The Independent's HIV survey: the questions and answers

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The Independent Online

We have had about 40 replies to our HIV vaccine survey and they are still coming in. This is what we asked scientists and the replies to each field of the questions posed. Some scientists ticked more than one box (they are scientists after all) and others answered in other ways, claiming the questions were “too binary” or simplistic. However, here are the raw results so far. Edited comments of some of the scientists who took part appear below the survey. I’d like to thank all of those who spent time on answering the poll.

The Independent Survey: Towards an HIV Vaccine April 2008

The Independent newspaper in London is asking leading Aids researchers about their views on the prospects of an Aids vaccine in the light of recent events, namely the failure last September of the Merck clinical trial and the recent Summit on HIV Vaccine Research and Development held by the NIAID. We would like your participation in answering these questions:

1. Are you more or less optimistic about the prospects of an HIV vaccine compared to a year ago?

More optimistic [ 2]

Less optimistic [15]

About the same [19]

2. Are you more or less optimistic about the prospects of an HIV vaccine compared to FIVE years ago?

More optimistic [4 ]

Less optimistic [16]

About the same [15]

3. Do you agree that we now need to change the direction of HIV vaccine research given the failure of clinical trials so far?

Agree [30]

Disagree [6]

If you disagree, briefly explain why:

4. Do you agree with the statement that the money being spent on developing an HIV vaccine would be better spent on education and prevention?

Agree [4 ]

Disagree [30]

Briefly explain why you agree/disagree:

5. Do you agree that an HIV vaccine will be developed within the next TEN years?

Agree [10]

Disagree [22]

If you disagree, when do you think we are likely to see an effective HIV vaccine?

Many thanks for completing this short questionnaire. Please include your name and institution and let us know whether you would like your comments to be attributed.

Your name:

Your institution:

Would you like your comments attributed in a future article? Yes / No

Edited comments from the scientists who took part in the survey

Seth Berkley, president of the International AIDS Vaccine Initiative: “While scientists don’t know how long it will take to develop an AIDS vaccine, we do know that a vaccine is the only way to end a major viral epidemic. And there is scientific evidence to support the belief that an AIDS vaccine is possible. Most people’s immune systems hold HIV in check for years before they develop AIDS. A small number of HIV-infected people seem never to develop the disease. There are also documented cases of individuals who have been repeatedly exposed to HIV, but have not become infected. If scientists can work out the type of immune responses that protect these individuals, it might provide vital clues about how to create a vaccine.”

Samuel J McConkey, Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland: “Perhaps we will never have a true preventative vaccine. One HIV infection does not prevent further infection: what I am saying is that there is no infection-acquired immunity. This is different from malaria, and most other infections for which there is a vaccine at present. However in some cases, like tetanus, vaccination can not just mimic, but improve on infection-related acquired immunity.”

Professor Robin Weiss, University College London: “I think that the general direction of HIV vaccine discovery research is broad and sensible, and should not be changed, unless some very exciting and novel concepts or facts emerge. I think that the candidate vaccines that failed in recent trials perhaps should not have gone to trial in the first place. We need monies both for HIV vaccine R&D, and for other means of prevention including education. It was a vaccine, not education or alleviation of poverty, that led to the eradication of smallpox. It would be foolhardy to predict [when we will have an HIV vaccine] because we need new discoveries, not simply development of something already in the pipeline. One cannot put an accurate timeline on something yet to be discovered.”

Professor Andrew Leigh-Brown, Edinburgh University: “There is a continuing need for education and prevention, but efforts in those areas have failed to prevent a doubling in transmission among MSM [men who have sex with men] since 1997 in the UK. [When do you think we are likely to see an effective HIV vaccine?] Possibly never, with the approaches that are currently being taken. Among related viruses in monkeys, none are controlled by classic immunity despite millenia of continual high prevalence exposure. Naturally infected monkeys have developed sophisticated strategies of living with their SIV infections, but not of controlling them.”

Guido Silvestri, University of Pennsylvania School of Medicine: “We need fewer clinical trials and less focus on product development (as we don’t know what products will work anyway). We need more basic science to understand how HIV and the immune system interact, and particularly more studies of in vivo SIV infection in non-human primates. [When do you think we are likely to see an effective HIV vaccine?] Hard to say—my guess would be greater than 20 years.”