Abstract
HIV is one of the global diseases that have scientists are still researching for the cure-all over the world. HIV is a representation of the Human Immunodeficiency Virus, the pathogen that assaults the immune system of humans to cause HIV infection and AIDS. The virus was first isolated in 1983 by researchers in Pasteur Institute, France. It is mainly transmitted through contact with sexual activities. HIV can be transmitted through contacting infected blood and pre-seminal fluid, anal mucus and rectal fluid, and breast milk. This paper will briefly discuss the background of HIV, how HIV has transformed over the years, and how people cope with HIV prevalence. Since HIV was identified as declared the cause of AIDS in 1984, U.S. HHS Secretary Margaret Heckler made it public about the AIDS vaccine that would be available in two years. HIV has been around for about thirty-seven years, with researchers still working on vaccines and cures for the virus. Different organizations have come up with antiretroviral medication to temporarily suppress the effects of AIDS while constantly creating awareness on preventive measures. With the first-ever vaccine being tried out in 1988, recent results released in 2017 showed the Imbokodo Phase 2b proof-of-concept still on experimental vaccines aimed at enabling the human immune response to resist a more comprehensive range of HIV strains.
Introduction
The HIV epidemic has been in play for over thirty years, causing havoc worldwide. Right before the 1980s, it has been believed that HIV first cases were from Kinshasa, DRC, Africa at around the 1920s when the virus crossed from Chimpanzee species to the human species (McKay 2021). It is unclear how many people were infected from 1920 to 1980 when any signs or symptoms never accompanied the HIV transmissions. HIV mainly attacks the immunity of humans, weakening it to allow other diseases to take advantage of the weak immune system. The research on HIV vaccine was first released in 1987 when a clinical trial was opened by the NIH Clinical Center in Bethesda, Maryland. Different improvements and tests have been carried on since to help the immune system resist different strains of the virus. Though many sources still show that there is currently no approved vaccine by the FDA to prevent HIV, there is a sequence of events right from the 1980s to 2017 detailing the order in which other research has formulated and tested the HIV vaccine. This paper will highlight and discuss the gradual development of the HIV vaccine from 1987 to date while discussing breakthroughs and limitations. The report will also attempt to discuss some of the failures of the vaccines—the theory behind all the failures given the time that has been taken while developing the vaccine.
What is HIV, and how is it Spread?
Human Immunodeficiency Virus, popularly known as HIV, is a type of virus that weakens the immune system of humans. The human immune system is responsible for fighting off infections and diseases in the body. When the body is exposed to HIV, the immunity gradually weakens over a period rendering the body weak against pathogens causing diseases. HIV further results in Acquired Immune Deficiency Syndrome, generally known as AIDS, which frequently causes the body to get attacked with opportunistic infections due to immunity deficiency. It usually takes up to ten years for HIV to fully transform into AIDS.
HIV can be spread from one person to another in various ways. The virus can be transmitted to another person through blood, seminal fluids, virginal fluids, and breast milk. Other body fluids like vomit, saliva, tears, sweat, and urine have meager chances of transmitting HIV limited to blood in the mentioned fluids. People are at a higher risk of getting infected when they share a couple of things with an infected person. It does not matter the religion, ethnicity, economic or political background, or sexual orientation; everyone is at risk of contracting HIV (McKay 2021). The most common way people get infected is by sharing sharp objects with an infected person or engaging in unprotected sexual activities with an infected person. Mothers with HIV are at a very high risk of infecting their infants during pregnancy, at birth, and when they breastfeed.
Ways through which HIV affects the health of a person
Since HIV affects a person gradually as it turns into AIDS, many people may live a longer period before noticing they are infected. To quickly and effectively know the HIV status, it is recommended that you carry out tests. Some common first symptoms of HIV may be in the form of skin rashes, flu-like symptoms, swollen glands, or fever (McKay 2021). The symptoms may quickly appear and disappear without necessarily treating them. However, HIV stays and grows in the blood system while still fighting the remaining immune system that helps fight off the symptoms. Individuals with HIV symptoms may feel better with treatments; however, they will keep falling sick more often and develop harder to treat symptoms that are not common in sick people without HIV.
Infants have a range of symptoms that may affect them if they are infected during pregnancy, at birth, or from breast milk during breastfeeding. Some infants may experience slow growth characterized by low weight gain, slow-talking and walking rate, and swollen glands. Other symptoms include thrush due to yeast infections, swollen liver and spleen, lung infections and pneumonia, and other infections that are not common among healthy babies.
