Evidence map›Paper›PMID 29241646›Full record

ArticleVaccine2018

HIV population-level adaptation can rapidly diminish the impact of a partially effective vaccine.

Joshua T Herbeck, Kathryn Peebles, Paul T Edlefsen, Morgane Rolland, James T Murphy, Geoffrey S Gottlieb, Neil Abernethy, James I Mullins, John E Mittler, Steven M Goodreau

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Vaccine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Joshua T HerbeckInternational Clinical Research Center, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA. Electronic address: herbeck@uw.edu.
Kathryn PeeblesInternational Clinical Research Center, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
Paul T EdlefsenVaccine and Infectious Disease Division, FHCRC, Seattle, WA, USA.
Morgane RollandUS Military HIV Research Program, WRAIR, Silver Spring, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.
James T MurphyDepartment of Microbiology, University of Washington, Seattle, WA, USA.
Geoffrey S GottliebDepartment of Medicine, University of Washington, Seattle, WA, USA.
Neil AbernethyDepartment of Biomedical Inf. and Medical Education, University of Washington, Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA.
James I MullinsDepartment of Global Health, University of Washington, Seattle, WA, USA; Department of Microbiology, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA; Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
John E MittlerDepartment of Microbiology, University of Washington, Seattle, WA, USA.
Steven M GoodreauCenter for Studies in Demography and Ecology, University of Washington, Seattle, WA, USA; Department of Anthropology, University of Washington, Seattle, WA, USA.

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI Kenneth Sherr · 1988 to 2026
$104.9M
Scientific/Technical CoreP2CHD042828 · NICHD · UNIVERSITY OF WASHINGTON · PI SARA R. CURRAN · 2017 to 2026
$6.3M
Integrated bio-social models for HIV epidemiologyR01AI108490 · NIAID · UNIVERSITY OF WASHINGTON · PI GOODREAU, STEVEN M., HERBECK, JOSHUA T · 2014 to 2018
$3.4M
Modeling the Evolutionary and Public Health Impacts of HIV Adaptation in Response to VaccinationR01GM125440 · NIGMS · UNIVERSITY OF WASHINGTON · PI HERBECK, JOSHUA T · 2017 to 2018
$841k
NIAID NIH HHS P30 AI027757NIAID NIH HHS R01 AI108490NICHD NIH HHS P2C HD042828NIGMS NIH HHS R01 GM125440
6 · The paper itself

Abstract

backgroundDevelopment of an HIV vaccine might be essential to ending the HIV/AIDS pandemic. However, vaccines can result in the emergence and spread of vaccine-resistant strains. Indeed, analyses of breakthrough infections in the HIV phase 3 vaccine trial RV144 identified HIV genotypes with differential rates of transmission in vaccine and placebo recipients. We hypothesized that, for HIV vaccination programs based on partially effective vaccines similar to RV144, HIV adaptation will rapidly diminish the expected vaccine impact. METHODS AND

findingsUsing two HIV epidemic models, we simulated large-scale vaccination programs and, critically, included HIV strain diversity with respect to the vaccine response. We show here that rapid population-level viral adaptation can lead to decreased overall vaccine efficacy and substantially fewer infections averted by vaccination, when comparing scenarios with and without viral evolution (with outcomes depending on vaccination coverage, vaccine efficacy against the sensitive allele, and the initial resistant allele frequency). Translating this to the epidemic in South Africa, a scenario with 70% vaccination coverage may result in 250,000 infections (non-averted by vaccination) within 10 years of vaccine rollout that are due solely to HIV adaptation, all else being equal.

conclusionsThese findings suggest that approaches to HIV vaccine development, program implementation, and epidemic modeling may require attention to viral adaptation in response to vaccination.

Indexed as

AIDS VaccinesAntiretroviral Therapy, Highly ActiveHIVHIV InfectionsHumansImmunogenicity, VaccineIncidenceOutcome Assessment, Health CarePrevalenceVaccinationAIDS VaccinesHIV preventionHIV vaccineMathematical modelSouth Africa

Identifiers

PMID29241646
PMCPMC6701864

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.