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Review of preventative HIV vaccine clinical trials in South Africa

Authors
  • Laher, Fatima1
  • Bekker, Linda-Gail2
  • Garrett, Nigel3, 4
  • Lazarus, Erica M.1
  • Gray, Glenda E.1, 5
  • 1 University of the Witwatersrand,
  • 2 The Desmond Tutu HIV Foundation, University of Cape Town,
  • 3 Centre for the AIDS Programme of Research in South Africa,
  • 4 University of KwaZulu-Natal,
  • 5 South African Medical Research Council,
Type
Published Article
Journal
Archives of Virology
Publisher
Springer-Verlag
Publication Date
Aug 14, 2020
Volume
165
Issue
11
Pages
2439–2452
Identifiers
DOI: 10.1007/s00705-020-04777-2
PMID: 32797338
PMCID: PMC7426202
Source
PubMed Central
License
Unknown

Abstract

New HIV infections continue relentlessly in southern Africa, demonstrating the need for a vaccine to prevent HIV subtype C. In South Africa, the country with the highest number of new infections annually, HIV vaccine research has been ongoing since 2003 with collaborative public-private-philanthropic partnerships. So far, 21 clinical trials have been conducted in South Africa, investigating seven viral vectors, three DNA plasmids, four envelope proteins, five adjuvants and three monoclonal antibodies. Active vaccine candidates have spanned subtypes A, B, C, E and multi-subtype mosaic sequences. All were well tolerated. Four concepts were investigated for efficacy: rAd5-gag/pol/nef showed increased HIV acquisition in males, subtype C ALVAC/gp120/MF59 showed no preventative efficacy, and the trials for the VRC01 monoclonal antibody and Ad26.Mos4.HIV/subtype C gp140/ aluminum phosphate are ongoing. Future trials are planned with DNA/viral vector plus protein combinations in concert with pre-exposure prophylaxis, and sequential immunization studies with transmitted/founder HIV envelope to induce broadly neutralizing antibodies. Finally, passive immunization trials are underway to build on the experience with VRC01, including single and combination antibody trials with an antibody derived from a subtype-C-infected South African donor. Future consideration should be given to the evaluation of novel strategies, for example, inactivated-whole-virus vaccines.

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