India is getting ready for the first trials of an AIDS vaccine. Phase I
trials will begin later this year or early next year at the National AIDS
Research Institute in Pune, Maharashtra.
The International AIDS Vaccine Initiative has been working closely with the
Indian Council of Medical Research and the National AIDS Control Organisation
since December 2000 to develop and evaluate AIDS vaccines in India.
To reduce fears that Indians will be used as guinea pigs for the trial of an
AIDS vaccine that will be used only in the Western world, the initiative has
been trying to forge collaborations with the government, non-governmental
organisations, and policy makers at national and state levels.
A vaccine is projected as the last hope for the control of AIDS in India,
which has some four million people who are HIV positive, the second largest
concentration in one country after South Africa.
The first candidate vaccine to be tested in India will be modified vaccinia
Ankara, a live attenuated vaccine that will target HIV-1 subtype C. "This
subtype is predominant in India, accounting for nearly 91% of cases," said Dr
Jean-Louis Excler, medical director of the initiative in India.
The other subtypes found mostly in northeastern India, albeit in smaller
numbers, include subtypes A, B, and E and a recombinant subtype AC, he added.
"There is, however, no really good epidemiological study of distribution of the
various HIV subtypes in India," cautioned Dr Excler.
The vaccine is currently being developed by Therion Biologics, a company
based in Boston, Massachusetts. Talks are taking place with some Indian
companies for the manufacture of the vaccine in India when the phase I trials
end, said Ms Anjali Nayyar, the International AIDS Vaccine Initiatives country
director for India. "We have at least two other candidate vaccines also in mind
for testing in India, but a decision on that will be taken after later
consultation with scientists," she said.
"Toxicology data will be submitted to the drugs controller of India by
October this year, and we hope to get his permission for clinical trials soon
thereafter," said Ms Nayyar.
In the first phase of clinical trials, which will last about a year, the
vaccine will be tested on 39 HIV negative people at low risk of infection from
the Pune area in western India. "We will ensure that informed consent is
followed strictly and the trials are cleared by the institutional ethics
committee," she added. The issue of monetary incentives could be looked into
more seriously after the phase I trials are over, added Ms Nayyar.
"The vaccine is very safe," she assured, "and there is no possibility of
volunteers getting infected through the vaccine." However, there could be minor
side effects, which could be treated routinely, she added.
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