Professor Hendrik Streeck manages the first German HIV Research Institute at Duisburg-Essen University Clinic.
In the interview for the German media Gesundheitsstadt Berlin, the researcher told about his ultimate goal, a preventive vaccine against HIV.
Professor Streeck, you have stated that “Made in Germany” vaccine is underway. But researchers have been trying to discover a preventive vaccine for as long as three decades already.
That’s true. At that time, they did not yet know how complex the immunodeficiency virus was. To date, we possess extensive knowledge not only in the field of infectious diseases science, but also in immunology. If we manage to integrate this massive knowledge in a correct manner, then we will be able to develop a vaccine against HIV. I am quite optimistic as to this outlook.
That is, you did not have to start from scratch in your lab in Essen?
Of course. Everything we do at the HIV Research Institute is based on international developments, in particular, the achievements from the United States. I myself participated in the US Military HIV Research Program (MHRP), where I had the opportunity to analyze the Thailand study outcomes. This study was conducted in 2009, then the HIV vaccine demonstrated a 30% efficacy. This rate was too low for the vaccine to be approved, but we saw that developing a vaccine that will provide protection against HIV is possible. Six months after vaccination, 60% of participants were protected from HIV transmission. The only problem is that the immune defense response provided by the vaccine was not sustained at the same level and after 12 months decreased to 44%, and after 18 months – up to 30%.
Why does the protective response of the vaccine decrease so quickly?
The reason for this decrease is the immune response decline. Surprisingly, the immune response fades away from 60 to 44% simultaneously with the protective response from the vaccine, and after one year it is no longer manifested. I am convinced that we can extend the immune response and at the moment we are working to achieve this.
Based on this, your “Made in Germany” vaccine has foreign roots?
HIV research is not something a country can do on its own; it may only be efficient within the framework of global networking. Moreover, the immunology concepts we apply on the basis of the ALVAC/AIDSVAX_BE vaccine are not originating from Germany, but we are pleased to be involved in their development.
You have been managing the HIV research institute throughout the year and have access to the know-how of a large research community. How much time is needed to develop the vaccine in the current conditions?
Our preclinical studies are gaining momentum and should be completed by the end of the next year. No later than the beginning of 2019, we want to test the vaccine on different candidates in the first clinical study. The phase III clinical trial with the best candidates should start in 2022. We hope that this attempt will show better performance.
This would be the world’s first approved HIV vaccine.
A new vaccine is currently being tested in the НVTN702 trial in South Africa. Therefore, it is difficult to assume what will happen in five years, but this will not affect our plan in any way.
Phase III of the clinical trial will be held in Germany?
We need to figure this out in the “Brahms” study. Participants will be interviewed every three months and screened in clinical settings. We expect the study results to bring a groundbreaking information on the way HIV and other sexually transmitted diseases are transmitted in Germany. Also, it is necessary to study what protection measures are best taken and how often the patients contract STDs at the same time. We do not have enough knowledge on these matters to date, and absolutely new strategies might be developed on the basis of study results.
What will happen if it turns out that research is not feasible in Germany?
Then the third phase of the clinical trial will be conducted in other countries. I am pretty convinced that this will be Thailand and an African country.
The last question: the development of the vaccine entails huge expenses. Is it worth spending so much when there is a pill-based pre-exposure HIV prevention?
Reasonable question, though. There are positive reports from other countries such as the United States, the United Kingdom and Australia, showing that PrEP may prevent a significant number of new cases of HIV infection. But nevertheless, I think that PrEP is not a solution to overcome the HIV epidemic globally. HIV is first and foremost a problem of poor countries. And expensive therapy that should be taken daily will not work well for these countries. If we really want to curb HIV, we need a vaccine that is also accessible to people in Eastern Europe, Russia and Africa. From the global perspective, the vaccine remains the best solution.