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HIV News: An Ineffective Vaccine, a Potential Target for Gene Therapy

Patients may ask about two widely reported findings concerning HIV this week.

First, the disappointing news: In an international, phase 2 trial published online in Lancet, 3000 high-risk, HIV-negative adults were randomized to receive a cell-mediated, adenovirus-based vaccine or a placebo. Vaccination did not reduce HIV infection rates or, among people who became infected, plasma viral load. In fact, in some subgroups, infection rates were higher with the vaccine.

Now, the encouraging news: The Wall Street Journal has described the case of an HIV-infected man who has been off treatment and free of detectable HIV for more than 600 days — ever since he had a bone marrow transplant for leukemia. The bone marrow donor was homozygous for a genetic mutation (CCR5 delta 32) that made him virtually immune to HIV.

Writing in HIV and ID Observations, a Journal Watch blog, Paul Sax concludes: "If ever there were a plausible target for gene therapy, the CCR5 delta 32 mutation seems like a great place to start."

LINK(S):

Lancet randomized trial (Free abstract; full text requires subscription)

Lancet analysis examining findings from the randomized trial (Free abstract; full text requires subscription)

Lancet comment (Subscription required)

Wall Street Journal story on man with undetectable HIV after bone marrow transplant (Free)

HIV and ID Observations posting on transplant case (Free)

Published in Physician's First Watch November 14, 2008