HIV Vaccines
Can humans develop a resistance to HIV infection?
Generally speaking in my mind these mechanisms are mainly not immunological but by genetic factors that people have been defining in the field for more then a decade. We know reasons why one individual resists more then another but yet there are other individuals we don't know why; that has to be determined yet. Some of these resistance mechanism's do not involve something of, what we call the adaptive immune system, namely the antibodies and the killer T-cell kind of cellar immunology phenomenon but there may be genetic factors that are normally present that help us resist viral infection. That we're learning about through research of HIV that was not discovered until HIV research.
Why is a vaccine critical in the fight against HIV?
We have to get rid of the virus and the way we're going to get rid of it is medical science solves it and that's a preventive vaccine. That won't help, very likely, the people who are already infected, they'll need to be treated and taken care of. But if a preventive vaccine is successful it means that nobody else will get infected or at least the reduction will go way down and the epidemic will gradually disappear.
Are there any approved vaccines for HIV in the market?
In the market, I mean, not like you can go in the store and buy your vaccine because none are proven effective, but of course there is supported programs of candidate vaccines that the federal government is supporting right now. In my mind, not many are very interesting, if any.
How can a successful HIV vaccine be created?
Make the Monkey models much more available which we should have done a long time ago is number one. Make more research support for basic science immunology and basic science in virology which is dwindling greatly in the last few years. Those are the thing that are needed; after that, I think we can begin to see some type of potential for a pathway that seems rational, where as earlier it was much harder to see pathways that are a little rational.
Will I be at risk for HIV if I volunteer for a vaccine clinical trial?
No, of course not. I shouldn't say, "Of course, not", because everybody thinks that. And I often see people getting credit for innoculating themselves. There is nothing dangerous to innoculating themselves. It is people's protein. You eat it every day. Protein of HIV is not going to kill you. It engenders an immunity response unless you have some kind of bizarre allergic disorder. I have not seen that with anybody with HIV infection so I don't think it is something that we are responding to in a massive allergic disorder and drop dead. Imagine if HIV didn't go on to destroy the immune system. What do you have in the earliest day that's what we can get from a vaccine, which is nothing? I don't mean two weeks later that you get the viremia and all things. You might get a little chill. It's possible you will get a low grade fever for a day or two; I don't think so. It would be an unusual reaction. There is no danger in a vaccine in terms of getting AIDS whatsoever any candidate vaccine ever so far. Some people were thinking of a live vaccine. I don't think anybody else was and the FDA wasn't so unless you hear that it is a live virus, I don't mean a live carrier, innocuous virus that carries a gene for HIV to make a protein temporarily. You don't fool around with the virus replication. That's not the same. I am talking about a live HIV that somebody believes they have crippled, and they are going to use that as a vaccine.No one is doing any of that. There was a small group interested in thinking that way, but that hasn't gone anywhere and won't. So, no candidate vaccine available today or in the future is going to cause AIDS in anyone ever.
Is it important to test for HIV across all races and genders?
Well I don't know if it is, I mean it is politically correct to say so because of genetic differences and to make sure that everybody is included because it could be important. No one knows for sure if it will be important. My guess is it probably won't be very important. I don' think men and women are going to differ very much. I don' think black, white and Indian, and I don't think Poles and Italians and Irish and Jews are going to differ very much, if at all. But it is a possibility and so therefore we have this story being made a little more important than it probably is.
When can we expect to have an HIV vaccine?
We can't expect, we can hope. And when we can hope, I would say best hope is a mistake to date. The last time I heard somebody date it was 14 years ago, and he said it would be in 10 or less years. And that was a political leader, and I don't want to be in that position. As soon as you say something, it's misinterpreted, or misquoted, or misrepresented or all of the above. At Margaret Heckler's press conference in 1984, she said after talking with CDC and myself, when they was pressed about a vaccine, she said, "Well, now that we can culture and grow the virus in massive amounts because of a breakthrough that occurred in our lab, that a vaccine could be tested within a few years time." That was rational, it was real and in fact my friend in Paris Danielle Zugury, did so. But she never said we will have an effective vaccine in two years. Doesn't matter, it gets misquoted all the time, including Altman, in the NY Times, does it all the time, and you can't talk to him to get it corrected. For whatever reason, they want that to be the case. Somebody does. So, that's the case. You know, no one has the power to change it. Altman will probably say it next week in the New York Times. Go back and read the initial announcement and the transcript. Nobody cares about the truth in such matters. It's what's convenient, and what sells. So we will say that no one can say when to this day. We can say that the understanding of how HIV enters the cell has gained momentum in the past 6, 7 years. And I believe that information is imperative for a successful vaccine, in order to successfully block the virus upon entry. And that is important, it's happening and we begin to see some potential for some avenues that seem rational.
Can HIV or AIDS be cured?
In theory yes, in practice no so therapy must be lifelong. By theory I mean that on paper we can think of conceptual ways to cure individual, but in practice, it's not feasible, it is way to more experimental and in some instances and in some ideas perhaps too dangerous. Might we evolve into a stage where HIV is curable? Yes. Would it happen in the next 10, 20 years? I don't know. And I don't believe anyone anywhere can answer that question anymore accurately. But I wouldn't be shocked if 10 years from now an approach that we can put on paper was put through, maybe even in 3 years an answer that someone got cured. But I would hesitate in media reporting such a thing, they'd have to report it but don't get too excited because translating that to common therapy for common people over the world would be at its infancy and very likely to not be practical.
