AIDS VACCINE 2013: Surprise success, disappointments, change all part of ongoing quest at last-of-its-kind HIV vaccine-focused conference

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aidsvaccine2013Science Speaks is live-blogging from AIDS Vaccine 2013 this week. Meeting in Barcelona, Spain, with the theme “Progress, Partnership and Perserverance,” from Oct. 7 to Oct. 10, this event brings together a history of hope, and an update on opportunities that have shown themselves in recent years.

BARCELONA, SPAIN – The field of HIV vaccine research has weathered great expectations, dashed hopes, and three decades of progress so incremental that only four potential vaccine candidates made it to the phase of clinical trials.

After years of frustration and surprise success, the field abides, and, organizers say, is poised to become part of something larger.

This will be the last conference dedicated solely to HIV vaccine research. The next conference for sharing such information will part of the HIV Research for Prevention 2014 Conference in Cape Town, South Africa.

Optimism is integral to the quest for an AIDS vaccine, it becomes clear as researchers gather this week to share data — on progress, plans, and probably disappointments as well — at the last solely dedicated AIDS Vaccine conference in the foreseeable future. A vaccine is essential to the eventual end of the HIV epidemic, those here agree, but it is not the only advance that will lead to that end, and the best case scenario still puts a licensed distributed vaccine at least a decade away.

On the eve of the opening of this last AIDS Vaccine Conference researchers are voicing excitement that, in another field, would suggest more immediate gratification is close at hand. They are energized by the modest, but pleasantly surprising results of the Thai RV 144 trial, which, in 2009, showing a 31 percent reduced chance of infection among those taking the product tested rather than a placebo, provided proof of concept that a protective vaccine can be developed. Talk also lights on research to be presented later this week showing a vaccination provided some protection to macaque monkeys. And they are excited that this, the 13th and last AIDS Vaccine Conference, also has gathered steam over the years, with this year drawing a record number of abstracts, of which 450 will be presented, more scholarships, with 1,000 attendees, and more young and early career investigators (see last year’s YECIs) than ever before.

“It’s okay to fail,” Dr. Jerry Sadoff of the Crucell Vaccine Institute says. “You have to take risks to succeed. How do you know you’re taking risks? Because you fail.”

This is more than logic to Sadoff. It is experience. He has had what he calls some “spectacular failures,” including the STEP AIDS vaccine clinical trial, one of the great disappointments in the brief history of AIDS vaccine research. But he also has seen spectacular successes, among them the development of the shingles vaccine, for which countless baby-boomers and their descendants can thank for sparing them years of agony.

He knows the human immune system on such familiar terms that his voice softens as he talks about “cognate immunity,” also known as “adaptive immunity,” which he compares to Marcel Proust’s Remembrance of Things Past because “It has memory!” He is talking about the kind of learned immune response that vaccines can build on. And that, he believes, will inform the development of a vaccine that one day will be part of the end of the AIDS epidemic.

Jill Gilmour“I believe that Mother Nature tells us that a vaccine is possible,” Jill Gilmour of IAVI says, citing the initial suppression of the virus most infected patients’ immune systems accomplish on their own, and pointing to existing populations — i.e. of Kenyan women involved in sex work who stayed uninfected through years of multiple exposures, and those people known as long term nonprogressors whose immune systems suppress the virus without treatment — who have shown HIV can be controlled.

But she also points to work in progress, that  she says, shows the field has built on its failures as well as its successes, that technology moves quickly. And, like others here, she points out, the quest won’t end until a vaccine that controls the virus that leads to AIDS exists, because the epidemic won’t end without it. As the one intervention that won’t depend on regular behavior, it is necessary, she says, pointing out: “People don’t like changing behavior so much.”

Science Speaks will be covering the research, releases, issues and plans as the conference unfolds, starting today.

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