HIV Vaccine Development ‘Frustrating, Challenging,’ but Progress Being Made, NIAID’s Fauci Writes in Opinion Piece

In a CNN opinion piece in advance of his talk at the XVII International AIDS Conference in Mexico City on Wednesday, Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, examines the progress against HIV/AIDS, as well as the work that "remains to be done." He writes that with his talk he hopes to "leave the audience with at least a tentative answer to an important question ...: Will we ever have a cure or a vaccine for HIV?" Despite "considerable success" in managing HIV and improving the length and quality of life for people living with HIV/AIDS, there are "no well-documented cases of anyone truly being cured of HIV," he writes.

He adds, "HIV vaccine development has been frustrating and challenging for a number of reasons, including the fact that the virus mutates rapidly, hides from the immune system, and targets and destroys the immune system cells that are successful in fighting and clearing most other viruses from the body." He writes, "With HIV we will have to do better than nature if we are to develop a vaccine."

Although no "avenues of prevention" are "more essential than an HIV vaccine," the world's "best hope for eradicating HIV ... may be to diagnose and treat people aggressively very early in infection," he writes. Fauci adds, "Even if the virus is not completely eradicated ... early, intense treatment, perhaps with the help of immune-boosting drugs, might keep the reservoir small -- and the immune system strong -- thereby allowing a person to come off therapy. This would be a 'functional' cure. Other approaches are being pursued as well."

A "cure is critical to our attempts to ultimately contain the pandemic," Fauci writes. He adds, "As antiretroviral therapy is at present a lifelong commitment, it is extremely unlikely that we will have the logistical or financial capacity to reach and treat -- indefinitely -- everyone who requires antiretroviral therapy."

Fauci writes that he is "cautiously optimistic that we will be able to cure some patients under certain circumstances" and "develop a vaccine that will protect some people against HIV infection or slow the progression of disease in some patients who do get infected." Fauci invokes the conference theme, concluding, "we need 'Universal Action Now' to accelerate the exceptional momentum of the past few years ... in delivering proven tools of HIV prevention and therapy to communities around the globe" (Fauci, CNN, 8/5).

Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference. A webcast of Fauci's talk is available online at kaisernetwork.org.