AIDSWEEKLY Plus, Monday, 3 March 1997
Daniel J. DeNoon, Senior Editor
Envelope-based candidate HIV vaccines are poorly immunogenic in people with HIV infection - even those with high T-cell counts.
The findings apparently end hopes that the Genentech and Biocine recombinant gp120 envelope glycoprotein vaccines can strengthen the anti-HIV immune responses in people with existing infection.
Robert T. "Chip" Schooley presented the new data in a report to the Fourth Conference on Retroviruses and Opportunistic Infections, held January 22-26, 1997, in Washington, D.C.
"Env vaccines were immunogenic in only a minority of HIV infected patients regardless of CD4 count," Schooley and colleagues wrote in their presentation abstract. "These findings may explain the lack of clinical benefit of Env-based vaccines in Phase III trials."
The data came from two Phase II National Institute of Allergy and Infectious Diseases (NIAID) clinical trials testing the Genentech gp160 vaccine.
ACTG 209 included 164 antiretroviral-treated and antiretroviral-naive patients with CD4 counts of 50 to 500 cells/(micro)L; ACTG 214 included 128 antiretroviral-naive patients with CD4 counts of >500 cells/(micro)L.
Participants in ACTG 209 received the Genentech HIV-1[MN] rgp120 vaccine. Participants in ACTG 214 received either the Genentech HIV-1[MN] or HIV-1[IIIB] rgp120 vaccines in alum or the Biocine HIV-1[SF-2] rgp120 or HIV-1[SF-2] env2-3 vaccines in MF59 adjuvant.
Only five of 51 (ten percent) of the evaluable vaccine recipients in ACTG 209 had increased lymphocyte proliferation to gp120 from HIV-1[MN]. Four of these five responses occurred in patients with CD4 counts between 350 and 500 cells/(micro)L who were receiving antiretroviral drugs.
In ACTG 214, HIV specific lymphocyte proliferation occurred in only one of 20 rgp120[IIIB] recipients and in only two of 19 env2-3/MF59 recipients.
"In both studies, responses were restricted to the specific Env type used as the vaccine antigen," Schooley noted.
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