Anthony Fauci on the Great HIV-LYMErix Screw-Up (New)
Mort Zuckerman
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Subject: Anthony Fauci on the Great HIV-LYMErix Screw-Up (New)
Date: May 17, 2010 6:54 PM
ARTICLE BELOW
====================
Indeed. Had Yale and the ALDF.com
gang told the truth about LYMErix
we would have not lost, what, at least
10 years in discovery in all major
illnesses: Lupus, Cancer, MS, ALS,
HIV, Tuberculosis,...
HIV-Pam3Cys-LYMErix:
http://www.actionlyme.org/Pam3Cys_Version15.htm
HIV gp120/41 = Pam3Cys:
http://journal.kcsnet.or.kr/main/j_search/j_download.htm?code=B961118
Fauci is a dang foo and should
be fired. He lied about LYMErix
to the American Public on the CNN
Lou Dobbs show:
http://www.actionlyme.org/The_Fauci_Files.htm
KMDickson
http://www.actionlyme.org
========================
http://www.medscape.com/viewarticle/721410?sssdmh=dm1.617281&src=confwrap&uac=9137PK
May 7, 2010 (Bethesda, Maryland) — HIV vaccine research is diverging
from classic vaccinology and its focus on the adaptive immune
response, to a field of its own. There has been a shift from
protecting against infection to changing the nature of the infection,
Anthony Fauci, MD, director of the National Institute of Allergy and
Infectious Diseases (NIAID), in Bethesda, Maryland, said in his
keynote address here at the National Foundation for Infectious
Diseases 13th Annual Conference on Vaccine Research.
The principles of classic vaccinology are that "the response to
natural infection is the guidepost to the vaccine. . . . The proof of
concept is already done for us by the natural response to
infection. . . . The vast portion of people spontaneously recover," he
said.
"The virus is cleared and eradicated and the person is left with a
protective immunity that, in most cases, is complete and lifelong."
But beginning with the gp160 trial in 1987, researchers quickly
learned that the principles of classic vaccinology "didn't apply
particularly well to HIV. . . . I've been taking care of HIV-infected
individuals for almost 29 years and I have never seen anybody
eradicate the virus or spontaneously recover," Dr. Fauci said.
"And protective immunity against subsequent infection doesn't appear
to occur. That is amazing. You are infected with a microbe and, while
you are infected, you get reexposed to the microbe and you get
reinfected. That is depressing for vaccinologists."
"There is no proof of concept to help us. We really have to start from
scratch," he said. Basic research has been able to generate a few
antibodies that are broadly neutralizing to laboratory strains of HIV,
but not to wild-type virus, Dr. Fauci noted.
Once these facts began to sink in, the field shifted toward developing
a vaccine that would not protect against infection but that might
shift the course of disease progression to one that is less lethal,
perhaps even benign. The public health goal of reducing transmission
might be accomplished by lowering the viral load of those who are
infected. "Those attempts, thus far, have not been successful," Dr.
Fauci said.
STEP Back
The early stopping of the STEP trial, which was testing an HIV vaccine
developed by Merck with the support of NIAID, led the field to another
reevaluation. The mix of basic and developmentally oriented research
was recalibrated back toward the former.
Then came the Thai study (RV144) "using a pox virus vector and an
envelope boost, which, when you looked immunologically, had virtually
none of the classical parameters that would predict protection.
[Cytotoxic T lymphocytes] were nowhere to be found; neutralizing
antibody, nowhere to be found," Dr. Fauci said.
But "for the first time we found a modest, weak, but real signal of
prevention of acquisition," he said. "There was no doubt that the
Kaplan–Meier curves were separated. We now had a weak signal upon
which to build."
The fact that the vaccine had no effect on the viral load of those who
became infected confounded the expectations of many, but not Dr.
Fauci.
"I think it argues for the dichotomy of effect on acquisition vs the
control of chronic viral infection. It is telling us something that
perhaps we should have realized a long time ago — an immune response
that protects against acquisition might be quite different from the
immune response that actually controls chronic virus replication."
"What we have now is a whole new way of looking at things. . . . We
really know what is going on and what is needed."
He sees the way forward as building on the empiricism of the RV144
trial while, at the same time, pursuing the fundamental issues of
basic research.
Dr. Fauci is not sure that it will be possible to isolate correlates
of protection from acquisition from the small number of infections in
the Thai trial, "but it certainly will tell us what they are not. And
what they aren't is 750 ELISPOTS on an assay. What they aren't is
broadly cross-reacting neutralizing antibodies. . . . It may be that
they are important, but they are not a requirement."
Different Virus
"As scary and dangerous as HIV infection is, it is a very
inefficiently transmitted infection. One of the reasons is that there
is a bottleneck to transmission." It has become apparent that "the
transmitting virus might be quite different from the chronic
replicating virus."
The transmitting virus appears to have a unique hypoglycosylated
molecular signature that, surprisingly, appears to be easier to
neutralize than variants found later in infection. However, once
infection is established, the virus rapidly diversifies with
conformational changes and the addition of glycands that can shield
antibody binding sites, and the virus evades immune control.
Dr. Fauci pointed to the work of Dennis Burton, showing that "when
looking at acquisition, you really need low levels of neutralizing
antibody, much lower than you would have predicted" from the study of
established infections. "There is a direct correlation between the
ease of neutralization of a transmitting virus [and] the virus that
has been replicating for years."
He added that "as the quasi-species develops, the virus diverges. The
further you are from infection, the more divergent the virus is; the
closer you are to the initial infection, the more homogeneous the
virus is."
"Once the virus robustly replicates and gets into the lymphoid tissue,
for all practical purposes, the ballgame is over for a vaccine. No
matter what we do, you don't eradicate the virus. . . . The focus
really needs to be on blocking acquisition. That is the end game."
It is why he is focusing on very early events, far earlier than the
adaptive immune system is capable of reacting to.
Dr. Fauci indicated that, taken together, the cytotoxic T lymphocyte
response will play, at best, a small role in future research toward a
preventive vaccine. It might have some role in immunotherapy for HIV
disease, but his comments on the effectiveness, tolerability, and cost
of available small-molecule drugs create a high bar in moving HIV
immunotherapy from basic research into regular clinical practice.
Dr. Fauci has disclosed no relevant financial relationships.
National Foundation for Infectious Diseases (NFID) 13th Annual
Conference on Vaccine Research: Session 8. Presented April 27, 2010.
[CLOSE WINDOW]
Authors and Disclosures
Journalist
Bob Roehr
Bob Roehr is a freelance writer for Medscape.
"[Real] scientists are *fiercely* independent. That's the good
news."-- NIH's Top Fool, Anthony Fauci