The Argentine who leads the race for the HIV vaccine: “It is a combination of doses that gives protection”

“I am a product public educationfrom kindergarten to college. Also my research to learn how to prevent it diseases for the virus human immunityHIV, and shame which is due to support from Stateboth in the Argentina as in the United States“, says the renowned scientist and expert in immunology Cesar Boggiano.

Since last August, Boggiano the vaccine research program director within the AIDS Division of the National Institutes of Health, located in Bethesda, Maryland, United States.

From that position, Dr. Boggiano – who studied Biology at the Faculty of Direct and Natural Sciences at the University of Buenos Aires, Argentina – overseeing a staff of over 40 professionals and a portfolio of more than 364 million dollars that “are invested in subsidies to carry out preclinical and clinical research, contracts and clinical trials, as well as overseeing the HIV Vaccine Trials Network,” he explains in an exclusive interview with Infobae.

It aims to direct funds to develop better and more accessible tools to prevent HIV and tuberculosis.

All over the world, yes 39.9 million people are living with HIVbut almost a quarter (9.3 million) are not receiving the life-saving treatment, according to the latest report from For him. As a result, one person dies every minute from AIDS-related causes.

Regarding the spending, 10.6 million people worldwide The bacteria that cause this disease took effect in 2022. In the same year, 1.3 million people died from tuberculosis (among them, 167,000 people with HIV, who had a co-infection).

Today, tuberculosis is the second deadliest infectious disease after COVID-19 and ahead of HIV and AIDS, according to the World Health Organization.

During the conversation with Infobaethe scientist Boggiano told the challenges of getting a protective vaccine, after more than 40 years since HIV was described.

“The research history for the development of HIV vaccines spans nearly four decades. Different methods were used,” he said. “I started my career as a scientist by discovering these vaccines. Today I have the honor and the responsibility direct investments to design, produce and test vaccine candidates not only in the United States, but also in other countries,” he said.

At first, the work focused on the strategy with antibodies with neutralizing functions with the idea that they would be able to prevent the virus from entering the cells. Several attempts have been made, but so far none worked.

“This is the life of a scientist. We eliminate what doesn’t work and are always looking for new ideas for future evaluation. laboratorythen enter animals and finally in clinical trials in human volunteers,” he said.

“Most vaccines prevent serious disease and not disease. On the other hand, with HIV, that window of opportunity is much smaller. Because you have to first prevent the person from getting infected with HIV and to establish the reservoir virus. The pathogen enters CD4 cells, integrates into the nucleus and thus creates a virus reservoir. “It is very difficult to kill these cells with the virus,” he said.

For this reason, he explained, “we must vaccines that work very quickly and to prevent it “The virus enters people’s cells. “

In January 2023, phase 3 of the MOSAIC STUDIOwho evaluated the efficacy and safety of a regimen of 2 vaccines against HIV in more than 50 centers in 8 countries, including Spain, Argentina, Mexico, Peru and Brazil.

This measure was decided upon by an independent review committee that scheme was not effective to prevent infections compared to the placebo group, although the experimental vaccine was generally safe and well tolerated.

Another reason that vaccine development is slower is that a a significant difference of HIV in each person. He also has potential rapid change. These are some of the factors that make it very difficult to stimulate the human body’s immune system to develop a successful and sustainable response.

But the race continues and Boggiano follows the progress minute by minute. “Today we are evaluating 22 products as part of the development of new vaccines for HIV prevention. Each cannot be said to be a vaccine in itself, but based on current knowledge, it is likely that, in the future, a a variety of vaccine doses with different structures that could protect people,” he said.

He explained what the goal is: “We are trying to develop an HIV vaccine that is effective, safe and affordable. Although today the treatment is used as prevent “Effectively, there is still a need for a vaccine that can provide longer protection and increase population maintenance.”

The main strategy for vaccine development is to introduce “broad spectrum neutralizing antibodies“, he said. This is a group of antibodies that can recognize many types of HIV and prevent them from entering healthy cells. These antibodies can activate other cells to help destroy HIV-infected cells.

The ongoing projects are based on studies carried out with animal models and on two randomized trials of neutralizing antibodies to prevent HIV acquisition, which were. published in the journal New England Journal of Medicine.

“We know that it can neutralize broad-spectrum antibodies prevent HIV infection “If the circulating virus strains are susceptible,” he said. When these antibodies naturally formedthat is, without vaccination, in people with HIV, they come from a very small number of B lymphocytes.

Considering the uniqueness of what happens in a group of people with HIV, researchers are working on ways to get them through a vaccine.

Recently, a group, working with a subsidy from the National Institutes of Health, Bill & Melinda Gates Foundation, Alexander von Humboldt Foundationamong other institutions, did a publication in the journal Natural science.

“Vaccination requires several steps to expand these few lymphocytes and train them to become highly effective antibody producers. Each step may require vaccination vaccine that is slightly different from the previous one. It’s not the dose that changes, but the structure of the portion of HIV that we give to the immune system to help it produce these superantibodies,” he said.

“Each of the 22 products is designed to stimulate and amplify parts of the immune system with the ability to prevent HIV infection (such as stimulating the production of B lymphocytes that produce antibodies) or of already infected cells by stimulating cytotoxic T cells. The results could be part of a complex vaccine management, which multiple vaccinations would be required to provide protection. What is called a heterologous scheme“, said.

In addition, among the products under evaluation, vaccine candidates with proteins with adjuvants and immunogens are expressed that use Messenger RNA, DNA and viral vectors. This means that they are exploring a range of options.

In terms of consumption, for more than 100 years there is a vaccine against the bacillus that causes the disease and is known as BCG. It is applied to babies and children.

The program led by Boggiano – which is located within the institute that until last year was led by the doctor and former medical adviser of the United States Anthony Fauci – subsidizes clinical studies on three products in the United States and other countries.

“The products we are evaluating for use with tuberculosis different platforms to stimulate the immune system. One uses proteins with helpers, another a viral vector and the last one is a reduced pathogen, a strategy developed in Spain,” he said.

“We are also subsidizing the design and development of other vaccines with new immunogens and adjuvants,” he said, “which are being evaluated in animal models and have not yet been tested in clinical studies. “

Tuberculosis is also a concern for people living with HIV: they are 16 times more likely to get the bacillus than people who do not have the virus.