A landmark international study involving top South African scientists has unlocked some of the human immune system's deepest secrets, boosting hopes of developing the world's first successful Aids vaccine.
The study, which appears in the latest edition of the scientific journal Nature, identifies the "genetic battleground" where the struggle between the human immunodeficiency virus (HIV) and the human immune response occurs and shows for the first time which category of immune cells are actually fighting the virus and which are not.
It is hoped that the finding will lead to ways of circumventing the virus's ability to avoid vaccines by rapid mutation.
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"The Aids crisis will only be solved with the development of an effective vaccine," said Dr Bruce Walker, a co-author of the study and the director of the Partners Aids Research Centre (PARC) at Massachusetts General Hospital, the institution that established the study.
"The results help to focus this effort by telling us what the most effective immune responses are."
Professor Hoosen Coovadia, the co-leader, with Dr Photini Kiepiela from the University of KwaZulu-Natal, of the study's South African research arm, described the information as "critical". A more accurate combination of viral particles would significantly boost the chances of developing a vaccine, he said.
The main focus of the research process was to look at the success of different groups of immune response genes in responding to HIV infection.
The researchers found that the human leukocyte antigen B molecules (HLA-B) - cells that send an alarm signal to the "killer" T cells when a virus or foreign body is present - were the key players on the HIV battlefield, whereas HLA-A and HLA-C were ineffective.
Kiepiela said that it was now clear that patients who had particular HLA-B molecules in their body coped better with HIV infection and had a lower viral load. It was also found that infected pregnant mothers with a protective version of HLA-B were more likely to survive and less likely to pass on the infection to their infant at birth.
Said Coovadia: "It is possible that in the long term, after tremendous cost in human lives and suffering, that we will have populations with the 'protective genes' in large proportions and that like the 'Black Death', the epidemic will eventually burn out."
Kiepiela said that while the evidence of HLA-B's ability to "summon the forces" was "overwhelming", the research work would continue. "We believe we can be even more specific by identifying which of the immune responses generated through HLA-B genes are the Rolls-Royce version and which are not."
Dr Philip Goulder, a principal investigator from PARC, said the findings would help in understanding how the immune system could succeed or fail against HIV, "a pre-requisite for a rational approach towards the design of an HIV vaccine".
The three-year research programme was conducted in communities around the world hardest hit by the HIV epidemic, most of which are in Africa.
- This article was originally published on page 1 of Sunday Independent on December 12, 2004
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