Miracles Start in the Lab: The Quest for a Vaccine to Cure AIDS

To commemorate World AIDS Day, News Medical spoke with Dr. Larry Corey, internationally renowned expert in virology, immunology and vaccine development, and former president and director of Fred Hutch, about his work in the field. HIV/AIDS research and vaccine development.

Can you introduce yourself and tell us about your experience in virology, immunology and vaccine development?

I’m Dr. Larry Corey. I am a professor at the University of Washington and the Fred Hutchinson Cancer Center. I am a virologist by training. I have worked in the field of HIV since the beginning of the recognition of the virus. Initially, I was the head of the US government’s AIDS clinical trials group, which focused on antiviral chemotherapy. Early in my career, I was fortunate enough to be involved in the development of the first effective antiviral drug called Acyclovir, which was intended for herpes virus infections, specifically genital herpes.

In the late 1990s I changed my interests from therapy to trying to develop an HIV vaccine and founded the HIV Vaccine Trials Network with my friend and colleague Tony Fauci. We worked together to develop an HIV vaccine and built a network of researchers in the United States to tackle the immunology of HIV, which has been really great. It is in this network that probably 80 or 90% of clinical trials of HIV vaccines have been conducted in the world over the last 20 years.

How have you seen the field of HIV/AIDS research evolve during this time? How have patient outcomes changed?

HIV remains a pandemic disease. We still have 1.4 million new infections every year. We have a growing number of people living with AIDS, and it’s always a perfect storm. You acquire it subclinically, you pass it on subclinically, and you get it from people you don’t suspect have it. We still need better prevention methods.

Antiretrovirals have saved more lives than any other medical procedure or medical group of therapies in the past 50 or 60 years. We’ve gone from a disease that killed everyone to now a disease that, if you take the pills, you can essentially live a normal life. It’s an incredible feat that happened in the decade since the virus was isolated.

HIV research has changed dramatically and has become much more sophisticated. We are cloning B lymphocytes in the germ lines. We do things you couldn’t imagine 40 years ago. Certainly, a vaccine will be necessary to end AIDS and make my granddaughters grow up as I grew up, without worrying about AIDS.

Patient outcomes for treatment have changed markedly. You can live a normal life. But we haven’t made as many breakthroughs in prevention. The reason is that we don’t have a vaccine. When you look at how to prevent disease acquisition on a population basis, it has only been with a vaccine. So, as difficult as it is, the vaccination effort must continue.

In your laboratory, you study genetically modified T cells to treat HIV-1. How have recent advances in cancer treatment influenced the treatment of HIV/AIDS? How can immunological approaches treat chronic viral infections?

In oncology, the use of the cell as an anti-tumor drug in CAR T-cell therapy is the greatest advance. The lab is trying to take these approaches used in cancer and use them against HIV through these adopted transference experiments. We think we’ve had some success, so that’s our area of ​​focus at the moment.

You are also the lead investigator for the Fred Hutch-based operations center of the COVID-19 Prevention Network. What impact has the COVID-19 pandemic had on HIV/AIDS research?

People working in HIV and the HIV infrastructure have contributed to the effort against COVID-19. RNA, used in COVID-19 mRNA vaccines, can allow experiments to be done faster because it’s synthetic, and you can make a vaccine and get it into humans by doing an early clinical trial. From ideation to getting a shot in your arm, it still doesn’t happen as quickly with HIV as it does with COVID-19. Still, it’s faster, and we’re optimistic that this RNA technology will help us develop an HIV vaccine faster.

The goal of the HVTN is to develop a safe and effective vaccine to prevent HIV worldwide. How close are we to achieving this goal? From a global perspective, what would it mean to have an effective vaccine?

We make these vaccines that elicit largely neutralizing antibodies. If we do, we will get there because we have already proven that broadly neutralizing antibodies can prevent the acquisition of HIV. Now the question is how do we achieve that goal now that we know what the goal is? You must be optimistic. Miracles begin in the laboratory.

The theme for this year’s World AIDS Day is “Equalize”. What does this theme mean to you personally? What needs to be done to fight inequality and help end AIDS?

Everyone wants to be healthy. I think equalizing is a big word for World AIDS Day. I think HIV has always been a disease of the underdog.

But words have meaning and must be actionable. I think the word equalize is just another call to how we refresh the tools and maximize the use of the tools we have. COVID-19 has taught us that even if research invents a remarkably good vaccine, the process of implementing it on a population basis is complicated and must be equalized between haves and have-nots. Sociology and health economics need to be equalized globally.

What’s next for you and your research?

I have my hands full trying to make an HIV vaccine.

Where can readers find more information?

About Dr. Larry Corey

Dr. Larry Corey is an internationally renowned expert in virology, immunology, and vaccine development, and the former president and director of the Fred Hutchinson Cancer Research Center. His research focuses on herpes viruses, HIV, novel coronavirus, and other viral infections, including those associated with cancer. He is the Principal Investigator of the HIV Vaccine Trials Network (HVTN), which conducts HIV vaccine studies at more than 80 clinical trial sites in 16 countries on five continents. Under his leadership, the HVTN became the model for global collaborative research. Dr. Corey is also the Principal Investigator of the Fred Hutch-based Operations Center of the COVID-19 Prevention Network (CoVPN) and co-leads the network’s COVID-19 vaccine testing pipeline. CoVPN manages Operation Warp Speed’s extensive portfolio of COVID-19 vaccines and monoclonal antibodies to protect people against COVID-19.

Dr. Corey is a Fellow of the US National Academy of Medicine and the American Academy of Arts and Sciences, and received the Parran Prize for his work on HSV-2, American Society of Microbiology Cubist Award for his work on antivirals, and the Distinguished Alumnus Award from the University of Michigan Medical School. He is one of the most cited biomedical researchers for the past 20 years and has authored, co-authored or edited over 1000 scientific publications.