30 Years of AIDS Vaccine Research

In almost every way, AIDS is exceptional.

In 1981 when this new human disease was first reported in the US, there were few drugs to treat any virus. Thirty years later, there are more than 30 antiretrovirals (ARVs) to treat HIV/AIDS. Combination ARV therapy, which was introduced in 1995, rescued people from the brink of death, and the success of ARVs doesn’t stop there.

These drugs can also protect against HIV infection in the first place. First, a study showed that a microbicidal gel formulation of an ARV was able to reduce HIV infection rates in women. Then, another trial showed that a daily dose of a combination ARV tablet was able to reduce HIV infection rates among men who have sex with men. Just last month, researchers reported results from a trial known as HPTN052 that indicated infected individuals on ARVs are 96% less likely to transmit HIV to their uninfected partner (see Can Treatment End AIDS?).

If cost wasn’t an issue, which of course it is, and finding and testing those most likely to be HIV infected was a surmountable problem, ARVs might be able to break the back of the pandemic. But as it stands now, there are 34 million people estimated to be living with HIV/AIDS, and only six million people in low- and middle-income countries are currently able to access these life-saving medicines.

This suggests that after 30 years, the war on AIDS is far from over. And one weapon that remains elusive is a vaccine.

But as in other areas of HIV prevention research, prospects for a preventive vaccine are brighter today than at any time in the past three decades. After many failed attempts at designing vaccine candidates, there are promising new leads, making researchers more optimistic.

If the power of science combined with political will continues to be at the forefront in the battle against AIDS, perhaps the fourth decade will bring about a prevention revolution that rivals the amazing strides in treatment.