HIV Vaccine goes to Clinical Trial A vaccine therapy that could functionally cure AIDS is edging closer to reality after Professor Chen Zhiwei, Chair Professor of the Department of Microbiology, School of Clinical Medicine, and Director of HKU’s AIDS Institute, was awarded a Theme-based Research Scheme (TRS) grant to bring his discovery to multicentre clinical trials. Professor Chen first discovered the potential of a PD1enhanced DNA vaccine in 2023 against HIV-1 that causes AIDS, and he has been progressing ever since to bring it from the laboratory to patients. Under an earlier TRS, he and his collaborators successfully showed the vaccine could control AIDS virus in rhesus monkeys for over six years in the absence of combination antiretroviral therapy (cART). They also did a separate phase one human trial to show it was safe for people living with HIV-1 (PLWH). Now, with new TRS funding, they will conduct phase two human clinical trials in Hong Kong, Shenzhen, Beijing, Guangzhou and other hospitals to test the vaccine’s efficacy in humans as it is in monkeys. They will also investigate the mechanism that makes it work. About 40 million PLWHs and another 40 million have died since it was first discovered in 1981. Only seven people have ever been cured, through difficult and expensive bone marrow transplantation. For most, life-long cART remains the only way to manage the infection, which is costly and can lead to clinical problems such as heart disease, neurological disorder, diabetes and depression. Professor Chen’s therapeutic vaccine aims to enhance T-cell immunity to control virus replication in the body. The phase two clinical trials will be conducted with The Third People’s Hospital in Shenzhen (which also collaborated on the phase one trial), industry partner Immuno Cure, HIV clinic at The Chinese University of Hong Kong and other participating hospitals in Mainland China. The idea is that initially, patients who receive the vaccine will continue their cART treatment. But if all goes well, they may be able to stop cART. ‘We will improve the vaccine immunogenicity continuously to identify patients that could stop conventional drug treatment,’ Professor Chen said. ‘If we can achieve a certain percentage of patients having long-term virus control, we are going to be very happy.’ He noted that collaboration across the Greater Bay Area was essential because Hong Kong does not yet have a vaccine GMP facility or sufficient resources for a multi-centre clinical trial. This is also true for another major project he was recently awarded under the government’s RAISe+ programme, to advance an antibody drug he developed against cancers and infections. ‘It is very busy having these two big projects at the same time, both stemming from our original discoveries – they are first-in-class new drug discoveries. We are actually creating new therapies. That is the beauty of these projects,’ he commented. ‘We aim for a functional cure because eradicating HIV-1 is challenging. Based on our monkey data, we believe we can achieve long-term, cART-free control of the virus, which would be a significant scientific achievement and would benefit patients facing toxicity issues from current therapies.’ Professor Chen Zhiwei 7 HKUMed News Winter 2024
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