Superior efficacy of an HIV vaccine combined with ARV prevention in SHIV challenged non-human primates
Résumé
Although vaccines and antiretroviral (ARV) prevention have demonstrated partial success against HIV infection in clinical trials, their combined introduction could provide more potent protection. Furthermore, combination approaches could ameliorate potential increased risk of infection following vaccination in the absence of protective immunity. We used a non-human primate model to determine potential interactions of combining a partially effective ARV microbicide with an envelope-based vaccine. The vaccine alone provided no protection from infection following 12 consecutive low dose intravaginal challenges with SHIVSF162P3, with more animals infected compared to naïve controls. The microbicide alone provided a 68% reduction in risk of infection relative to the vaccine group and a 45% reduction relative to naïve controls. The vaccine-microbicide combination provided an 88% reduction in per exposure risk of infection relative to vaccine alone, 79% reduction relative to controls. Protected animals in the vaccine-microbicide group were challenged a further 12 times in the absence of microbicide and demonstrated a 98% reduction in risk of infection. Taken together a total risk reduction of 91% was observed in this group over 24 exposures (P=0.004). These important findings suggest that combined implementation of new biomedical prevention strategies may provide significant gains in HIV prevention.
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