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“The first clinical trial of an HIV/AIDS vaccine designed and developed in South Africa was launched in Cape Town” Monday, the SAPA/The Times reports. The trial will seek to determine the immune response of HIV-negative people to two experimental vaccines — SAAVI DNA-C2 and SAAVI MVA-C (7/20).

Similar tests of the vaccine began in the U.S. earlier this year, the AP/Washington Post reports. The University of Cape Town developed the experimental vaccines with technical assistance and manufacturing of the vaccine provided by the NIH, according to Anthony Mbewu, president of South Africa’s Medical Research Council. “With 5.2 million already infected and with hundreds getting infected every day despite all the condom distribution and behavioral education programs, we know that a vaccine really is what we need,” Mbewu said, adding, “When the next influenza pandemic hits the world, every country will be scrambling to develop a vaccine … so it is important that countries like South Africa have the technology and capacity to develop vaccines and the industry to manufacture them” (Faul, 7/20).

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, called the partnership between South Africa and the U.S. “the most important AIDS research partnership in the world,” but cautioned the years ahead would prove challenging as researchers test the safety and efficacy of the HIV vaccine, the AP/Google.com reports.

“South Africa was the site of the biggest setback to AIDS vaccine research, when the most promising vaccine ever, produced by Merck & Co. and tested here in 2007, found that people who got the vaccine were more likely to contract HIV than those who did not,” the news service writes, adding that “AIDS vaccine research is so filled with disappointments some activists are questioning the wisdom of continuing such expensive investments. They say the money might be better spent on prevention and education” (Faul, 7/20).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

Kaiser Permanente researchers found no disparities by race or ethnicity in risk of AIDS and death among HIV-infected patients in a setting of similar access to care. This is despite lower Anti-Retrovir al Therapy adherence among Hispanics and African-Americans compared to whites. Researchers also saw a trend toward better outcomes for Hispanics.

The study, which appears online in The Journal of General Internal Medicine, is one of the largest to date to evaluate racial and ethnic differences in clinical outcomes among HIV-infected patients.

“When it comes to HIV among Kaiser Permanente members, it appears that access to care is the key to eliminating racial and ethnic disparities,” said the study’s lead author Michael Silverberg, a researcher at the Kaiser Permanente Division of Research. He explained that equal access may likely improve prevention and also encourage early treatment.

Kaiser Permanente is the largest private provider of HIV care in the United States. Dr. Silverberg said that certain aspects of Kaiser Permanente care may reduce differences in outcomes among racial/ethnic groups in that most patients have medical insurance coverage and their HIV care is guided by the principles of integrated, chronic condition management and multi-disciplinary HIV specialty care. Another advantage of this setting is Kaiser Permanente’s large HIV registry, which has historical data on more than 17,000 patients, including a substantial number of racial/ethnic minorities.

This study is among the first to include a large number of Hispanic patients and comprehensively account for other factors — such as socioeconomic status, HIV disease stage and ART adherence — that may contribute to racial/ethnic disparities, according to the investigators. Hispanics had a statistically significant 34 percent survival benefit compared with whites and a 42 percent survival benefit compared with blacks. However, no statistically significant differences for racial/ethnic groups were observed after adjustment for demographics, socioeconomic status and clinical factors.

The study was a retrospective observational cohort study from 1996 to 2005 in Kaiser Permanente, an integrated delivery system with more than 3 million members in Northern California. Researchers studied 3,106 whites, 919 Blacks and 661 Hispanics infected with HIV and looked at differences in ART adherence, new AIDS events and all-cause mortality.

“This observation of reduced mortality in HIV-infected Hispanics is somewhat surprising giving the observed lower adherence rates, reduced immunological responses and lower census-based socioeconomic status compared to whites,” said Silverberg. Hispanics had particularly low numbers of cardiovascular and cancer-related deaths. He explained that this phenomenon, also called the Hispanic Paradox, may occur because of differences in diet, genetics and extended family support.

This study is part of Kaiser Permanente’s larger ongoing work to end health disparities by providing equitable access and care to its 8.6 million members, by targeting resources to areas in need in communities across the United States, by investing in disparities research, and by implementing strategies that support equity in health nationwide, including universal health coverage.

Additional investigators on the study include Wendy Leyden, MPH, Charles P. Quesenberry, Jr., Ph.D., and Michael A. Horberg, MD, MAS, all affiliated with the Kaiser Permanente Division of Research in Oakland, Calif. The research was funded by a Community Benefit grant from Kaiser Permanente Northern California, and a career development award from the National Institute for Allergy and Infectious Diseases, part of the National Institutes of Health.

Source:
Emily Schwartz

Golin/Harris International

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globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.