Thursday, July 8, 2010

O'Connor on HIV

Dane County Health & Human Needs on Research on Monkeys part 1 from luciano M on Vimeo.

[Breaking news: Breakthrough in HIV-fighting antibodies discovered. See bottom link.]

David O'Connor begins his comments to the Dane County Committee on Health and Human Needs at approximately 24:30 in the above video.

At about 25:19, he says:
However, the case of using nonhuman primates in AIDS research, which I do every day, is entirely different [than dissecting animals in anatomy classes] because its the cutting edge of science in the public interest.(1) Wanting to contribute to this effort is what motivated me to become an AIDS researcher 12 years ago and it continues to motivate me today. Simply put, the search for an AIDS vaccine relies on research with nonhuman primates.(2) Opposition to nonhuman primate research is therefore opposition to AIDS research, full stop.(3)

Don't just take my word for it. Here's what Dr. Anthony Fauci, who has directed the National Institutes of Health, the National Institute for Allergy and Infectious Diseases since 1984, wrote about HIV and nonhuman primates recently. Quote: The bar that a candidate HIV vaccine needs to pass will be raised on knowledge of prior clinical trials, nonhuman primate studies, and fundamental research.

Hum... OK, I won't take O'Connor's word for it.

Fauci didn't actually say this. The quote is from a report in Science with eleven authors, titled: HIV Vaccine Research: The Way Forward (Science 25 July 2008.) The report was published on the heals of yet another failed clinical trial of a vaccine that was developed using monkeys.

The MRKAd5 HIV-1 Gag/Pol/Nef candidate vaccine advanced to a phase 2b test-of-concept trial known as STEP, conducted by Merck & Co., Inc., and the HIV Vaccine Trials Network (HVTN). The vaccine neither prevented infection nor had an impact on early plasma virus levels in those who received the vaccine compared with the placebo recipients. In addition, a completely unexpected observation emerged in the STEP trial. Although a strict statistical analysis could not be performed because the data were analyzed in a post hoc manner, there was a trend toward a greater number of vaccine recipients infected, compared with the placebo recipients.
The report went on to say:
Although the vaccine in the STEP trial failed to show efficacy, the trial unequivocally demonstrated that the current simian-human immunodeficiency virus (SHIV) NHP challenge model is not appropriate for evaluating T cell vaccines; that the SIV NHP challenge model is more predictive ...
... After the disappointing results in the STEP study, the National Institute of Allergy and Infectious Diseases (NIAID) held a scientific summit in March 2008 (21, 22) to solicit input on how best to reinvigorate and advance the field of HIV vaccine discovery research.
...The summit provided no clear consensus on whether a vaccine should demonstrate efficacy in a NHP model of AIDS as a criterion for entering clinical trials (the "gatekeeper" role).
... Given the extraordinary genetic diversity of HIV, the many features of the envelope glycoprotein that shield the virus from antibody-mediated neutralization, and the speed at which viral replication occurs and latency is established, design of a vaccine that blocks HIV infection will require enormous intellectual leaps beyond present day knowledge.

It's far from clear that the primate researchers are capable of such mental feats.

In fairness to O'Connor, the report does champion the continued use of monkeys in the study of HIV. But, as noted a gazillion times by every critic of this model, the experimental disease isn't HIV, and it doesn't cause disease in humans; using the SIV model is probably a dead end and has been demonstrably misleading as was demonstrated in the STEP trial mentioned above.

And the authors seem to have a strong vested bias toward the continued use of monkeys:

Anthony S. Fauci

Margaret I. Johnston

Carl W. Dieffenbach

Dennis R. Burton: uses monkeys

Scott M. Hammer

James A. Hoxie: uses monkeys

Malcolm Martin: uses monkeys

Julie Overbaugh: uses monkeys

David I. Watkins: uses monkeys

Adel Mahmoud

Warner C. Greene

1. Ahem. "The cutting edge of science in the public interest?" If this means something like "the most important question in medicine," then he's just wrong. While HIV/AIDS is the leading cause of death in the developing countries, it doesn't make the top ten in the developed world. This means then, that access to treatment and condoms is very important, and relative to people dying, access to treatment and condoms is clearly more important than finding a vaccine. Finding a vaccine might be impossible but prevention and treatment clearly aren't. If the "cutting edge" means the most important medical question, then very many other questions stand in front of an AIDS vaccine.

2. "AIDS vaccine relies on research with nonhuman primates." Gibberish. Monkeys don't get AIDS as a result of HIV infection. Anthony Fauci came much closer to the target when he said: "Finally, understanding how some HIV infected individuals, the so-called “elite controllers” who are able to keep the virus in check for years to decades may provide a different sort of “proof of concept”. Perhaps the best that we can achieve is the best that nature has already done. Although developing a vaccine capable of preventing infection is the ultimate goal, development of a vaccine that enables the recipient to control infection for years to decades would delay the need to initiate antiretroviral therapy and potentially even reduce secondary transmission to others." [Fauci: Why there is no AIDS vaccine: Scientists need a better grasp of HIV's interaction with the immune system. MSNBC. 2009.] An AIDS vaccine, if possible, will likely come from an understanding of HIV infection in humans.

3. "Opposition to nonhuman primate research is therefore opposition to AIDS research, full stop." You're either with us or you're against us, by gawd! When I read silliness like this, I can't help notice the stark contrast between O'Connor's (and other vivisectors') mental fogginess and the "enormous intellectual leaps" that will be needed in order to develop an HIV vaccine.

In fact: see this: Antibody Kills 91% of HIV Strains. Wall Street Journal. July 8, 2010.

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