Document 0196
 DOCN  M9610196
 TI    Potential impact of low efficacy HIV-1 vaccines in populations with high
       rates of infection.
 DT    9601
 AU    Anderson RM; Swinton J; Garnett GP; University of Oxford, Department of
       Zoology, U.K.
 SO    Proc R Soc Lond B Biol Sci. 1995 Aug 22;261(1361):147-51. Unique
       Identifier : AIDSLINE MED/96047959
 AB    A safe and effective HIV vaccine to prevent infection and/or to moderate
       disease is urgently needed. Research progress has been slower than
       anticipated for a variety of reasons including uncertainty over which
       immunogen to use (i.e. recombinant subunit envelope proteins or whole
       HIV-1 products), confusion on which immunological markers best correlate
       with protection, the relevance of the HIV-1 chimpanzee model to
       infection in humans and the significance of the rapid evolution of
       HIV-1, with different clades of the virus emerging in different parts of
       the world. However, what some would interpret as encouraging results,
       from Phase I and II trials of recombinant envelope glycoprotein
       vaccines, have raised the question of whether the time is right to start
       Phase III trials in humans with immunogens that may have low to moderate
       efficacy. By using mathematical models and data from epidemiological
       studies, we examine the potential impact of such vaccines within
       heterosexual communities with high rates of infection. Analyses suggest
       that it will be difficult to block HIV-1 transmission even with very
       high levels of mass vaccination. The cost of sustaining high levels of
       herd immunity with a vaccine of short protection duration is likely to
       be high. However, assessments of impact over the long duration of an
       HIV-1 epidemic indicate that many cases of HIV infection and associated
       mortality can be prevented by immunogens with efficacy of 50% or less
       and a five year protection duration.(ABSTRACT TRUNCATED AT 250 WORDS)
 DE    Animal  AIDS Vaccines/*PHARMACOLOGY  Chimpansee troglodytes  Clinical
       Trials, Phase I  Clinical Trials, Phase II  Clinical Trials, Phase III
       Female  Human  HIV Infections/EPIDEMIOLOGY/*PREVENTION &
       CONTROL/TRANSMISSION  HIV-1/*IMMUNOLOGY  Male  Models, Theoretical
       Pregnancy  Pregnancy Complications, Infectious/EPIDEMIOLOGY/PREVENTION &
       CONTROL  Prostitution  Support, Non-U.S. Gov't  Time Factors  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).