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World AIDS Day puts spotlight on landmark DoD study

Dr. John Mascola, director of the National Institutes of Health Vaccine Research Center, discusses HIV vaccine progress at the Walter Reed Army Institute of Research, Nov. 26, during a World AIDS Day commemoration.  (U.S. Army photo) Dr. John Mascola, director of the National Institutes of Health Vaccine Research Center, discusses HIV vaccine progress at the Walter Reed Army Institute of Research, Nov. 26, during a World AIDS Day commemoration. (U.S. Army photo)

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The Walter Reed Army Institute of Research (WRAIR) hosted a World AIDS Day event Tuesday, Nov. 26, highlighting advances in DoD-led HIV research and celebrating the 10th anniversary of the Army-led RV144 HIV vaccine study.

WRAIR’s Military HIV Research Program or MHRP headed the RV144 study, the first-ever – and only to-date – clinical trial to demonstrate that an HIV vaccine regimen was safe and modestly effective in preventing HIV infection. The study sought to determine what methods could be used to lower risk of contracting the disease.

The RV144 trial represented a massive undertaking for the Army and serves as a model of international and interagency collaboration. It involved more than 16,000 adult volunteers and a large network of partners who still work with WRAIR today, including the Thai Ministry of Public Health; the National Institute of Allergy and Infectious Diseases – part of the National Institutes of Health; and Sanofi Pasteur.

In 2009, the Army announced that the study’s investigational prime-boost vaccine regimen lowered the rate of HIV infection by 31.2 percent. These results, although modest, gave the global community hope that a vaccine to prevent HIV infection is possible at a time when such an achievement seemed elusive.

“RV144 was the light at the time in the field, without which we may have given up,” said Dr. John Mascola, director of the National Institutes of Health Vaccine Research Center and the featured speaker at WRAIR’s World AIDS Day event. “In the last 10 years of HIV vaccine progress, RV144 is the anchor.”

The landmark trial continues to provide scientific direction to help guide vaccine development and testing. RV144 and its follow-on trials allowed researchers to discover of risk factors, provide targets for optimizing vaccine boosting, and form a foundation for three HIV vaccine candidates currently undergoing efficacy testing. A video featuring many prominent HIV researchers who were involved with RV144 was shown at the World AIDS Day event.

Also at the event, Lt. Gen (Ret.) Eric B. Schoomaker, 42nd surgeon general of the United States Army and former commanding general of the United States Army Medical Command, highlighted the military’s earliest contributions to HIV research, which include the development of a disease staging system and promoting the finding that HIV can be transmitted heterosexually. The military’s HIV research efforts were consolidated in 1986 with the establishment of MHRP.

MHRP’s initial mission was to advance an HIV vaccine to protect service members and the global community from HIV, but has since expanded beyond vaccine development to include cure research and prevention and treatment services in Africa under the President’s Emergency Plan for AIDS Relief or PEPFAR. Via PEPFAR initiatives, WRAIR provides life-saving antiretroviral therapy to more than 350,000 people living with HIV in sub-Saharan Africa, which contributes to global health security.

WRAIR supports PEPFAR activities within military and civilian communities in four countries where it conducts research (Nigeria, Tanzania, Uganda, and Kenya), which strengthens community trust and provides an ethical framework for clinical studies. The Department of Defense HIV/AIDS Prevention Program, led by the U.S. Navy, is responsible for assisting foreign military partners with the development and implementation of military-specific HIV/AIDS prevention and treatment programs in more than 55 countries around the globe, also supported by PEPFAR.

“Those countries that partner with us on PEPFAR have a 40-percent decrease in violence and a 40-increase in political stability,” said WRAIR Commander Army Col. Deydre Teyhen. “So we say that soldier health is world health. But in fighting HIV/AIDS, WRAIR researchers are also working to advance world peace.”

More information can be found on the RV144 HIV Trial web page.

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