Thirty-three million people throughout the world are infected with HIV. Nearly two-thirds of those infected live thousands of miles away in Africa, lacking treatment, support and education.
But five miles west of the University of Wisconsin campus, a team at the AIDS Vaccine Research Laboratory in University Research Park works daily to build a vaccine against the virus.
“What we’re trying to do is guide the field of HIV vaccine research,” said UW pathobiological sciences professor Thomas Friedrich, who is also the principal investigator of the Friedrich Laboratory. “We’re trying to help determine what are the best ideas for building a vaccine against HIV, because we don’t know how to do it.”
The Friedrich Lab is one of several labs that make up UW’s AIDS Vaccine Research Laboratory, which opened in 2005 and is run by UW pathology professor David Watkins.
“Madison is a unique place in the sense that we have a large number of graduate and undergraduate programs on campus,” said Donna Paulnock, associate dean of the UW graduate school and professor of medical microbiology and immunology. “As a result, we have a very large number of faculty working in a lot of different areas of biomedical research, and it’s just a very strong group of creative people doing basic scientific research into infectious diseases.”
Since HIV was discovered 25 years ago, it has become “probably the best studied pathogen of all,” Friedrich said. But even with vast knowledge about the virus, researchers cannot determine how to stop it from spreading.
“Despite all that, we don’t have the key things. We can’t cure it, we can’t prevent you from getting infected,” he said. “So there’s an intense amount of research and a huge number of dollars that are now being mobilized to come up with a cure and a vaccine.”
While much of the HIV research done around the world focuses on vaccines that can immediately be sent to clinics, researchers at UW are “trying to come up with a vaccine that actually works,” Friedrich said.
The factor that sets HIV apart from other viruses like Hepatitis A, measles and yellow fever — which all have vaccines — is HIV’s ability to rapidly mutate. Because of this, the standard method for making a vaccine will not work.
“You need some kind of outside the box thinking. We need to come up with something new,” Friedrich said. “So the sort of glib answer is, if I knew what the next breakthrough was, then it would have happened. I would have had that idea already.”
He added research goes beyond trying to cure individuals who are already infected with the virus.
“What we’re trying to is come up with novel ideas for coming up with vaccines, try to understand what immune responses you need to control the virus and how can you put all of this together into a vaccine or a therapy that will prevent people from getting infected, or at least prevent them from passing the virus on,” Friedrich said.
Another aspect of Friedrich’s research involves “elite controllers” — people who get infected with the virus and can live up to 25 years without treatment. These elite controllers make up about 1 percent of the population.
“We don’t know why these particular genes are good to have if you have HIV, but having identified these monkeys, we’re trying to figure out what about them gives them an apparently successful immune response against the virus,” he said. “So if we can understand that in the monkeys, then we can start to build the picture of a successful immune response against an AIDS virus.”
All the new and innovative ideas for HIV vaccinations are designed to be safe as possible, Friedrich said, but because there are always effects researchers cannot foresee, vaccines are often tested on macaques to guide what vaccines will be tested in humans.
As the HIV virus only infects primates, monkeys must be used to study the effects of vaccines in a model system, Friedrich said.
He added there is strict oversight on animal testing by both UW and federal regulators, which involves submitting a detailed experimental protocol showing the animals will be used “ethically and responsibly.”
“These are intelligent beings, they’re not amoebas and we all think about that everyday, but … there are 33 million people who are infected with HIV, virtually all of whom will die unless we come up with a cure,” Friedrich said.
As it is both impossible and unethical to test every experimental vaccine in humans, he said, the animal model gives researchers some indication of which experimental vaccines “actually stand a chance of protecting people against HIV.”
The majority of funding for the Friedrich Lab comes from the National Institute for Health, which focus on HIV and AIDS research through the Institute for Allergy and Health, as well as from the Bill and Melinda Gates Foundation.
The research lab gets some money from the state, which is typically used to purchase equipment, but the large majority of funding comes from federal or private grants.
Additional funds will soon be available for HIV and AIDS research, as the Recovery and Reinvestment Act injects almost $10 billion into the American International Health Alliance funding stream, Friedrich said, which will be allocated in “challenge grants” to unique approaches to studying the virus.
“It is a very exciting time for everyone, because there are unexpected dollars available to support research, especially in infectious diseases, although in other areas as well,” Paulnock said. “People are very excited and there’s a call for innovate and creative proposals.”
Even with the increase of funds and support for HIV and AIDS research, Friedrich said he was hesitant to speculate about the future.
“The optimistic part of me says, ‘Yeah, eventually we’ll come up with something.’ In studying HIV, we’ve learned so much just about how the immune system works — it really seems like the dark ages in 1984 compared to what we know now,” he said. “So if we’ve come this far in just a couple of decades, why not?”