Thai Research Team Studies Efficacy Of HIV Vaccine

[webfact]

Thai research team studies efficacy of HIV vaccine

Pongphon Sarnsamak

The Nation

BANGKOK: -- A Thai research team is working on two new studies to see how a vaccine can boost people's immunity against HIV.

" These studies will help us determine if a vaccine can strengthen immunity against the virus," Prof Dr Punnee Pitisuttithum, chief of Mahidol University's Vaccine Research Centre, said.

About 500,000 to 600,000 people are living with HIV/Aids in Thailand, and though the situation has improved in terms of treatment, the efficiency of preventative measures has been below expectation and the annual average of 10,000 new patients is higher than projected.

The trials, divided into two, will involve a total of 632 volunteers. The first study, called RV305, will evaluate immunity boosting strategies for noninfected participants.

In 2009, the HIVvaccine efficacy trial, RVI44, tested a combination of two vaccines - ALVAC HIV (prime vaccine) and AIDSVAX B/E (the booster) - on more than 16,000 HIVnegative men and women from Chon Buri and Rayong provinces. The outcome of the trial showed that the combined vaccine lowered the rate of HIV infections by 31.2 per cent, but had no effect on the amount of the virus in the blood.

The results of RV144 trial also showed that the efficacy rate of primeboost vaccine, one year after being administered, was approximately 60 per cent.

A recent discovery suggested that the potential immune correlatesantibody so called V1/V2 region is likely to be protective leading to further studies using similar regimen.

"The previous trial helped us to learn more about the type of antibodies that could improve a human's immunity to fight against HIV. This was why we are conducting two studies to find out more details about the efficacy of the HIV vaccine," Dr Punnee, who is leading the studies, said.

About 167 people, who were part of the previous RV144 trial, will participate in the RV305 trial and receive eight shots of the combined vaccine in one year. The RV305 trial began last month and the result should be ready in two years.

The second study, named RV306, will focus on the efficacy of the HIV vaccine on 465 volunteers who are not at a high risk of getting infected. The trial will evaluate different booster vaccines one year after the volunteers have received either AIDSVAX B/E or ALVACHIV alone or a combination of both. The trial will also study specific immunity responses to various bodily fluids, including secretions from the cervix and the anus. The results of this trial should be ready in three years, though the research team is awaiting approval from the university's ethics committee.

"We don't know if these vaccines are capable of activating the immune system in other parts of the body," Dr Punnee said.

The two studies will be conducted in collaboration with several institutions, namely the Public Health Ministry, Vaccine Trial Centre, Mahidol University's Faculty of Tropical Medicines, the US Armed Forces Research Institute of Medical Sciences, Research Institute for Health Science, the Chulalongkorn University and the Thai Red Cross Society. The World Health Organisation (WHO), Vaxgen Inc and the Military HIVVaccine Research Programme are also supporting the trials.

-- The Nation 2012-05-12

[geriatrickid]

If anyone wants to send a thank you note to the USA and the US Army, for providing most of the funding, feel free to send it to the US Military HIV Health Research Program in Bethesda Maryland.

The results of the RC144 immunity mechanism lab studies published in the NEJM in April provided the first signs of hope in many years. Again, you can send your thank you note to Col. Jerry Kim of the MHRP. Col. Nelson Michael, the big boss over at MHRP, was a co-author with Dr. Kim. Those guys are brilliant.

The Thai research units recruit & screen the volunteers, administer the vaccines, take blood and do follow ups. All the key research is done at facilities in the USA.

They are doing the recruiting at Bang Lamung Hospital in Chonburi. Its a small 90 bed public hospital so you may have to sit with the great unwashed.

[noitom]

If anyone wants to send a thank you note to the USA and the US Army, for providing most of the funding, feel free to send it to the US Military HIV Health Research Program in Bethesda Maryland.

The results of the RC144 immunity mechanism lab studies published in the NEJM in April provided the first signs of hope in many years. Again, you can send your thank you note to Col. Jerry Kim of the MHRP. Col. Nelson Michael, the big boss over at MHRP, was a co-author with Dr. Kim. Those guys are brilliant.

The Thai research units recruit & screen the volunteers, administer the vaccines, take blood and do follow ups. All the key research is done at facilities in the USA.

