- The Trump administration reportedly plans to cut almost all funding for HIV vaccine research.
- Experts say the decision comes at a time when research in this field is making substantial progress.
- Many effective treatments are available for HIV, but these are lifelong commitments that manage a chronic disease rather than cure it.
Treatments for HIV infection have come a long way since the 1980s, when too many lives were lost during the epidemic.
Today, antiretroviral therapies and other treatmentsย allow people with HIV to live longer lives and, in many cases, prevent the transmission of the virus that causes the disease to other people.
Scientists now say the next step in the fight is a vaccine that protects against HIV.
However, that next development could be on the chopping block.
Trump administration officials reportedly plan to halt funding for a wide array of HIV vaccine research.
Researchers told CBS News they have been informed by officials at the National Institutes of Health (NIH) that the Department of Health and Human Services (HHS) has instructed the agency not to issue any more funding during the next fiscal year for HIV vaccine research.
NIH officials said HHS officials have instead decided to โgo with currently available approaches to eliminate HIV.โ
The decision will close down HIV vaccine research projects at theย Duke Human Vaccine Instituteย and theย Scripps Research Institute, according to aย reportย in the journalย Science.
Officials at Moderna also told CBS News that their current clinical trials on HIV vaccines have been put on hold.
Experts say the decision to cut funding for an HIV vaccine is short-sighted and reckless.
โIโm stunned by this decision,โ said Jake Scott, MD, a clinical associate professor of medicine at Stanford University in California who specializes in infectious diseases.
โThere is no scientific or medical evidence to justify these cuts at the exact moment this field is showing real promise,โ he told Healthline.
Carl Baloney Jr., the chief executive officer-elect of AIDS United, agreed.
โEliminating funding for HIV vaccine research undermines decades of scientific progress and turns our back on a future where HIV could be preventable for all, regardless of where someone lives, their income, or access to healthcare,โ he told Healthline.
Why an HIV vaccine is important
Experts say that treatments for HIV are incredibly effective.
However, they note that most involve daily adherence and arenโt necessarily readily available or affordable for many people.
โThere are a lot of good options, but they can be really expensive,โ Scott said. โThese medications are also not a cure. They are a lifetime burden.โ
The experts add that people with low levels of HIV in their system can still have weakened immune systems. That can raise the risk of serious infections as well as inflammation that can lead to conditions such as heart disease.
โA vaccine can help prevent all this,โ said Scott.
Experts note that a vaccine research program may be difficult to put back together even if a new administration restored funding in the near future.
They say it took decades to build these programs and restarting them would take time. In addition, researchers will leave the field of HIV prevention to set up shop in another industry that is receiving funding.
โWe could lose an entire generation of scientists,โ said Scott. โThis is setting the field back a decade or more at a critical time.โ
โThis isnโt just about canceling [a] clinical trial. Itโs about sidelining the scientists, institutions, and community partners driving innovation forward,โ added Baloney. โThese setbacks could delay the development of a successful HIV vaccine by years or even decades.โ
How scientists fought against HIV
Theย first treatmentย for HIV was approved by the Food and Drug Administrationย (FDA) in 1987.
Azidothymidine (AZT) was first developed in 1964 as a treatment for cancer. It was ineffective in that usage, but in the 1980s, scientists discovered AZT could suppress HIV replication without damaging healthy cells. It helped treat people with AIDS as well as people who were HIV positive but had no symptoms.
In the 1990s, other nucleoside reverse transcriptase inhibitors (NRTIs) were developed and approved. Laboratory tests to measure viral load and cell countsย acceleratedย this research.
From there, scientistsย experimentedย with combining drugs to help counter the HIV virusโs ability to mutate and replicate. In 1996, a triple-drug therapy proved effective in thwarting HIV replication and creating a barrier against drug resistance.
Since then, these antiretroviral drugs have become more effective and more available.
The effectiveness of these medications is nothing short of miraculous.
In the 1980s, theย average life expectancyย after an AIDS diagnosis was one year. Today, people who adhere to combination antiretroviral drug therapiesย can expect to liveย a near-normal life span.
In some cases, the medications can reduce the HIV viral load in a person to the point where the virus is undetectable and canโt be transmitted to another person.
How is HIV treated today?
More thanย 50 types of HIV medicationsย are now approved for use. Some of the more commonly usedย antiretroviral medicationsย are:
- Combination NRTI drugs that includeย Truvadaย andย Descovy. These medications work by preventing HIV from converting its RNA into DNA. This prevents the virus from making copies of itself..
- Integrase strand transfer inhibitors (INSTIs) that includeย Vocabriaย andย Biktarvy. These drugs work by blocking an enzyme that HIV uses to put HIV DNA into human DNA inside cells.
- Protease inhibitors (PIs) such asย Lexivaย andย Crixivan. These medications work by blocking an enzyme that HIV needs as part of its life cycle.
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs) that includeย Intelenceย andย Viramune. These drugs work by preventing the HIV virus from making copies of itself.
- Entry inhibitors such asย Fuzeonย andย Selzentry. These medications work by blocking HIV from entering CD4 T cells.
In addition, there are drugs known asย Cytochrome P4503A (CYP3A) inhibitors,ย such asย Tybostย andย Norvir,ย that help boost the levels of HIV medications in the bloodstream.
There are also medications known as post-attachment inhibitors that when used with antiretroviral drugs can help prevent HIV from entering immune cells. Trogarzo was the first of these drugs to become available, having been approved in 2018.
In addition, there are attachment inhibitor medications, a newer form of HIV drug that works by attaching to a viral protein, which prevents that protein from entering healthy T cells. Only one type of this medication, Rubokia, is currently available, having been approved in 2020.
Most people with HIV are given medications, but there also are long-acting injections that are given once a month or once every other month.
Scott said these treatments are cures that have turned HIV into a โmanaged chronic diseaseโ to the point where he and other colleagues now refer to AIDS as โadvanced HIV.โ
Baloney said, however, there are limits to how much treatments can do.
โCurrent treatments and prevention tools have transformed HIV into a manageable chronic condition, but they are not a cure and theyโre not accessible to everyone,โ he said. โAn HIV vaccine would be a game-changer, especially for communities facing systemic barriers to care.โ
Preventive measures for HIV
Even with the available treatments, experts agree that itโs better for a person if they donโt contract HIV in the first place.
They say condom use, along with dental dams and gloves, can beย effective barriersย to contracting HIV.
Limiting sexual partners is alsoย recommended, as are sterile needles for intravenous drug users.
Getting tested for HIV is also an important component. Itโsย estimatedย that more than 1 million people in the United States have HIV, and 13% of them donโt know they have contracted the virus.
There are medications available that can be taken as a precaution or after potential exposure to HIV. These drugs include:
- Preexposure prophylaxis (PrEP): These medications can be taken as a daily pill or a bimonthly injection. The first injectable PrEP drug wasย Apretude, which wasย approvedย by the FDA in 2021. Truvada can also be used as PrEP therapy. These medications help prevent HIV from getting a foothold in the body.
- Postexposure prophylaxis (PEP)ย drugs: These are designed to be taken within 72 hours of potential exposure to HIV. It is a pill ingested once a day for 28 days.
- Lenacapavir: This injectable drug has been tested in clinical trials as a potential PrEP therapy. The FDA isย scheduledย to vote on its approval on June 19.
Experts say all these preventive measures are good practices, but they note that vaccines are still the most effective.
โNone of these replace the potential power of a preventive vaccine, especially in communities where stigma, criminalization, and health disparities limit the reach of existing tools,โ Baloney said.
