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The main problem these variants pose for vaccines is that some mutations are in parts of the virus that the immune system tends to attack.
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Over the course of years, a single person can carry myriad variants in their body, though only a select few variants can be transmitted to others. Each of those new copies carries on average at least one unique mutation. That’s because the virus makes new copies of its genetic blueprint at a dizzyingly fast rate, generating tens of thousands of new copies every day in a single person, Rolland says. But “it’s a completely different world for HIV,” says Morgane Rolland, a virologist with the Military HIV Research Program at the Walter Reed Army Institute of Research in Silver Spring, Md. Much like the coronavirus, which has variants that are more transmissible or able to evade parts of the immune system ( SN: 1/27/21), HIV has variants too. One major challenge is the immense genetic diversity among HIV viruses infecting people around the world.
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Much of the difficulty in making a vaccine comes from the complex biology of the virus itself. “The work that’s gone into HIV vaccine development has been by far the most sophisticated and creative.” Complexities of HIV The absence of a good HIV vaccine is not for lack of trying, says Mark Feinberg, a viral immunologist who is president and CEO of the International AIDS Vaccine Initiative in New York City.
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The trial was halted in February 2020 after an interim analysis found that the vaccine was not effective at preventing HIV infection. A pharmacist brings shots for the first participants in an HIV vaccine clinical trial called HVTN702 in KwaZulu-Natal, South Africa, in November 2016. They speculated that those participants were more susceptible to HIV because they already had immunity to adenovirus 5 and that dampened HIV-protective responses from the vaccine. Unfortunately, a clinical trial to test the HIV vaccine showed that participants who had already been naturally infected with adenovirus 5 were more likely to become infected with HIV. Johnson & Johnson’s COVID-19 vaccine uses a virus called adenovirus 26 the first HIV vaccine candidates used adenovirus 5. That carrier delivers instructions to cells to make the viral proteins needed to train the immune system to recognize the invader. The shot uses a common cold virus that has been altered so that it no longer causes disease. The technology behind Johnson & Johnson’s COVID-19 jab, for instance, was first developed as a strategy to tackle HIV because it triggers a strong immune response ( SN: 2/27/21). Still, that funding stream has allowed for advances in HIV research, which partly enabled the rapid success of multiple COVID-19 vaccines. Funding for HIV vaccine research comes in five-year installments, making it difficult to allocate the money in an efficient way to get a vaccine off the ground. For COVID-19 vaccine development, “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. The lack of an effective HIV vaccine stands in stark contrast to COVID-19 vaccines that took less than a year to develop ( SN: 11/9/20). It’s also a tricky virus to pin down, with many variants and an uncanny ability to evade the immune system.Īnd money is an issue too.
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That long-lasting infection is just one reason why no vaccine against HIV exists yet. To date, only three people have beaten an HIV infection (SN: 8/26/20). That toll would undoubtedly be much higher if it weren’t for advances in antiviral treatments that can prevent infected people from dying from HIV and from transmitting the virus to others ( SN: 3/4/20 SN: 11/15/19). Approximately 32.7 million people have died. More than 75 million people have been infected around the world as of the end of 2019. Meanwhile, the HIV pandemic, which probably got its start in Congo in the 1920s, has led to devastating loss.