The non-elixir disease, Human Immunodeficiency Virus[HIV] is steeping gradually. India itself estimates that about 2.4 million Indians are having HIV, while 83% are in the age group of 15-49 where 39% (around 930,000) are among women. This epidemic is largely concentrated in only a few states it accounts for around 55% of all HIV infections in the country. However, according to the latest census, there is a notable declining trend in adult HIV. Even though, Historically low-risk states such as Orissa, Kerala, Chandigarh, Jharkhand, Jammu and Kashmir, Meghalaya show a spike in adult HIV infection in the past four years. According to India’s National AIDS Control Organization [NACO], the bulk of HIV infections in India occur during unprotected heterosexual intercourse and by injecting drug use with contaminated injecting equipment. Recent studies show that there is a rise in the number of cases in gay or bisexual men. So far there is no preventive vaccine for AIDS exists.
AIDS VACCINES SO FAR
As the first case of Acquired immunodeficiency syndrome [AIDS] reported in 1980, for decades now researchers are working to come up with a vaccine against HIV which are safe, affordable, long-lasting, and with an effective immune response. The first large-scale HIV vaccine trial of AIDSVAX began in North America and Netherland(1998). By involving 5,400+ volunteers, with a history of high-risk behavior such as using drugs via injection and having sex with multiple partners, or having sexually transmitted infections but results were not that effective. Later various vaccine regimen such as LVAX003, HUTN 505, RV 144 trailed worldwide. However, among all these RV144 were effective but not effective enough as predicted. Thus, immunization was stopped due to the lack of efficiency.
Interactive sessions and addressing blood safety being effective to an extent though it’s not a permanent solution for this highly virulent virus. The success of active immunization against other infectious diseases such as smallpox makes immunization an attractive approach to prevent HIV infection.
- The lack of understanding of the mechanism of HIV-I [most common].
- The magnitude of genetic variation of the virus mutates very rapidly.
- The lack of effective animal models of HIV-I infection making the testing of the vaccine challenge.
- HIV has a long-dormant period so the infection progresses to AIDS by then so the vaccines are only for disease not for infection.
- Most vaccines are effective for viruses that enter through respiratory or gastrointestinal systems whereas. HIV is something that spread through body fluids or directly through blood itself.
- Weakened or killed HIV vaccine is not at all effective to produce an immune response in the body through any life form would be dangerous.
An Effective Vaccine for AIDS
The MOSAIC VACCINE, a new preventive vaccine that is more effective than the previous models created from the genes of different HIV strains. It is designed to protect against multiple types of HIV clades and the results are more promising so far. From the studies so far, the Mosaic vaccine is almost 31% more effective than RV144. One of the drawbacks is this vaccine has 6 jabs to complete the course and to produce an effective immune response.
There are different phase trails for a vaccine first trail is in animals in small dose if it safe and have the ability to produce beneficial immune response then it moves on to testing in humans. The Mosaic vaccine is currently under the second phase called IMBOKODO where around 2,600 volunteers are involved who are newly infected with HIV. The third phase called MOSAICO where the phase is improved by adding a protein to the vaccine which makes it more effective to use. If the vaccine regimen came out safe and successful that will be suitable for the global population. The completion of the trial is expected by 2023.
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At the time when the deadly virus somewhat unheard of in India, the first case of AIDS got reported in the U.S. It was only in 1986 where Dr. Yusaf Hameed an Indian scientist associated with one of the leading pharmaceutical companies called CIPOLA start manufacturing the drug ZIDOVUDINE (AZT) was the only effective and available drug back then. Later he came out with a combination of 3 drugs known as Highly Active Anti Retroviral Therapy(HAART) and NEVIRAPINE which limit the transition of disease from mother to the child was very effective for AIDS but it was not at all affordable for the Indian population. Through constant protests and struggles medication came out to be affordable and India starts exporting the life-saving medication to the much-needed countries.
The urgent need for a safe, affordable, and effective vaccine was and still is the concern. In India, leading institutions like ICMR, NACO, and IAVI have been intensely involved in AIDS vaccine development. The Insufficient funding allotted to the vaccine development and the difficulty to initiate a trial being the biggest concern for India being a developing country. There are only two vaccines that successfully completed the phase 1 trial. Adeno-associated virus(AAV) based vaccine (tgAACO9) and Modified Vaccine Ankara(MVA) were the preliminary results that had a satisfactory 100% immunogenicity.