HIV/AIDS has been a major global health concern for decades, claiming millions of lives and destroying communities around the world. While considerable progress has been achieved in the prevention and treatment of this lethal illness, the hunt for a permanent solution remains paramount. Enter the Hiv/Aids vaccine, a ray of hope that has the potential to revolutionise the fight against this intractable disease. In this article, we look at the present state of HIV/AIDS research, the hurdles of creating a vaccine, and the groundbreaking advances that offer renewed hope for a future free of HIV/AIDS.
HIV does not make people dangerous to know, so you can shake their hands and give them a hug: Heaven knows they need it.
– Princess Diana
What is HIV?
HIV (human immunodeficiency virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected intercourse (intercourse without a condom or HIV medicine to prevent or treat HIV), or through sharing injection drug equipment.
If left untreated, HIV can lead to the disease AIDS (acquired immunodeficiency syndrome).
The human body can’t get rid of HIV and no effective HIV cure exists. So, once you have HIV, you have it for life.
Luckily, however, effective treatment with HIV medicine (called antiretroviral therapy or ART) is available. If taken as prescribed, HIV medicine can reduce the amount of HIV in the blood (also called the viral load) to a very low level. This is called viral suppression. If a person’s viral load is so low that a standard law can’t detect it, this is called having an undetectable viral load. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through intercourse.
In addition, there are effective methods to prevent getting HIV through sex or drug use, including pre-exposure prophylaxis (PrEP), medicine people at risk for HIV take to prevent getting HIV from intercourse or injection drug use, and post-exposure prophylaxis (PEP), HIV medicine is taken within 72 hours after a possible exposure to prevent the virus from taking hold.
Symptoms of HIV:
The only way to know for sure if you have HIV is to get tested. Testing is relatively simple. You can ask your healthcare provider for an HIV test. Many medical clinics, substance abuse programs, community health centres, and hospitals offer them too. If you test positive, you can be connected to HIV care to start treatment as soon as possible. If you test negative, you have the information you need to take steps to prevent getting HIV in the future.
HIV self-testing is also an option. Self-testing allows people to take an HIV test and find out their results in their own homes or other private location. With an HIV self-test, you can get your test results within 20 minutes. You can buy an HIV self-test kit at a pharmacy or online. Some health departments or community-based organizations also provide HIV self-test kits for a reduced cost or for free. You can call your local health department or use the HIV Sevices Locator to find organizations that offer HIV self-test kits near you. (Contact the organization for eligibility requirements.)
Note: State laws regarding self-testing vary and may limit availability. Check with your healthcare provider for additional testing options.
What is AIDS?
AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus.
In the U.S., most people with HIV do not develop AIDS because taking HIV medicine as prescribed stops the progression of the disease.
A person with HIV is considered to have progressed to AIDS when:
- the number of their CD4 cells falls below 200 cells per cubic millimetre of blood (200 cells/mm3). (In someone with a healthy immune system, CD4 counts are between 500 and 1,600 cells/mm3.) OR
- they develop one or more opportunistic infections regardless of their CD4 count.
Without HIV medicine, people with AIDS typically survive about 3 years. Once someone has a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year. HIV medicine can still help people at this stage of HIV infection, and it can even be lifesaving. But people who start HIV medicine soon after they get HIV experience more benefits—that’s why HIV testing is so important.
Quest for a Vaccine:
There are numerous scientific challenges to developing an HIV vaccine. The unprecedented genetic variability of the virus, its ability to quickly establish a persistent lifelong infection, and the fact that not a single person has cleared HIV on their own are just some of the obstacles researchers face in trying to understand how to induce protective immunity against the virus.
Given the complexity of combating HIV, traditional approaches to vaccine development that led to many of the licensed vaccines in use today are either impractical or have so far failed to result in effective vaccines.
Because of these challenges, IAVI’s scientists and their collaborators are pursuing innovative strategies to design vaccine immunogens capable of activating both arms of the adaptive immune response — antibodies and T cells — to induce durable immunity against HIV.
After more than a decade of concerted effort, new HIV vaccine candidates based on immunogens that are designed to stimulate B cells of the immune system to generate broadly neutralizing antibodies (bnAbs) against the virus are now in clinical trials.
Innovative HIV vaccine technologies:
A significant research focus at IAVI involves vaccine technologies that allow for the efficient and effective delivery of immunogens into the body. IAVI and its collaborators are investigating two technologies to achieve this goal.
One technique is to utilise a replicating viral vector, and IAVI researchers are especially interested in vesicular stomatitis virus (VSV). They are developing a recombinant VSV vector with an HIV Envelope gene that is being tested in preclinical research. The rVSV vector with the HIV gene insert is intended to be used as a prophylactic vaccination, but it may potentially be used therapeutically. In addition, IAVI is working on rVSV-vectored vaccine candidates for Lassa fever, Marburg virus disease, Ebola Sudan virus disease, and COVID-19.
Messenger RNA (mRNA) delivery is the second method IAVI is looking at for the purpose of delivering vaccine immunogens. Your body needs proteins to carry out its numerous functions, and mRNA controls their creation inside cells. It safely transmits instructions to cells to generate a SARS-CoV-2 protein that triggers a protective immune response and was initially employed in licenced COVID-19 vaccines. IAVI and the biotechnology firm Moderna are examining the use of mRNA to transmit HIV antigens and trigger specific immune responses in IAVI G002 and IAVI G003.
Preventive Measures:
Anyone can get HIV, but you can take steps to protect yourself from HIV.
- Get tested for HIV. Talk to your partner about HIV testing and get tested before you have sex. Use the GetTested locator from the Centers for Disease Control and Prevention (CDC) to find an HIV testing location near you.
- Choose less risky sexual behaviours. HIV is mainly spread by having anal or vaginal intercourse without a condom or without taking medicines to prevent or treat HIV.
- Use condoms every time you have intercourse.
- Limit your number of sexual partners. The more partners you have, the more likely you are to have a partner with poorly controlled HIV or to have a partner with a sexually transmitted disease (STD). Both of these factors can increase the risk of HIV.
- Get tested and treated for STDs. Insist that your partners get tested and treated, too. Having an STD can increase your risk of getting HIV or spreading it to others.
- Talk to your healthcare provider about pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention option for people who do not have HIV but who are at risk of getting HIV. PrEP involves taking a specific HIV medicine every day to reduce the risk of getting HIV through sex or injection drug use. For more information, read the HIVinfo fact sheet on Pre-Exposure Prophylaxis (PrEP).
- Do not inject drugs. But if you do, use only sterile drug injection equipment and water, and never share your equipment with others.
