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A Glimmer of Hope for an HIV Vaccine


By Eduardo  Gonzales, MD

Q: Is it true that a vaccine against HIV will be available soon? How serious is the HIV-AIDS epidemic in the Philippines? —ginny_pide@gmail.com

A: There appears to be a glimmer of hope in the decades-long search for a vaccine against HIV—the virus that gives rise to Acquired Immune Deficiency Syndrome (AIDS). An article published recently in the journal The Lancet reports of a new vaccine that was tested in 393 healthy people considered at low risk for infection and 72 rhesus monkeys. The vaccine was well-tolerated by all the test subjects. It also induced an immune response against HIV in the human subjects and provided 67 percent protection against infection from the simian-human immunodeficiency virus in the rhesus monkeys.

Despite this latest report, it is too early to rejoice. The results of the early trial do not mean a viable vaccine. Despite the facts that the new vaccine proved to be protective in monkeys, and produced antibodies against HIV in humans, it is unclear whether the vaccine will protect against infection. What the results merelysignify is that the vaccine is safe enough to go into the next phase (phase 2) of clinical testing, which involves a larger number of humansthat are at higher risk of infection. This phase has already started with 2,600 women across sub-Saharan Africa as subjects. If it hurdles this phase 2 trial, the vaccine still has to go through phase 3, which involves a still greater number of subjects.


Incidentally, there are two major types of HIV, 1 and 2. HIV-1, which was discovered first, is the most widespread type worldwide. HIV-2 is less prevalent and less pathogenic (disease-causing). It is found primarily in Western Africa. The two types of HIV differ genetically, thus if a vaccine is developed against one type, it will most likely not be effective against the other type. The current vaccine that is undergoing testing, if finally proven safe and effective, will only prevent HIV-1.

An HIV vaccine will certainly be a game changer on the war against HIV, but while one is still not available, there are proven ways to stem the HIV/AIDS epidemic.

HIV in the Philippines

For decades the spread of the human immunodeficiency virus (HIV) in our country has been “low and slow,” which means its prevalence rate is low and its transmission is slow. In fact, from January 1984, when the first case was reported in the Philippines, up to December 2010 (a period of 21years) only a little over 6,000 cases were recorded in our HIV-AIDS registry. Things have since changed, however. Department of Health (DOH) figures clearly show an alarming upsurge of HIV infections in our country in the last few years. As of the end of March 2018, a month when 912 new HIV positive cases where recorded, the total number of Filipinos who have tested positive for HIV is already 53,192.

Male millennials are at greatest risk
Of the reported HIV positive Filipinos in the last five years, more than 95 percent are males. Their median age is 28 years old with more than half from the 25 to 34 year age group. In so far as mode of transmission is concerned, 50 percent of the infections in the last five years were acquired by sex between males.

The figures clearly show that male millennials, especially males who have sex with other males, are at greatest risk for the disease.

HIV infection is easy to prevent
An HIV vaccine will certainly be a game changer on the war against HIV, but while one is still not available, there are proven ways to stem the HIV/AIDS epidemic.

HIV is a very fragile virus that can only survive within the body. Consequently, it can only be transmitted by sexual contact with an infected person, sharing needles and/or syringes (among drug users), transfusion of contaminated blood or blood products, being pricked with a needle containing infected blood or contact of broken skin or mucous membrane with infected blood, and from an infected woman to her baby, before or during birth, or through breastfeeding.

Thus, HIV transmission can easily be prevented by refraining from practices that puts one at risk of acquiring the disease, which for the average person basically means: One, indulging only in monogamous sex, or short of that, by practicing safe sex, which essentially means using condoms during the sex act (although condoms are not 100 percent effective), and two, refraining from using illegal drugs.

By the way, the DOH runs more than 50 facilities in the country that perform HIV testing and dispense anti-retroviral treatment (ARV) for free.

Note: Email inquiries on health matters to: medical_notes2@yahoo.com

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