AIDS Vaccine Presentation Overview

1. AIDS Vaccines: the basicsCindraFeuerAVAC: Global Advocacy for HIV Prevention20 April 2010The HIV Research Catalyst ForumBaltimore, Maryland www.avac.org/presentations

2. AIDS Vaccine Presentation Overview • What is a vaccine? • How would an AIDS vaccine work? • Where are we in the search? • How to get involved? www.avac.org/presentations

3. What is a vaccine? • A substance that teaches the immune system how to protect itself against a virus or bacteria • No effective AIDS vaccine available today • AIDS vaccines cannot cause HIV • No vaccine is 100% effective. Most vaccines licensed in the US 70%-95% effective. www.avac.org/presentations

4. Why the interest in an AIDS vaccine? • Need for a range of HIV prevention methods (There’s no silver bullet) • Proven prevention options have slowedHIV’s spread but thousands of people continue to get infected daily • Vaccines are one of the world’s most effective public health tools • Cost-effective (administered once) www.avac.org/presentations

5. Types of AIDS vaccines • Preventive Vaccines: • Designed for people who are not infected with HIV • Reduces risk of infection or viral load set point after infection • Therapeutic Vaccines: • Designed for people who are living with HIV • Uses the body’s immune system to control HIV in the body www.avac.org/presentations

6. How does a vaccine work? • By teaching the body to recognize and fight invaders • Subunit—small amount of virus or copy of virus in the form of vaccine • Body reacts by creating antibodies or killer cells • Upon viral infection, antibodies and killer cells are there waiting to attack www.avac.org/presentations

7. How a preventive AIDS vaccine would work • Humoral • Antibodies • Y-shaped proteins that look for HIV to stop it from infecting cells • Adaptive immune system www.avac.org/presentations

8. How preventive vaccines would work (con’t) • Cellular immunity • White blood cells or CTL • White blood cells that look for HIV-infected cells and kill them www.avac.org/presentations

9. PREVENT ESTABLISHED INFECTION? ***** C A HAART B Vaccine Administered A. Lower Initial Peak of Viremia B. Lower Set Point C.Delay Progression How an HIV vaccine might work HIV www.avac.org/presentations

10. How are most vaccines made? • Live attenuated vaccines(examples: measles, mumps, and rubella) • Whole killed virus vaccines (example: influenza and rabies) www.avac.org/presentations

11. How are AIDS vaccines made? • Recombinant vaccines • Do not contain HIV • DNA vaccines • Vector vaccines www.avac.org/presentations

12. Developing an AIDS vaccine is difficult • Numerous modes of transmission • HIV kills the very immune cells uses in defending the body against HIV • HIV makes many copies of itself and mutates, making itself unrecognizable to the immune system • Mutation leads to different subtypes of the virus throughout the world www.avac.org/presentations

13. Vaccine research in perspective Duration between discovery of microbiologic cause of selected infectious diseases and development of a vaccine www.avac.org/presentations Source: AIDS Vaccine Handbook, AVAC, 2005

14. Timeline of results from AIDS vaccine efficacy trials www.avac.org/presentations

15. Thai prime-boost AIDS vaccine trial www.avac.org/presentations

16. The Thai trial: RV144 • First glimpse of evidence a vaccine has a protective effect • 31.2 % (modest effect) • Not for licensure • Research ongoing www.avac.org/presentations

17. Ongoing vaccine trials • About two dozen safety and immunogenicity studies • HIV Vaccine Trials Network (HVTN 505) www.avac.org/presentations

18. HVTN 505 • Phase II, uses a DNA prime/rAd5 boost (T cell-based) • Currently recruiting circumcised MSM at sites across the US • Parts of this vaccine regimen are similar to the vaccine used in Step and Phambili • Reduce viral load in individuals who receive the vaccine and go on to become infected with HIV www.avac.org/presentations

19. HVTN 505 continued • Not expected to prevent HIV infection • Not on the path to licensure • Better understand and develop T cell-based vaccines   • Like in all prevention research studies, all participants will receive the best available prevention services • Results expected 2013 More information about HVTN 505: www.hopetakeaction.org Get involved: www.bethegeneration.org; www.hvtn.org/about/sites/html; www.vaccineforall.org www.avac.org/presentations

20. What is needed now? • Vaccination to protect against infection, mitigate infection and prevent transmission to others • Focus investigation to better understand the Thai trial result • Ensure diversity of approaches beyond the Thai trial, exploring novel directions for vaccine design • More community involvement www.avac.org/presentations

21. What can you do? • Join a Community Advisory Board • Ask your local AIDS organizations if they are aware of or involved in vaccine research • Support trial volunteers and recognize their contribution to the fight against HIV/AIDS • Volunteer to be in a clinical trial www.avac.org/presentations

22. Stay informed • Join the Advocates Network • AVAC publications: Px Wire, Anticipating and Understanding Results series, AVAC Report • Attend events (AVAC calendar) AVAC: Global Advocacy for HIV Prevention www.avac.org International AIDS Vaccine Initiative www.iavi.org HIV Vaccine Trials Network www.hvtn.org Global HIV Vaccine Enterprise www.hivvaccineenterprise.org www.avac.org/presentations

23. The search must go on “... they are ill discoverers that think there is no land when they can see nothing but sea.” — Francis Bacon (1561-1626) www.avac.org/presentations