Funding
Testing

James Grissom
HIV Positive
Steve Sherman
Coordinator, NC AIDS Drug Assistance Program
Peter Leone, M.D.
Medical Director, HIV/STD Prevention & Care Branch
Fred Wiggins
HIV Positive
Milford Evans
Benefits Advocate
Bart Haynes, M.D.
Director, Center for HIV/AIDS Vaccine Immunology, part of the National Institutes of Health

Acute HIV Testing
AIDS Funding
AIDS Research
AIDS Volunteers

Click here for to view more video online, to download podcasts and view more educational resources.

Viewing video requires a REAL player. Click here to download a free REAL player.

What work is Duke's Human Vaccine Institute doing?
Play Video: LOW Speed - HIGH Speed

We're working on five major problems related to HIV vaccine development, and then we also have programs in TB [tuberculosis] vaccine development as well. The five major problems in HIV vaccine development relate to inducing the right kind of immune responses, and a number of different types and pieces of the AIDS virus delivered in certain ways can do this. And then the group is working on the diversity problem. This is a very rapidly mutating virus, and the virus you have today in a community is not the same virus that one will have five yeas from now. So the AIDS virus is a moving target. And we're working on inducing long-term immune responses to the virus to last long enough to be clinically useful. The fourth problem is making the right kind of antibodies against the AIDS virus, so we have a team working on that. Then the fifth problem is making certain kinds of responses called T-cell responses, and to a large degree most of the immunogens we have, or vaccine candidates we have and others have, can do that. So we're really working on three of the five problems that are yet to be solved, so we have teams working on each one of those. Then for TB vaccine development, we have a team made of individuals from a number of institutions, the Albert Einstein College of Medicine most prominently, Harvard University, that work with us to make a better TB vaccine. Then finally we're working to combine the TB vaccine with our HIV vaccine that we're developing and make it into one HIV and TB vaccine because HIV and TB synergize in the patient to cause a very devastating disease.

With regard to the extraordinary evolving of the AIDS virus and the diversity it's created, we've teamed up with a group from the Los Alamos database out in Los Alamos National Laboratory in New Mexico, and there for the past 20 years they've been collecting all the sequences of HIV isolated around the world and have more than 100,000 individual sequences. So you can see just from that the enormous breadth of the target that the vaccine developing groups are trying to focus on. And so we've gotten supercomputers to work on these sequences to come up with what's called consensus sequences which are artificial sequences that are more like all the other sequences in the database than any other individual wildtype sequence might be. And so we're studying these for their ability to induce more broad immune responses than might be available through other wildtype viruses that we might isolate from a patient in a given location. Folks down at the University of Alabama - Birmingham have taken these sequences that have been designed and made them into artificial genes, and we're now taking these genes and incorporating them into our vaccine candidates and have put them into animals and have teams working here, doctors that work in the Vaccine Institute, that are now looking at the responses to these new vaccines, and they're looking like they're doing better than the wildtype genes, and so we're pursuing this.

Is there a chance of finding one vaccine that will work for all types of HIV?
Play Video: LOW Speed - HIGH Speed

There's always that hope, and I think that's what keeps a lot of people in the field working so hard. In reality, while we all hope there's going to be a major breakthrough and we're going to find a vaccine candidate that works in all people against all strains, I suspect that what has already started to happen will continue to be what we'll likely see and that is we'll take our best candidate today and put that in clinical trials and it will induce a certain level of immune response and a certain breadth of immune responses for a certain number of strains. Then we'll take that and make it better and go to the next clinical trial. It's going to continue to be an iterative process and hopefully it will get us to the same goal of having something that's 80 to 100 percent effective going in increments as opposed to one big jump. We're still all trying to make the one big jump as well, but my bet is it's going to be an iterative process.

How is developing the HIV vaccine different from other types of vaccines?
Play Video: LOW Speed - HIGH Speed

It's different in the sense that all the current vaccines for infectious diseases try to prevent - or do successfully prevent - disease as opposed to preventing infections. Whereas what we're asking for an HIV vaccine in the best of all possible worlds is to completely prevent infection. We know in some animal models that vaccines that we already have will delay disease - will in some cases for three to four years in monkeys that have been treated or been given a certain vaccine and then given a challenge of an AIDS-like virus. Whether that will work in humans or not for that duration is an important question that's getting ready to be asked in human clinical trials. So I think the first thing we'll see is a vaccine that prevents disease or retards disease or causes a less severe disease, and how effective that vaccine's going to be, as I say, is a real critical question which is going to be answered soon. I'm just not wise enough to know, because of the difficulty of the problems in completely preventing the HIV infection related to the diversity and inducing the right kind of antibodies, I'm not wise enough to know at this point when or if there will be a totally preventive vaccine. That's certainly what we're working on.

What does it take to do this type of work?
Play Video: LOW Speed - HIGH Speed

I think it's important that this work is being done by teams, not one particular individual. It's a pleasure and an honor to be able to work with so many bright people who are dedicated, and in the Vaccine Institute alone there are over 30 people who are working in individual teams on the projects, and I think it's important for people to realize that this type of work takes a lot of hard work by a lot of dedicated individuals who enjoy and are skilled at working in teams and that the main theme that I have seen evolve over the years, in my 20 years in HIV research, is that the field has come together and coalesced into some teams, some very hard working teams involving multiple institutions to try to solve this difficult problem. So I'm optimistic that progress will continue to be made.