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While prophylactic medications like pre-exposure prophylaxis (PrEP) can significantly reduce the risk of contracting HIV, their effectiveness relies on daily intake. Developing a vaccine that offers lasting protection has been a longstanding challenge for researchers. However, a promising strategy may now be within reach.
In a 2019 clinical trial, an experimental vaccine created at Duke University stimulated a rare type of broadly neutralizing antibody in a small cohort of participants. These groundbreaking results have been published today in the esteemed scientific journal Cell.
Glenda Gray, an esteemed HIV specialist and the CEO of the South African Medical Research Council, lauds the study as “a crucial milestone in the realm of HIV vaccine research.” Gray, who was not directly involved in the research, remains hopeful about the vaccine’s potential.
A few years back, a joint effort between Scripps Research and the International AIDS Vaccine Initiative (IAVI) showcased the possibility of activating the precursor cells essential for generating these rare antibodies in individuals. The Duke study has taken this a step further by eliciting these antibodies, albeit at modest levels.
Gray expresses optimism, noting, “This achievement in science instills confidence that an HIV vaccine regimen can be devised to steer the immune response in the necessary direction for protection.”
Vaccines operate by instructing the immune system in recognizing and combating a virus or pathogen. By introducing a virus-mimicking agent—like a fragment or weakened form of the virus—vaccines prompt the body’s B cells to produce defensive antibodies. These antibodies persist in the system, enabling a rapid immune response upon subsequent encounters with the actual virus.
Despite the swift development of Covid-19 vaccines, creating an HIV vaccine has posed a more intricate challenge due to the virus’s unique characteristics. HIV undergoes rapid mutations, enabling it to evade immune responses expediently. Moreover, it integrates into the human genome shortly after exposure, evading immune surveillance.
Barton Haynes, a paper co-author and the director of the Duke Human Vaccine Institute, remarks, “Segments of the virus resemble our own cells, hindering antibody production against self-components.”
Of interest to researchers are broadly neutralizing antibodies capable of recognizing and obstructing various virus strains. Given the virus’s shape-shifting behavior, there exist two primary HIV types, each with multiple variants. A successful vaccine must target multiple strains.
Haynes explains that some HIV-infected individuals generate broadly neutralizing antibodies after prolonged virus exposure, yet their production is insufficient for eradicating the virus. These distinct antibodies emerge from unconventional B cells containing mutations acquired over time in response to the virus’s transformations within the body. “These antibodies are unique,” Haynes remarks. “Their formation is not typical.”
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