HIV Diagnosis and Treatment
Diagnosis
HIV is commonly diagnosed through saliva or blood tests. Most available HIV tests comprise antigen-antibody tests, antibody tests, and (NATs). Antigen/antibody tests commonly entail sampling blood from the veins. Antigens are noticeable substances within the HIV that will result in a positive result after a few weeks of HIV exposure. Antibodies are formed by the body’s immune system if an individual is exposed to HIV. It may take several weeks or months for the antibodies to be detected. Antigen/antibody combination tests often require two to six weeks to test positive. Antibody tests are typically carried out to check the level of anybody to HIV within the saliva or bloodstream. Most of the rapid HIV tests, mostly self- test done from home, fall under this category. It usually requires three to twelve weeks from exposure to test positive. NATs often aim at identifying the actual viral load in your blood system. Tests are always curried out using blood sample from the veins. NAT is usually recommended for individuals who had recent exposure to HIV in a few weeks because it is often the first test to become positive among the trials.
Other tests may help the doctor identify the stage of an individual’s illness and the best medication after diagnosis, with CD4 T cell count, viral load, and drug resistance. CD4 T cells are the specifically targeted and destroyed white blood cells by HIV. Regardless of symptoms, HIV converts to AIDS with a CD4 T cell count below 200. HIV RNA or viral load is a measurement of the virus in the bloodstream. Treatments are always targeting an untraceable viral load to be effective. Reducing the viral load reduces the chances of getting opportunistic diseases and related infections. Certain HIV strains are resistant to medication. Drug resistance test helps control the exact form of the virus that has developed any resistance to the guided treatments.
Treatment
There is no known antidote for HIV/AIDS currently; therefore, the body cannot personally free itself from the virus once acquired. However, there are many ways to control HIV with treatments and medications that prevent further complications. The medicines used to avoid complications in HIV patients are known as antiretroviral therapy (ART). ART combines three or more medicines sorted from various other drug classes. The combination of ART from different types of drugs provides the ideal chance of dropping the quantity of HIV in the bloodstream. Several ART medications association of three medications in a single pill prescribed to be ingested once a day. Different classes of medication have unique abilities to counter the virus. Some of the effects of the drugs on the virus include medications that account for the viral genotype that contributes to resistance. Other forms of medicine avoid the creation of new drug resistance HIV strain. The third class maximizes the suppression of the virus in the blood. The courses from which the drugs are combined include; NRTIs, which are faulty building blocks that HIV requires to replicate multiple times. Examples of NNRTIs include lamivudine (Epivir), abacavir (Ziagen), and Zidovudine (Retrovir), which are mixed with other combination medicine like Truvada and Descovy to be effective. NNRTIs are responsible for turning off a vital protein needed by HIV to replicate itself. Different classes of anti-HIV drugs include; Protease inhibitors, entry or fusion inhibitors, and integrase inhibitors.
Development of HIV vaccine
Background Information
During the period when many world’s deadly diseases were being kept under control with vaccines around the globe in the 1990s efforts, HIV, which was first identified around 1984, had already infected several millions of people around the world. The amount of people existing with HIV has since risen from eight million people to 37.7 million from 1990 to 2020. Since the onset of the HIV/AIDS epidemic, over a 35million lives have been claimed by AIDS. However, the number of deaths and new cases per year has continued to drop due to treatment and individuals exercising caution to stop transmission of HIV from one person to another (Hsu & O’Connell 2017). The HIV pandemic is still a significant public health distress not only because it cannot be controlled utilizing vaccines, but it will also stay in the host once acquired, mainly targeting their immune system.
The early ages of the HIV/AIDS pandemic were characterized by a particular death spike within those who lived with the virus that only claimed life within few years of infection. However, many individuals from the medicinal and health fraternity urged to straight funding and study required to the health crisis caused by the virus. While U.S. government responders were relatively slow on the issue, vocal activism by HIV infected people, the allies to the HIV infected persons, and the advocates in the scientific world are among the issues which led the U.S. government responders to awaken their action towards responding to the epidemic (Hsu & O’Connell 2017). One of their main highlights touched on the necessity for effective treatment, the dire need to enable contact to the effective therapies once availed, and the health benefit of plummeting stigma among people living with HIV.
Though ART treatments have an immensely made better life expectancy and value of life for people existing with HIV, the primary goal remains to prevent the infections, mainly for the developing countries where the HIV pandemic has hit. Many years of effort have been employed in finding a vaccine for HIV prevalence. Unlike many viruses, HIV poses unique challenges to the development of vaccines. All other vaccines work the same way by backing the immune system making it able to fight or weaken attacks by similar pathogens in the future. But, HIV has unique abilities providing challenges to researchers, making it hard to settle on a formula that ultimately fights off the virus.
