The tortuous path of the AIDS vaccine – 08/31/2021 – Esper Kallás

Covid-19 vaccines have been a topic since the end of 2020, as they have had a great impact on preventing hospitalizations and deaths from the disease. Is this an indication that it is possible to solve the problems of all communicable diseases? Unfortunately, not quite.

An example of this difficulty is the tortuous path taken by vaccines to prevent HIV, the cause of the AIDS pandemic, which has plagued humanity for 40 years.

When it was discovered that AIDS was caused by a virus, many imagined that the disease could be easily prevented with the use of a vaccine. Time has proven otherwise.

HIV has genetic material about three times smaller than that of the new coronavirus. However, it changes too much, which makes the search for the vaccine much more complex. Its ability to mutate is so great that a single infected person, without treatment with the antiretroviral cocktail, may have more HIV variants than all the variants of the new coronavirus found around the world, which greatly hinders the discovery of an effective vaccine.

Proof of this was the disappointing news, published on Monday (30), of a large study that did not show success in another attempt. Held in Africa, Imbokodo assessed whether the combination of two HIV vaccines would be able to prevent infection in vulnerable women in a region hard hit by AIDS. After analyzing the data, in about 2,600 volunteers, it was verified that the protection did not reach the goal.

A curiosity is that one of the vaccines used was designed with the same platform used to create a product that proved to be highly effective in preventing Covid-19. A group from Harvard University, together with pharmaceutical company Johnson & Johnson, also used adenovirus 26 to produce a safe vaccine capable of teaching the defense system to fight the virus. What worked very well for the new coronavirus did not work for HIV.

Should we stop looking for a vaccine against HIV and AIDS? Evidently not.

The Mosaico study, which employs a similar combination of vaccines, is continuing its course to assess the protective capacity of those vulnerable to HIV infection in several countries, including Brazil.

For now, we know that further research is needed into possible alternatives to achieve an effective vaccine.

In the meantime, we need to invest in other measures that have already proven useful and effective in the fight against the AIDS pandemic: guaranteeing those living with HIV easy access to treatment, so that these people stop transmitting the virus sexually once they have the undetectable viral load; expand the application of strategies known as pre- and post-exposure prophylaxis (PrEP and PEP); diagnose and treat other sexually transmitted infections that can facilitate the sexual transmission of HIV; and, of course, to keep encouraging the use of condoms and the practice of safer sex.

Here is an important warning. Brazil, regarded as an example in the fight against HIV and AIDS, has seen a decrease in the discussion on this topic. The number of campaigns for prevention and treatment is scarce and the fight against prejudice against vulnerable people, or people living with the virus, is a debate that has lost space.

The Covid-19 pandemic has rekindled the debate for more investment in health science. We hope that it will also make evident the need to give due attention to other infectious diseases, whatever they may be.

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