Over the years, research to find a cure for the human immunodeficiency virus (HIV) has advanced by leaps and bounds in the areas of medication and prevention. However, efforts to eradicate the infection globally continue to look to a vaccine, which is believed to be getting closer.
“We currently have more advanced vaccines that are in the third phase of research and studies to test whether they can actually prevent HIV,” said researcher Dr. Irma Febo.
These are Ad26 and gp140, designed to signal the body to make proteins similar to those found on the surface of HIV to develop antibodies. They are not made from live HIV, dead HIV, or human cells infected with the virus, so they cannot cause HIV infection or Acquired Immune Deficiency Syndrome (AIDS).
“The clade C protein gp140 is made in such a way that it resembles an HIV protein that is most commonly found in southern Africa. The mosaic gp140 vaccine is made in such a way that it resembles a combination of several different HIV proteins found throughout the world. The body’s immune system can respond to these proteins, recognize the same proteins in HIV and fight the virus if a person is exposed to it in the future, ”explained infectologist Dr. Jorge Santana.
Relevant advances in vaccines
Both Dr. Febo and Dr. Santana will be the local researchers in charge of the Mosaic study of experimental vaccines for HIV -which began in 2019- and in which Puerto Rico will be participating through the GAMMA Project and the ACTU Project of the Campus. of Medical Sciences (RCM) from the University of Puerto Rico (UPR).
The landmark study seeks to gather 3,800 volunteers to participate in it.
To participate in the research, you must be a cisgender man or a transgender person who has sex with cisgender men or transgender people. You must be between the ages of 18 and 60, not infected with HIV, and have decided not to use pre-exposure prophylaxis (PrEP) to prevent HIV infection.
There are also other criteria that must be met. They may have comorbid conditions (diabetes, high blood pressure, high cholesterol) and be vaccinated against covid-19. They cannot be taking medications that suppress the immune system.
“The interest of this study is from the preventive point of view. So the vaccine is for people who are within risk populations, do not have HIV and want to protect themselves from the virus, ”explained Dr. Febo.
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“When the incidence data is evaluated worldwide in the United States, about 35 thousand new cases are presented annually. In Puerto Rico, cases have dropped in the last seven or eight years from 1,100 to 300 to 400 cases per year. The incidence and prevalence reflect that heterosexual adults and intravenous drug users -which in many parts of the world kept contagion numbers high- have dropped significantly. That is why the vaccine is going to be confined to populations at risk such as men having sex with other men and transgenders, which in many countries are causing the highest number of diagnosed cases ”, added Dr. Santana, also a professor and director of the RCM Integrated Clinical Trials Unit.
Santana noted that trials and research for preventive and therapeutic vaccines have been underway for more than 20 years. The RCM has even participated by looking at different molecules in search of the desired cure without obtaining the expected results.
“With this new vaccine there is a lot of enthusiasm because the preparation methodology is different from the previous ones. That fact has aroused the interest of many. The preclinical data is interesting and the formulation is something new so we are hopeful that it will be a major advance ”, added the doctor.
The specialists highlighted that another important fact about the Ad26 and gp140 is that they are the first to be carried out together with almost a dozen countries.
Since November 2019, when the Mosaic study began, participants have been included in countries such as Argentina, Brazil, Mexico, Peru, Italy, Poland, Spain, and the United States.
“These vaccines that we have have passed the stages of being tested in laboratories, animals and small groups of populations of healthy people. It has been seen that it is quite safe and that is why it passes to the third phase where it is tested in a greater number of people. This study is being carried out at the level of the United States, Mexico, and South America, and we are proud to be part of a global effort to achieve a vaccine that can be used throughout the world ”, stated Dr. Febo, who conducts studies of prevention in the Department of Pediatrics at the School of Medicine and directs the GAMMA Project of the RCM.
The Mosaic study investigations will last approximately two and a half years. As detailed by Dr. Febo, the study volunteers will receive three doses of the vaccine in the first half of the study and a fourth dose in the next six months. Then they will be observed for a year and a half. So far they have perceived a lot of interest in people to learn about the vaccine, so it is expected to finish the recruitment of volunteers at the end of the current year, to obtain the results between 2023 and 2024.
“HIV is the forgotten pandemic that has taken a back seat because it is manageable and treatable. It has been controlled and maintained as a chronic disease with effective treatments. But there are still millions of people in the world getting infected and it continues to be a public health problem ”, the researcher concluded.
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