AIDS Vaccine Research: Consider Co-Infections

Rob Gruters and Ab Osterhaus

 

In the News of the Week story "Trials of NIH's AIDS vaccine get a yellow light"  J. Cohen and B. Lester report on the NIH Vaccine Research Center (VRC) AIDS vaccine trial that was put on hold, and they discuss whether the initiative should be continued. The VRC AIDS vaccine is based on an adenovirus 5 (Ad5) vector similar to the Merck STEP vaccine for which the trial was halted earlier this year. The authors cite the arguments for and against continuing the VRC trial in a smaller group of participants that excludes people who have antibodies against Ad5. The arguments include ethical issues inherent in a vaccine with limited applicability and the lack of proven efficacy of the vaccine in preclinical research.

We suggest another factor to consider in making this decision: The risk for the Ad5 seronegative participants to become infected with both HIV and Ad5 should be taken into account, especially in countries, such as Swaziland, where both viruses are highly endemic (seroprevalence 25% and 90%, respectively).

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