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Global health breakthrough: New TB vaccine effective for HIV patients

Ano Lobb | Wednesday 3rd February 2010

A collaboration between Dartmouth Medical School and the Muhimbli University of Health and Allied Science in Dar es Salaam, Tanzania, reports that a new vaccine effectively reduces tuberculosis (TB), the cause of some 1 million deaths each year among HIV patients.

While other researchers toil to find a vaccine for HIV itself, this international collaboration-called the Dar Dar study- is about to bring the world a near-second: a shot that reduces the leading killer of HIV infected patients.

As HIV treatments have become more effective and available, the disease has changed from an acute cause of death to a chronic illness. HIV patients receiving treatment may live for decades with their infection, but are vastly more susceptible to death from co-infections that may assault their battered immunity. About one-third of the estimated 34 million people living with HIV are co-infected with tuberculosis, the acute cause of as many as half of all HIV deaths. TB is a potentially deadly but remarkably common respiratory infection. One in three people worldwide, or about 2 billion, are infected with TB, but only 8 to 10 million develop full-blown illness, and 2 million die from it. Being HIV infected makes you 50 times more likely to become ill with TB.

This phase-III clinical trial funded by the US National Institutes of Health followed 2,000 HIV infected patients in Tanzania for 7 years, and found that the vaccine reduced TB outbreak by 39%. The previous phase-I and phase-II trials (smaller, more preliminary research establishing safety in healthy and HIV infected people) were conducted in the US, Zambia and Finland. An inactivated vaccine, it is expected to be cheap and easy to produce.

Not only is this a potential watershed for the global efforts to fight HIV, but it was also a successful exercise in research capacity building and collaboration between so-called "northern and southern hemisphere" universities. While the technical expertise of institutions in Europe, the US, Japan and increasingly China are often looked for in searching for disease cures, there is no substitute for having such development, research and innovation happening in the regions of greatest need, in this case sub-Saharan Africa.

Researchers are now turning their attention to refining production methods that will allow a high volume of the vaccine to be available. Another international partnership, US-based Aeras Global TB Vaccination Fund and Immodulon Therapeutics in London, are currently developing the vaccine's manufacturing capacity.

(As a conflict of interest disclaimer, I am an employee and alumni of Dartmouth Medical School)

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