They are doing the recruiting at Bang Lamung Hospital in Chonburi. Its a small 90 bed public hospital so you may have to sit with the great unwashed.

Thanks for this informative post noting that funding was provided by the USA and US Army resources, staff, and facilities. Curious that the newspaper didn't note this. It would be interesting to know what Dr. Punee thinks about the new Quad HIV drug developed by Gilead Sciences of Israel. Curious that The Nation has never noted anything about this new drug currently approved by the FDA in the USA.

[agudbuk]

If anyone wants to send a thank you note to the USA and the US Army, for providing most of the funding, feel free to send it to the US Military HIV Health Research Program in Bethesda Maryland.

The results of the RC144 immunity mechanism lab studies published in the NEJM in April provided the first signs of hope in many years. Again, you can send your thank you note to Col. Jerry Kim of the MHRP. Col. Nelson Michael, the big boss over at MHRP, was a co-author with Dr. Kim. Those guys are brilliant.

The Thai research units recruit & screen the volunteers, administer the vaccines, take blood and do follow ups. All the key research is done at facilities in the USA.

They are doing the recruiting at Bang Lamung Hospital in Chonburi. Its a small 90 bed public hospital so you may have to sit with the great unwashed.

Thanks for this informative post noting that funding was provided by the USA and US Army resources, staff, and facilities. Curious that the newspaper didn't note this. It would be interesting to know what Dr. Punee thinks about the new Quad HIV drug developed by Gilead Sciences of Israel. Curious that The Nation has never noted anything about this new drug currently approved by the FDA in the USA.

Could be interpreted as US uses Thai people for drug research .

Would that be because of altruism, because it is cheaper in Thailand than the USA or because the tests would leave them open to law suits in the US or because the tests may not even be legal in the US?

Or am I just being cynical?

Edited May 12, 2012 by agudbuk

[irwinfc]

If anyone wants to send a thank you note to the USA and the US Army, for providing most of the funding, feel free to send it to the US Military HIV Health Research Program in Bethesda Maryland.

The results of the RC144 immunity mechanism lab studies published in the NEJM in April provided the first signs of hope in many years. Again, you can send your thank you note to Col. Jerry Kim of the MHRP. Col. Nelson Michael, the big boss over at MHRP, was a co-author with Dr. Kim. Those guys are brilliant.

The Thai research units recruit & screen the volunteers, administer the vaccines, take blood and do follow ups. All the key research is done at facilities in the USA.

They are doing the recruiting at Bang Lamung Hospital in Chonburi. Its a small 90 bed public hospital so you may have to sit with the great unwashed.

i wish i could agree with everything you wrote but i can't. the blood tests are being done here as well as the analyses. so that qualifies that most, if not all, of the key research is NOT being done in the US. i work across AFRIMS and know a handful of people that worked on the RV144. nevertheless, i do thank the US for funding and providing their research expertise.

[cowslip]

Deeply suspicious of this research.....actually more so of the reporting.

[how241]

Deeply suspicious of this research.....actually more so of the reporting.

I hope their on to something. Edited May 12, 2012 by how241

[blackthorn2005]

If anyone wants to send a thank you note to the USA and the US Army, for providing most of the funding, feel free to send it to the US Military HIV Health Research Program in Bethesda Maryland.

The results of the RC144 immunity mechanism lab studies published in the NEJM in April provided the first signs of hope in many years. Again, you can send your thank you note to Col. Jerry Kim of the MHRP. Col. Nelson Michael, the big boss over at MHRP, was a co-author with Dr. Kim. Those guys are brilliant.

The Thai research units recruit & screen the volunteers, administer the vaccines, take blood and do follow ups. All the key research is done at facilities in the USA.

They are doing the recruiting at Bang Lamung Hospital in Chonburi. Its a small 90 bed public hospital so you may have to sit with the great unwashed.

Respect, anyone making a positive contribution to this war deserved recognition.

[TinoThailand]

Yea Thailand want also to be seen I guess on this subject and many more.

However will they ever cure HIV/AIDS? With all the money going onn in it + bennefits for i dont know how many people. I'm sure it's a lot. Would you throw this away as fast as you can when you create the right booz?

Not in a money world... Where do you live?

[anterian]

How do they test the effectiveness of the vaccine, do they supply the test subject with a number of infected sexual partners?

