by 31.2 %.

In a December 2019 Science study, Saunders, Haynes and their colleagues showed that in vaccinated rhesus macaques and mice, they could spur first steps towards HIV antibodies that may soon become broadly neutralizing. Researchers are planning to move this vaccine to humans soon. “Whatever we see in the clinical trial, it’s breaking new ground,” says Früh, a viral immunologist at Oregon Health & Science University.

 

There’s a lot of research, time and money that went into HIV vaccine research, and the efforts will only get better with time. Even though the clinical trials showed promising results, we are still a long way from developing an effective vaccine for HIV AIDS. HIV doesn’t spread with kissing, sharing cutlery, touch, mosquito bites or coughing. There shouldn’t be any stigma carried by anyone against people who are suffering from HIV AIDS. A little kindness goes a long way, so be kind to everyone around you.

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