HIV Research Section, San Francisco Department of Public Health, San Francisco, CA 94102, USA.
J Acquir Immune Defic Syndr. 2010 Dec;55 Suppl 2(Suppl 2):S128-31. doi: 10.1097/QAI.0b013e3181fbca02.
A safe and effective HIV vaccine is needed to curtail the US and global epidemics. However, the search for one has been elusive despite more than 25 years of focused research. Results from the RV144 Thai efficacy trial have renewed hope that a vaccine may protect against HIV acquisition. We can draw several scientific and operational lessons from RV144 and other recent tests-of-concept efficacy trials. Here we describe how trial results, some unexpected, highlight the fundamental role these clinical studies play in HIV vaccine discovery. These trials also teach us that transparency in data analysis and results dissemination can yield substantial rewards and that efforts to engage communities, particularly those most heavily affected by the epidemic, are needed to augment research literacy and trial recruitment. Future efficacy trial designs may incorporate novel, partially effective prevention strategies. Although greater in size and complexity, these trials may offer unique opportunities to explore synergies with vaccines under study.
需要一种安全有效的 HIV 疫苗来控制美国和全球的艾滋病疫情。然而，尽管经过 25 年以上的集中研究，这种疫苗仍未找到。泰国 RV144 疗效试验的结果再次燃起了人们的希望，即疫苗可能有助于预防 HIV 感染。我们可以从 RV144 和其他最近的概念验证疗效试验中吸取一些科学和操作方面的经验教训。在这里，我们描述了试验结果（其中一些是出乎意料的）如何突出了这些临床研究在 HIV 疫苗发现中的核心作用。这些试验还告诉我们，数据分析和结果传播的透明度可以带来巨大的回报，并且需要努力让社区参与进来，特别是那些受艾滋病疫情影响最严重的社区，以提高研究素养和试验招募。未来的疗效试验设计可能会纳入新型、部分有效的预防策略。尽管这些试验的规模和复杂性更大，但它们可能提供独特的机会，探索与正在研究的疫苗之间的协同作用。