[geriatrickid]

If anyone wants to send a thank you note to the USA and the US Army, for providing most of the funding, feel free to send it to the US Military HIV Health Research Program in Bethesda Maryland.

The results of the RC144 immunity mechanism lab studies published in the NEJM in April provided the first signs of hope in many years. Again, you can send your thank you note to Col. Jerry Kim of the MHRP. Col. Nelson Michael, the big boss over at MHRP, was a co-author with Dr. Kim. Those guys are brilliant.

The Thai research units recruit & screen the volunteers, administer the vaccines, take blood and do follow ups. All the key research is done at facilities in the USA.

They are doing the recruiting at Bang Lamung Hospital in Chonburi. Its a small 90 bed public hospital so you may have to sit with the great unwashed.

i wish i could agree with everything you wrote but i can't. the blood tests are being done here as well as the analyses. so that qualifies that most, if not all, of the key research is NOT being done in the US. i work across AFRIMS and know a handful of people that worked on the RV144. nevertheless, i do thank the US for funding and providing their research expertise.

Yes antibodies are tested. So what? They do western blots in Uganada too. It was Dr. Bart Haynes team at Duke University's vaccine research center that was instrumental in doing the analysis along with Dr. Kim's team at Walter Reed that came up with the mechanism and identified the factors. I stand by my position that the key research, the "turning points" originate at US facilities. Congrats on working for AFRIMS. I direct you to your own press release, where not a word is mentioned about Thailand. I do however, owe an abpology to the Bill and Melinda Gates Foundation for not acknowledging its strategic funding..

The RV144 laboratory research was initiated and coordinated by the U.S. Military HIV Research Program at the Walter Reed Army Institute of Research, which receives funding from The U.S. Army Medical Research and Materiel Command and the Division of AIDS, NIAID, NIH. These studies were conducted by a large international collaboration led by the Center for HIV/AIDS Vaccine Immunology (CHAVI), which Dr. Haynes directs and is funded by the National Institute of Allergy and Infectious Diseases (NIAID)/National Institutes of Health (NIH), and by the Collaboration for AIDS Vaccine Discovery, which is funded by the Bill & Melinda Gates Foundation. The Statistical Center for HIV/AIDS Research and Prevention (SCHARP) at the Fred Hutchinson Cancer Research Center conducted the statistical design and analyses.

[geriatrickid]

Could be interpreted as US uses Thai people for drug research .

Would that be because of altruism, because it is cheaper in Thailand than the USA or because the tests would leave them open to law suits in the US or because the tests may not even be legal in the US?

Or am I just being cynical?

Could be, but not the case. You need to look at the history as to why Thailand was selected as the major clinical trial venue. Back in the 90's Thailand was at risk of a catastrophic HIV epidemic that had the potential of wiping out two generations. It was intense. It was also a country where HIV was also evident in the heterosexual population and where the researchers had the government's support to deal with the crisis. Unlike other regions with a similar health crisis, Thailand was a relatively safe venue for western scientists. It had a communication and logistics support base and a pool of support staff to draw upon. There were health facilities. As well, it was close to regional scientific hubs in Japan, Singapore and Australia. India and China were closed to the international health researchers and Africa was just too dangerous and too frustrating to get much done. Thailand offered the perfect clinical trial subject pool as every year it had a large number of young males conscripted into the military. This allowed large sample sizes to measure who was sero positive. The wide scale testing possibility is what originally made Thailand the place to be.

Now fast forward, the HIV clinical trials are part of the payback to Thailand for its early support of the research. There is a tacit understanding that Thailand is to be first on the list when new treatments are to be considered. This is only fair considering that Thailand helped make the research possible.

In respect to litigation, you should be aware that lawsuits would be brought in the USA. This is what happens now. You might want to look at what some of the large pharma companies are facing in India. The involvement of the USA makes the clinical trials more likely to conducted in an ethical and appropriate manner. There are only two other jurisdictions in the world that have tougher ethical and legal requirements; Germany and the Netherlands. (The Swiss run a tight shop too.)

