The WHO statement on strategies of HIV vaccinations: field trials in developing countries should await studies of the effects
Lennholm, B.
Lakartidningen 90(13): 1245-1246
1993
ISSN/ISBN: 0023-7205 PMID: 8469070 Document Number: 329662
The WHO steering committee for vaccine development reiterated its earlier position that the testing of HIV postinfectious vaccine candidates in developing countries must wait until there is initial proof that such a vaccine has some kind of effect in tests carried out in industrial countries. The often-used term about the latency of HIV infections is essentially faulty, as the infection means an ongoing destruction of the immune system for many years before symptoms appear. Therefore, it would be significant to have a therapeutic vaccine before the process has advanced too far. This is a practical problem, because the majority of the world's many millions of HIV-infected do not know that they are infected until there is an actual diagnosis of AIDS. Laboratory diagnosis to determine the number of CD4-T cells is expensive in developing countries where simple routines must be developed based on clinical observations. The study of vaccines would also provide important insights concerning the prevention of transmission of HIV infection to the child during pregnancy and childbirth. The WHO priority of developing and field testing an AIDS vaccine involves 4 field stations in Uganda, Rwanda, Thailand, and Brazil where the vaccine product could be tested, it is hoped, within 2-3 years. At the present time WHO is collecting and cataloging virus strains from various countries for the purposes of antigen selection. The vaccine candidate so far developed and tested in phase 2 trials is based on proteins from the coating of the virus. Ronald Desroisiers at the Harvard Medical School has made the virus apathogenic by removing several genes that accord it its virulence which also guarantees that it will not recur. All means have to be tried in view of the inexorable spreading of AIDS in Africa, Asia, and Latin America where in the worst affected areas 30-40% of pregnant women are HIV-infected.