Frontiers in Microbiology (Jul 2021)

Global and Regional Estimates for Subtype-Specific Therapeutic and Prophylactic HIV-1 Vaccines: A Modeling Study

  • Ramyiadarsini Elangovan,
  • Michael Jenks,
  • Jason Yun,
  • Leslie Dickson-Tetteh,
  • Shona Kirtley,
  • Joris Hemelaar,
  • WHO-UNAIDS Network for HIV Isolation and Characterisation,
  • Alash’le G Abimiku,
  • Simon Agwale,
  • Chris Archibald,
  • Boaz Avidor,
  • María Gabriela Barbás,
  • Francoise Barre-Sinoussi,
  • Banson Barugahare,
  • El Hadj Belabbes,
  • Silvia Bertagnolio,
  • Deborah Birx,
  • Aleksei F Bobkov,
  • James Brandful,
  • Helba Bredell,
  • Catherine A Brennan,
  • James Brooks,
  • Marie Bruckova,
  • Luigi Buonaguro,
  • Franco Buonaguro,
  • Stefano Buttò,
  • Anne Buvé,
  • Mary Campbell,
  • Jean Carr,
  • Alex Carrera,
  • Manuel Gómez Carrillo,
  • Connie Celum,
  • Beth Chaplin,
  • Macarthur Charles,
  • Dimitrios Chatzidimitriou,
  • Zhiwei Chen,
  • Katsumi Chijiwa,
  • David Cooper,
  • Philip Cunningham,
  • Anoumou Dagnra,
  • Cillian F de Gascun,
  • Julia Del Amo,
  • Elena Delgado,
  • Ursula Dietrich,
  • Dominic Dwyer,
  • Dennis Ellenberger,
  • Barbara Ensoli,
  • Max Essex,
  • Hervé Fleury,
  • Peter N Fonjungo,
  • Vincent Foulongne,
  • Deepak A Gadkari,
  • Feng Gao,
  • Federico García,
  • Roger Garsia,
  • Guy Michel Gershy-Damet,
  • Judith R Glynn,
  • Ruth Goodall,
  • Zehava Grossman,
  • Monick Lindenmeyer Guimarães,
  • Beatrice Hahn,
  • Raph L Hamers,
  • Osamah Hamouda,
  • Ray Handema,
  • Xiang He,
  • Joshua Herbeck,
  • David D Ho,
  • Africa Holguin,
  • Mina Hosseinipour,
  • Gillian Hunt,
  • Masahiko Ito,
  • