N.C. becomes center of HIV fight

The International AIDS Vaccine Initiative joins the Center for HIV/AIDS Vaccine Immunology at Duke in the search for a vaccine

The world's hope of beating HIV centers on a team of Triangle-based scientists.

The Center for HIV/AIDS Vaccine Immunology, headquartered at Duke University and drawing on researchers at Duke, UNC-Chapel Hill and more than 30 other universities, formed in 2005. This week, the center announced it will add even more brainpower with the addition of an international research consortium, signaling the mounting pressure to discover a vaccine.

The center and a privately funded research group, International AIDS Vaccine Initiative, agreed to cooperate, saying that the moral obligation to find a vaccine is too pressing for anyone to work alone.

"Competition retards work in this field," said Dr. Barton Haynes, the center's director and professor of medicine at Duke University Medical Center. "It's no longer ethical to do anything but move forward on this disease as fast as we possibly can because of the human cost."

The groups agreed to share virus samples and laboratories, and launch parallel studies. The center is particularly anxious to gain access to the Vaccine Initiative's large sample pool of the virus to get better reads on its mutations.

Such collaboration is unprecedented. It's also imperative, Haynes said.

"The science is daunting," said Haynes. "The bug had escaped and eluded us so many times. It's pretty audacious."

For nearly 25 years, HIV has outwitted scientists trying to stop the spread of the virus that causes AIDS. The latest setback: a vaccine that not only didn't work, it appeared to make otherwise healthy patients more likely to contract HIV.

Two trials tested the vaccine, drawing on participants in North and South America, the Caribbean, Australia and South Africa.

Each was to have 3,000 participants. When researchers noticed the troubling results in one of the trials last fall, clinicians halted the other study.

Back to basics

Haynes said the new mission is an old one: Tackle basic questions about the virus, which killed 2.1 million people worldwide last year.

Scientists at the center are working to better understand what's happening in the initial hours when HIV invades a healthy person. They are exploring genetic differences between those whose immune systems thwart the virus and those infected. Scientists have tried to get a picture of the virus in its native form so they can create antibodies to spot it.

Dr. Myron Cohen, a center leader and director of the Center for Infectious Diseases at UNC-CH, said the scientific work being done now is essential for breakthroughs to come. "It's been like putting glasses on," Cohen said. "We can finally see the face of our challenge specifically."

Even before Merck & Co. announced last month it would halt its vaccine trial, many HIV researchers were aware of the drug's shortcomings. Yet the failure still stung. Researchers mourned the money spent and the lives lost while scientists chased medicine that didn't work.

"The HIV vaccine is our holy grail," Cohen said. "We spend $1.3 billion a year. It hurts when it doesn't work."

The research community formed Center for HIV/AIDS Vaccine Immunology in 2005 after scientists realized that colleagues were refusing to share their research out of fear they'd lose funding, Haynes said.

The center, and now the new alliance with the Vaccine Initiative, forces collaboration by funneling large government, foundation and private donor block grants into a single consortium.

'Mortgaging our future'

All the while, HIV marches on. Since AIDS appeared in the early 1980s, more than 25 million have died. Last year, the virus infected another 2.5 million, according to UNAIDS, a United Nations group.

"We're scrambling," said Catherine Hankins, chief scientific adviser to UNAIDS. "We're mortgaging our future here."

In North Carolina, the number of new cases started to climb again in 2002. Last year, nearly 2,000 North Carolinians got the disease.

No one is more interested in a vaccine breakthrough than those already infected. "We don't want anyone else to go through this," said Steve Kueny, a Durham resident who has battled HIV since the early 1990s.

Over the past decade, antiviral therapies have transformed a deadly disease into a survivable one. But the same mutations that have made a vaccine so elusive also plague treatments.

Kueny relies on a combination of pills to survive. Any day, though, he could grow resistant to one or experience a debilitating side effect.

"The point is to stay alive until there's a new drug," Kueny said.