The use of Thailand is a best fit because of the large pool of people at risk and the existing infrastructure that allows for testing and data gathering. It is the ideal place to test for a vaccine, although the results will be skewed towards results in "asians". Drugs and vaccines work on different "ethnic" groups. The immune mechanisms identified from the Thai research can be applied for the benefit of other groups though. One of the reasons why the former east bloc countries are now popular for some clinical trials is because of the genetic profiles they offer. It's why India is popular for testing diabetes treatments. Clinical trials have specific specimen needs and an HIV vaccine trial is the right fit for Thailand. It is also why Thailand also sees so much funding for malaria research, even though malaria is more of a problem in Africa.

The fact is that the researchers cannot find the large numbers of people they need for a trial like this in the EU or North America.

Edited May 12, 2012 by geriatrickid

[Nomad97]

Thank you for your excellent and well informed comments on such an important subject. Makes for some very interesting reading.

[GentlemanJim]

Could be interpreted as US uses Thai people for drug research .

Would that be because of altruism, because it is cheaper in Thailand than the USA or because the tests would leave them open to law suits in the US or because the tests may not even be legal in the US?

Or am I just being cynical?

Could be, but not the case. You need to look at the history as to why Thailand was selected as the major clinical trial venue. Back in the 90's Thailand was at risk of a catastrophic HIV epidemic that had the potential of wiping out two generations. It was intense. It was also a country where HIV was also evident in the heterosexual population and where the researchers had the government's support to deal with the crisis. Unlike other regions with a similar health crisis, Thailand was a relatively safe venue for western scientists. It had a communication and logistics support base and a pool of support staff to draw upon. There were health facilities. As well, it was close to regional scientific hubs in Japan, Singapore and Australia. India and China were closed to the international health researchers and Africa was just too dangerous and too frustrating to get much done. Thailand offered the perfect clinical trial subject pool as every year it had a large number of young males conscripted into the military. This allowed large sample sizes to measure who was sero positive. The wide scale testing possibility is what originally made Thailand the place to be.

Now fast forward, the HIV clinical trials are part of the payback to Thailand for its early support of the research. There is a tacit understanding that Thailand is to be first on the list when new treatments are to be considered. This is only fair considering that Thailand helped make the research possible.

In respect to litigation, you should be aware that lawsuits would be brought in the USA. This is what happens now. You might want to look at what some of the large pharma companies are facing in India. The involvement of the USA makes the clinical trials more likely to conducted in an ethical and appropriate manner. There are only two other jurisdictions in the world that have tougher ethical and legal requirements; Germany and the Netherlands. (The Swiss run a tight shop too.)

The use of Thailand is a best fit because of the large pool of people at risk and the existing infrastructure that allows for testing and data gathering. It is the ideal place to test for a vaccine, although the results will be skewed towards results in "asians". Drugs and vaccines work on different "ethnic" groups. The immune mechanisms identified from the Thai research can be applied for the benefit of other groups though. One of the reasons why the former east bloc countries are now popular for some clinical trials is because of the genetic profiles they offer. It's why India is popular for testing diabetes treatments. Clinical trials have specific specimen needs and an HIV vaccine trial is the right fit for Thailand. It is also why Thailand also sees so much funding for malaria research, even though malaria is more of a problem in Africa.

The fact is that the researchers cannot find the large numbers of people they need for a trial like this in the EU or North America.

See, when you stay out of politics you are a grade A poster !! Seriously!

[prvtdetdave]

It is my feeling they want to find a treatment not a cure.

Like cancer; HIV treatment, patient care and research are big business.

A cure puts many out of work and reduces revenue intake for hospitals, pharmacuticals, practioners and the service industries that surround it.

[Docno]

How do they test the effectiveness of the vaccine, do they supply the test subject with a number of infected sexual partners?

Usually they select subjects who are are HIV negative but who are married to (or in relationships with) HIV positive individuals.

[Docno]

Deeply suspicious of this research.....actually more so of the reporting.

Why? And why are TV participants such a suspicious bunch... see this in almost every thread

[Bagwan]

It is my feeling they want to find a treatment not a cure.

Like cancer; HIV treatment, patient care and research are big business.

A cure puts many out of work and reduces revenue intake for hospitals, pharmacuticals, practioners and the service industries that surround it.

How very cynical but I fear probably accurate, particularly if by 'they' you mean the bosses of large pharmaceutical companies. It goes without saying that private Thai hospitals are in the same boat.