Unique Challenges of HIV
The April of 1984 is known for the public statement made by the U.S. Health and Human Services Secretary Margret Heckler concerning the HIV. She was making the statement based on an earlier dialogue she had with Robert Gallo, the co-discoverer of the virus. She made a hopeful pledge to have the vaccine prepared for challenging in two years from when she delivered the speech. Her statement was based on optimism because other viruses have taken from 10-20 tears to develop fully; furthermore, it has been about 37 years. But there are still no vaccines for HIV for reasons like lack of natural immunity for the virus, variability in the types of HIV, lack of protecting immunity correlates, and lack of an animal species that will give a reliable prediction of the human vaccine efficacy.
HIV has continued to challenge the position to approach a particular vaccine because, unlike other diseases like chickenpox and measles, there are no chances of natural recovery from infections from the virus. When an individual is infected by measles and manages to survive, the body typically develops sufficient immunity to prevent any future chances of being infected again by measles. Therefore, researchers use the naturally occurring immunity as a basis for developing a protective vaccine (Hsu & O’Connell 2017). Researchers cannot identify an immune response capable of counter-attacking the virus without the model for natural immunity, which makes developing a vaccine for HIV a more difficult avenue to pursue. However, individuals whose immune systems can control HIV from progressing into AIDS are known as elite controllers. Researchers have continued to look into the underlying immune system which makes these individuals resistant to AIDS; the findings may be helpful towards developing a vaccine.
A practical challenge in the hunt for vaccines lies in the frequent mutation of HIV. The unpredicted frequent mutations brand the virus as a moving target for the abilities of the vaccine. In addition, there are numerous subtypes of HIV that have distinct features, which can emerge more distinct subtypes in the future. Since a vaccine that may protect against one type is unfit to protect against a different kind, researchers are challenged and unable to come up with a vaccine.
Research has not been able to control the known associate of protective immunity to the virus infection. The correlate can be explained as a unique individual immunity closely related to protecting one against pathogens, disease, or other conditions. Since no one has ever contracted the virus and then eliminated the pathogens naturally, there is no evidence that any single individual may stand to protect themselves against the virus (Hsu & O’Connell 2017). The manufacture and validation of a vaccine are still unknown due to the uncertainty on whether the vaccine should be channeled to the ability of the T cells or whether the vaccine should be channeled towards replicating numerous amounts of specific antibodies like common in many other infections.
The final challenge revolves around the ideal species of animal to be used as a test experiment to portray how the virus behaves on human beings. There is no single consistent non-human animal HIV disease or resistant system fit for the type of test. However, several researchers have identified a close relation of the virus in simian monkeys called SIV; there is no relation between how HIV would affect the monkeys to generate a vaccine test. The tests that have already been done on animals have not proven accurate results on how the vaccine would work on Humans. Therefore, researchers are faced with difficulties in determining the ideal vaccine for the virus.
HIV vaccine’s current status and development
The journey towards the first positive result from RV144 trial research to evaluate the associate of protection from a combination of the prime-boost vaccine. The postulates that they must govern the precise combination of prime-boost against the HIV contagion. Researchers have been able to monitor the antibodies prompted by various prime-boost, identifying numerous types of antibody responses (Hsu & O’Connell 2017). They check on the activities and responsibilities of T-cells and how the individual genes responded as predicted during the vaccine combination. According to a 2012 study, the T-cell replies did not likely play a significant role in protection against contagion; however, the vaccine effectiveness was closely related to antibody replies to some regions of viral wrapper proteins. Further research is still studying the RV144 and how past research has responded to aid in future research trials.
Conclusion
HIV has been on the view for several years now. The article discussed the gradual development of the HIV vaccine right from the official declaration of the virus as a global pandemic in 1987. The paper has also highlighted the current status of the HIV vaccine and some of the challenges or failures related to vaccine research. Several world deadly diseases have been taken under control since the official launch of major disease vaccines in 1990. But, HIV has remained unbeaten for about four decades now. However, scientists and different researchers have found several medications that can be used to suppress the symptoms of the virus. The unique challenge of the virus lies within the ability of HIV to be a permanent parasite within the body of the host. Researchers have faced difficulties trying to form a vaccine that best fits all the variable types of the virus. Though the virus has claimed millions of lives in the first case in Kinshasa, DRC, efforts have been put towards limiting the effects and symptoms of the virus.
References
Hsu, D. C., & O’Connell, R. J. (2017). Progress in HIV vaccine development. Human vaccines & immunotherapeutics, 13(5), 1018-1030.
McKay, R. A. (2021). Patient Zero and the Making of the AIDS Epidemic. University of Chicago Press.
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