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1996-01-30
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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).