Abstract
This report summarizes a consultation meeting convened by the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), on 12 September 2017 to discuss the scientific rationale for selectively testing relevant HIV vaccine candidates in early life that are designed to initiate immune responses for lifelong protective immunity. The urgent need to develop interventions providing durable protective immunity to HIV before sexual debut coupled with the practicality of infant vaccine schedules supports optimizing infant HIV vaccines as a high priority. The panelists discussed the unique opportunities and challenges of testing candidate HIV vaccines in the context of distinct early-life immunity. Key developments providing rationale and grounds for cautious optimism regarding evaluation of early-life HIV vaccines include recent studies of early-life immune ontogeny, studies of HIV-infected infants demonstrating relatively rapid generation of broadly neutralizing antibodies (bNAbs), discovery of novel adjuvants active in early life, and cutting-edge sample-sparing systems biology and immunologic assays promising deep insight into vaccine action in infants. Multidisciplinary efforts toward the goal of an infant HIV vaccine are under way and should be nurtured and amplified.IMPORTANCE Young adults represent one of the highest-risk groups for new HIV infections and the only group in which morbidity continues to increase. Therefore, an HIV vaccine to prevent HIV acquisition in adolescence is a top priority. The introduction of any vaccine during adolescence is challenging. This meeting discussed the opportunities and challenges of testing HIV vaccine candidates in the context of the infant immune system given recent advances in our knowledge of immune ontogeny and adjuvant design and studies demonstrating that HIV-infected infants generate broadly neutralizing antibodies, a main target of HIV vaccines, more rapidly than adults. Considering the global success of pediatric vaccines, the concept of an HIV vaccine introduced in early life holds merit and warrants testing.
Highlights
IntroductionMeeting Highlights youth becoming newly infected with HIV remains unacceptably high [3], especially in young women who can become pregnant, efforts to expedite the discovery, manufacture, and testing of pediatric vaccines for HIV need to be more strongly emphasized
This report summarizes a consultation meeting convened by the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), on 12 September 2017 to discuss the scientific rationale for selectively testing relevant HIV vaccine candidates in early life that are designed to initiate immune responses for lifelong protective immunity
A consultation committee, in conjunction with the NIH AIDS Vaccine Research Subcommittee (AVRS) advisory panel meeting in September 2017, solicited suggestions about the critical gaps in the current research agenda related to early-life vaccination and the need to develop organized efforts, such as pediatric vaccine working groups, to address the prioritized gap areas relevant to pediatric HIV vaccine research and development
Summary
Meeting Highlights youth becoming newly infected with HIV remains unacceptably high [3], especially in young women who can become pregnant, efforts to expedite the discovery, manufacture, and testing of pediatric vaccines for HIV need to be more strongly emphasized. This goal is aligned with the UNAIDS Start Free-Stay Free-AIDS Free collaborative framework that embraces a life cycle approach to achieve an AIDS-free generation with a particular focus on children, adolescents, and young women [4].
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