I am not at all surprised that it is the US that is blowing its own trumpet again. The reality is that scientific research is carried out all over the World and knowledge gained is usually knowledge shared with all others in particular specialisations. The UK gave all it had on penicillin to the US early on during WW2 because only there could further research and mass production facilities be provided. The availability of penicillin saved the lives of thousands of war casualties. It was a Frenchmen who isolated and identified the HIV virus and my source for this snippet is a close friend of his who runs a charity clinic in Pattaya and who provides first class effective treatment to HIV patients at a fraction of the cost of private hospitals. Eminent scientists are attracted to the US because only there is the money available to pay for for the research facilities that they need. I wonder how many foreigners (or, this being Thailand, aliens) form part of these two US led teams. The deputy mayor of Huntsville, Alabama where much research work for NASA is carried out, once said to me that although Americans had walked on the Moon, it was Europeans who were largely responsible for that. All we did was provide the money he added; he said the town population was a veritable melting pot of nations.

In all my many visits to the US I have found the population open hearted and generous to a fault, but the'big boys' are all too quick to claim much of the credit for many advances and inventions. According to Hollywood the US won WW2 almost single handed and what makes that more risible is that Big John Wayne appears in many as the hero while the reality is he wriggled his way out of serving in the US Armed Forces. I understand that many former members of USMC revile the vainglorious imposter.

I am not anti American or wish to appear to kick them to death, but I do wish that the country as a whole, or rather their leaders and opinion makers, were more honest and appreciative of others. Many of their trite announcements smack of propaganda unfortunately. No man is an island, nor is any country.

[happysanook]

Not sure what's allowed here anymore, but here are a couple of excellent links regarding HIV... one specifically dealing with the Thai study and it goes into the particulars of how and why the vaccine worked for many.

http://healthland.time.com/2012/04/05/study-explains-how-the-first-effective-hiv-vaccine-worked/

this next article is about a man who received a bone-marrow cell transplant from a donor who is immune to HIV (1% of Caucasians are immune) and it cured him of HIV.

http://sanfrancisco.cbslocal.com/2011/05/16/apparent-immunity-gene-cures-bay-area-man-of-aids/

[Chopperboy]

Excellent HIV infection & replication animation -

This video is for an experimental drug which causes HIV's DNA to mutate at a rate that it can't support.

[media=]http://www.youtube.com/watch?v=YjYyTo5vEsw

[geriatrickid]

It is my feeling they want to find a treatment not a cure.

Like cancer; HIV treatment, patient care and research are big business.

A cure puts many out of work and reduces revenue intake for hospitals, pharmacuticals, practioners and the service industries that surround it.

How very cynical but I fear probably accurate, particularly if by 'they' you mean the bosses of large pharmaceutical companies. It goes without saying that private Thai hospitals are in the same boat.

I am not at all surprised that it is the US that is blowing its own trumpet again. The reality is that scientific research is carried out all over the World and knowledge gained is usually knowledge shared with all others in particular specialisations. The UK gave all it had on penicillin to the US early on during WW2 because only there could further research and mass production facilities be provided. The availability of penicillin saved the lives of thousands of war casualties. It was a Frenchmen who isolated and identified the HIV virus and my source for this snippet is a close friend of his who runs a charity clinic in Pattaya and who provides first class effective treatment to HIV patients at a fraction of the cost of private hospitals. Eminent scientists are attracted to the US because only there is the money available to pay for for the research facilities that they need. I wonder how many foreigners (or, this being Thailand, aliens) form part of these two US led teams. The deputy mayor of Huntsville, Alabama where much research work for NASA is carried out, once said to me that although Americans had walked on the Moon, it was Europeans who were largely responsible for that. All we did was provide the money he added; he said the town population was a veritable melting pot of nations.

In all my many visits to the US I have found the population open hearted and generous to a fault, but the'big boys' are all too quick to claim much of the credit for many advances and inventions. According to Hollywood the US won WW2 almost single handed and what makes that more risible is that Big John Wayne appears in many as the hero while the reality is he wriggled his way out of serving in the US Armed Forces. I understand that many former members of USMC revile the vainglorious imposter.

I am not anti American or wish to appear to kick them to death, but I do wish that the country as a whole, or rather their leaders and opinion makers, were more honest and appreciative of others. Many of their trite announcements smack of propaganda unfortunately. No man is an island, nor is any country.

