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Highlights from the 2006 AIDS Vaccine Conference, Amsterdam, August 29 - September 1

AVAC Reports from AIDS Vaccines 2006 Conference

Click here to jump to AVAC's slides and poster presentations

Click here for helpful and informative reports from NAM, a community-based HIV education organisation in the UK

This year the 5th Annual International AIDS Vaccine Conference was held in Amsterdam, Netherlands, where some of the most renowned AIDS researchers working on AIDS prevention from around the world discussed the latest developments in the search for an AIDS vaccine.  This conference, held August 29 – September 1, involved almost 1000 participants and represents the best snapshot of the latest developments in AIDS vaccine research.  Overall, much of the research has returned to basic science – trying to gain a better understanding of key questions such as:

• What makes a good antibody against HIV and why?
• What is it about adenovirus that makes it a good vaccine vector?
• What can we do to make vaccine research in developing countries more feasible?
• What novel vaccine ideas have shown potential?
• How is developing a vaccine for HIV/AIDS the same or different from developing other vaccines?
• How can we design better large scale efficacy trials?

Scientific highlights
There was much enthusiasm expressed about steps that are being taken to solve some of the enduring challenges facing AIDS vaccine developers. One source of this enthusiasm is the emergence of CHAVI (Center for HIV/AIDS Vaccine Immunology) and CAVD (Collaborative for AIDS Vaccine Discovery) – which are funded by the National Institutes of Health and the Bill and Melinda Gates Foundation, respectively. Both of these entities aim to add a new level of coordination to the field as they try to answer key basic science questions.  Both entities are working on goals that are laid out in the Scientific Strategic Plan of the Global HIV Vaccine Enterprise. CHAVI will work to identify correlates of protective immunity at mucosal surfaces in acute HIV-infected and exposed uninfected individuals.  CAVD will work to overcome major scientific obstacles facing HIV vaccine research, and accelerate the development of an effective vaccine.  Yet it is important to remember that, while these initiatives may yield answers, it will be several years before any of these discoveries are translated into new vaccine candidates.

For more on CHAVI or CAVD link to the first chapter of the 2006 AVAC Report

Looking at candidates that have entered human clinical trials, the conference brought news about the progress of two adenovirus 5 (Ad5) vaccine candidates now being tested in clinical trials. These so-called Ad5 vaccines, with and without an HIV DNA prime, have shown the ability to induce high T-cell responses.  One of these trials is a “test-of-concept”, called the “STEP” study and is well underway in terms of enrollment; a second trial of the same candidate is scheduled to start later this year. These trials are being conducted by Merck and the HVTN. Another “test-of-concept” efficacy trial is being planned of a DNA-Ad5 combination; this would be conducted by PAVE (the Partnership for AIDS Vaccine Evaluation) collaborative.  These studies are designed to provide indications of whether the candidates provide some level of efficacy either in preventing infection or in reducing viral load in individuals who are vaccinated and then become infected. These indications will help the sponsors decide whether to continue testing this strategy, and data should be available by 2009.

• The conference also featured discussions on the challenge of creating a vaccine that induces neutralizing antibody responses. Thus far, no vaccine candidate has been found which can produce antibodies which neutralize HIV and stop it from infecting CD4 and other cells. New research into the structure of HIV however is focusing on creating molecules that will induce – or cause the creation of - potent neutralizing antibodies.

Finally, researchers are renewing their focus on discovering why certain people living with HIV/AIDS (PLWHAs) are able to naturally suppress their viral loads. An observational study currently being conducted by The Partners AIDS Research Center and others seeks to enroll such individuals, often referred to as “long-term non-progressors”, from all over the United States.  It is hoped that the immune response of these individuals may yield clues to how an effective prophylactic, or perhaps a therapeutic, vaccine might be designed.

Other Highlights from the Conference
Helen Rees, head of the Reproductive Health Research Unit in South Africa, gave an excellent plenary speech, situating AIDS vaccines in the context of multiple prevention strategies.  Rees outlined the various prevention intervention strategies including structural interventions (educating girls, micro-financing, and prevention of violence against women) social/behavioral (HIV prevention education, risk reduction counseling, condom distribution) and biomedical (development of vaccines, microbicides, PrEP, etc.).  The take home message was that all of these strategies are necessary and must be worked on simultaneously. Slides from this presentation will be available on the Clearinghouse soon.

Anthony Fauci, Director of the National Institutes of Allergy and Infectious Disease (NIAID) at the National Institutes of Health (NIH) gave an interesting presentation comparing the development of other vaccines to the development of vaccines for HIV/AIDS. 

To see Dr. Fauci's slides click here.

Another highlight from the conference was a presentation from Mary Allen from the National Institutes of Health (NIH), who presented data on experiences of negative social impacts associated with participation in an HIV vaccine clinical trial.  Overall, it appears the occurrence of negative social events among HIV vaccine trial participants is low.  Data showed sites that worked with young people or conducted longer trials were more likely to have negative social impacts, but this might also be due to the way data was collected.  Slides from this presentation will be available on the Clearinghouse soon.

AVAC Posters and Slide Presentations (click to download the pdf)

Presentations:

- Why the best news for HIV vaccines may be a cancer vaccine

- Building partnerships in enhancing advocacy in future prevention

Posters:

- Toward A Collaborative Model of HIV Vaccine Research

- Increasing Community Involvement: Training Program Models

- Research Advocacy: Maximizing Preparedness for HIV Research

More information about the conference:

This annual international conference provides a unique opportunity for scientists, researchers, and clinicians from around the world to share their most current work, data and insights related to the development of vaccines for HIV/AIDS.   This meeting provides an overview of what's currently going on in AIDS vaccine research. This year's conference was organized around 14 key topics:
1.  HIV Transmission
2.  Acute HIV Infection
3.  Innate Immunity
4.  Mucosal Immunity
5.  T-cell Immunity
6.  B-cell Immunity
7.  Immune Escape
8.  Viral Diversity
9.  Vaccine Concepts & Design

• Antigen selection and design
• Delivery methods
• Adjuvants
• Live attenuated vaccines

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