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280 Regional Approach to HIV-1 Vaccine Development
M. Robb*1, N. Sewankambo2, J. Phillips3, L. Elson3, M. Wassunna4, L. Maboko5, T. Nkulila5, M. Hoelscher6, F. McCutchan3, and D. Birx1
1Walter Reed Army Inst. of Res., Washington, DC, USA; 2Makerere Univ., Uganda; 3KEMRI, Kenya; 4Henry M. Jackson Fndn., Rockville, MD, USA; 5Mbeya Regional Hosp., Tanzania; and 6Univ. of Munich, Germany
Background: International HIV-1 vaccine development presents many unique biological and political challenges. Specific evaluation of HIV vaccines on a regional basis offers scientific and practical advantages. Culture, language, health care, research infrastructure and technology, and comorbid disease burdens are often similar within a region.
Methods: Health care and research infrastructure activities and clinical cohort development protocols have been developed and are being implemented throughout East Africa specifically for HIV-1 vaccine development. Regional meetings have been conducted that explored different HIV-1 vaccines in development, molecular epidemiology, and laboratory assay development including serodiagnosis, vaccine immunogenicity assessment, and ethical conduct of clinical trials. These meetings have involved representatives from Tanzania, Uganda, and Kenya.
Results: Many of the issues arising in Uganda during cohort and vaccine development activities are also directly applicable to Tanzania and Kenya especially related to laboratory development, infrastructure development, health needs, and good clinical practices. HIV epidemics of subtype D, A, C, and recombinants of these subtypes have been identified in this region. The resulting clinical cohort development occurring simultaneously throughout East Africa has allowed more efficient transfer of technology and enhanced regional research efforts.
Conclusions: The regional approach to HIV-1 vaccine development in East Africa has provided unique data on the molecular epidemiology of HIV-1 infection in the region, but more importantly has allowed rapid clinical protocol development and conformity of risk factor evaluation. This regional approach has also facilitated the scientific exchange between researchers in the individual countries, which will support the evaluation of cross-subtype protection afforded by an HIV vaccine.
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