Your assessment is incorrect.

The HIV research here has nothing to do with big pharma. It is funded by public agencies and charitable foundations The public announcements are not the USA blowing its own horn, but are low key statements made in conjunction with peer reviewed research.

There is an obligation for all research facilities to provide updates and news releases. it is called accountability. There is also a need to remind people of the advances otherwise funding can and will be cut.

Yes, research is carried out all over the world and knowledge is shared. Individual components of discoveries are indeed established in multiple countries. The USA still has the largest and best funded research facilities. This doesn't mean that other countries don't have it. However, R&D goes hand in hand with universities. If countries do not have the educational facilities, then they are not going to be delivering on new scientific discoveries. Although, funding has been cut in the past decade, the USA still has a legacy of R&D infrastructure that's at the top of the heap. Many of those scientists come from other countries or are the offspring of immigrants.

At one time Russia had a core of R&D too, but look at what happened to the Russian scientists. Disrespected, underfunded and not appreciated. The result was a brain drain to the EU, Israel and North America. South Africa had a cadre of brilliant scientists, but political instability caused brain drain. Israel loses its best scientists to the USA because they can't stand the work environment. The tax situation in the UK drives the brightest scientists away. Why should they stay when they are punished with high taxes and a bureaucracy that induces head banging. The only places that manage to retain their scientists are China and Japan. BTW, how is it that China with a growing and serious HIV epidemic can fund its expansionist military, but is unable to fund its HIV researchers? One would think that China with all of its assets would be contributing more. It is not.

You refer to Penicillin. Yes, Alexander Fleming played a pivotal role. However, I suggest you look at the actual history of the drug. French, Italians, and others were instrumental. The discovery by Fleming was an accident. The moldy cantelope found in Peoria, Illinois that allowed the mass production of Penicillin is another example of fortuitious events. Everyone hears this tale in introductory pharmacology. Are you aware, that there are a number of historians that are of the opinion that Fleming took advantage of other's unpatented research?

The fact remains that in this matter, the funding is for the most part provided by the USA and the pivotal research was at US facilities.

[cowslip]

I read some very poor reviews of the Thai trials - but now mysteriously they don't come up in any searches.

One really has to see the peer reviews before jumping to any conclusions about the claims. Furthermore the PRESS are notoriously incompetent at reporting these sort of things correctly.

Anything the US army is involved in one should be deeply sceptical of the ethics too. These are the people who were withholding treatment of black US citizens with Syphilis in trials that lasted til the 1970s

[flying]

How do they test the effectiveness of the vaccine, do they supply the test subject with a number of infected sexual partners?

Usually they select subjects who are are HIV negative but who are married to (or in relationships with) HIV positive individuals.

Having just read this I would guess you are correct.

But also thinking about that I wonder how they can claim it is effective at all?

I mean I would guess as you do that the test subjects would be as you stated.

But if so then the one partner knows they are infected with HIV & most likely on the antiviral drugs.

So their viral level would probably be low or undetectable.

They would almost have to test this against someone with a high viral level wouldn't they?

I remember years ago a report...Swiss I think?....that stated it was near impossible for a male to get

infected during normal sex with a HIV+ woman on antivirals. I do not know if it was proven to be true or not.

But I have read folks on antivirals tend to have very low to undetectable viral levels.

I think it is great they are working at least on a vaccine but curious about the testing.

[cowslip]

How do they test the effectiveness of the vaccine, do they supply the test subject with a number of infected sexual partners?

Usually they select subjects who are are HIV negative but who are married to (or in relationships with) HIV positive individuals.

Having just read this I would guess you are correct.

But also thinking about that I wonder how they can claim it is effective at all?

I mean I would guess as you do that the test subjects would be as you stated.

But if so then the one partner knows they are infected with HIV & most likely on the antiviral drugs.

So their viral level would probably be low or undetectable.

They would almost have to test this against someone with a high viral level wouldn't they?

I remember years ago a report...Swiss I think?....that stated it was near impossible for a male to get

infected during normal sex with a HIV+ woman on antivirals. I do not know if it was proven to be true or not.

But I have read folks on antivirals tend to have very low to undetectable viral levels.

I think it is great they are working at least on a vaccine but curious about the testing.

The ethics testing procedures etc., will be laid out on the web site....if you can make head or tail of them.