AIDS Vaccine Testing at Crossroads

Successful vaccines mimic the protection the body normally provides when confronted with a virus, bacterium or other microbe. HIV, however, mainly attacks immune system cells, which are the ones a vaccine is trying to enlist for help.

Furthermore, unlike most viruses, HIV stitches itself permanently into the DNA of some human cells after entering them. That means that if a vaccine does not provide full protection within days -- and possibly even hours -- of exposure, irreversible infection occurs.

A few people who become infected with HIV are able to survive without treatment indefinitely -- so-called elite controllers. Many non-human primates also tolerate the monkey equivalent of HIV without becoming ill. In both cases, how the immune system achieves that outcome is unknown.

"We do not have a vaccine now. . . . We are not only not there, we are not close," said James Hoxie, a researcher at the University of Pennsylvania, who summarized the view of a panel of basic researchers who spoke at the meeting.

One organization yesterday called for the money now spent on AIDS vaccine research to be used for HIV testing, treatment of HIV patients and research on the use of antiretroviral drugs to prevent infection.

"I think we should pull the plug on vaccine research," said Michael Weinstein, president of the AIDS Healthcare Foundation, a private, nonprofit group that provides treatment for people with HIV.

"Do we have any other enterprise that has been studied for 25 years and for which we've spent billions of dollars where we have no results? There's no evidence we'll ever have an AIDS vaccine," he said.

However, Mitchell Warren of the AIDS Vaccine Advocacy Coalition, who attended the meeting, praised it as the beginning of a necessary readjustment of priorities.

"We are at a critical moment in the field. We've had a tremendous setback. But this field is not abandoning the research for a vaccine," he said. "This is not the end of the line for AIDS vaccine research. That was an important point for everyone."

Several people at the meeting said that they not only support greater spending on basic research, but also that the government must be willing to fund promising, yet unorthodox, proposals, or a generation of young scientists may abandon AIDS research in favor of fields that are less challenging.

Staff writer Rob Stein contributed to this report.