World AIDS Day: The Scientific Quest for the "Holy Grail" of Immunology; The HIV Vaccine
December 1st (Azar 10th), World AIDS Day, is not merely a calendar occasion to raise public awareness; for the scientific community, researchers, and vaccination specialists, it serves as a reminder of one of the greatest unresolved challenges in modern medical history. While Antiretroviral Therapy (ART) has transformed HIV from a fatal disease into a manageable chronic condition, ending the pandemic without achieving an effective and safe vaccine remains unlikely.
The First International Congress of Vaccine and Vaccination, while honoring global efforts, provides a specialized focus on the current status of HIV vaccine research and development (R&D).
Global Status and the Vaccine Imperative:
• Based on the latest reports from the World Health Organization (WHO) and UNAIDS, approximately 39.9 million people worldwide were living with HIV by the end of 2023. Although the rate of new infections has decreased, over 1.3 million people are still infected with the virus annually [1]. These statistics indicate that current prevention strategies (such as condoms and PrEP), although vital, are insufficient for eradicating the virus, making the need for a preventive vaccine more urgent than ever.
Key Point: The development of an HIV vaccine is recognized as one of the most difficult scientific projects of the century due to the virus's biological complexities.
Why Don't We Have an HIV Vaccine Yet? (Scientific Challenges)
Unlike viruses such as SARS-CoV-2 (the cause of COVID-19), which the immune system can often clear naturally, the human body can almost never eradicate HIV after the infection is established. According to articles published in Nature and the National Institute of Allergy and Infectious Diseases (NIAID), the main barriers include:
Extraordinary Genetic Diversity: HIV has a very high mutation rate and thousands of different subtypes, making it difficult to target.
Latency: The virus integrates its genome into the host's DNA, remaining in hidden reservoirs in the body.
Glycan Shield: The viral protein coat (Env) is covered with sugars that hide it from the view of antibodies.
Glimmers of Hope: Novel Technologies in Vaccine Design
Despite the failure of large clinical trials in the past (such as the Mosaico trial in 2023), the science of vaccination has entered a new era. Recent research pursued by IAVI (International AIDS Vaccine Initiative) and other institutions is focused on novel strategies:
Germline Targeting: This method seeks to activate rare B cells that have the potential to evolve to produce "broadly neutralizing antibodies" (bnAbs). The results of the Phase I clinical trial for the eOD-GT8 60mer vaccine showed that this approach could generate a desired immune response in 97% of participants.
mRNA Technology:
The success of COVID-19 vaccines has led the mRNA platform to be utilized for accelerating the design and testing of complex HIV vaccines. Several clinical trials using this technology are currently underway.
The Role of the International Congress of Vaccine and Vaccination
World AIDS Day provides an opportunity to emphasize the importance of international cooperation, data sharing, and investment in basic sciences. This Congress provides a platform for Iranian and international researchers to share their latest findings in novel adjuvants, antigen design, and vaccine delivery platforms.
We believe that the path to achieving an HIV vaccine, although long and challenging, will be achievable through reliance on science and global solidarity.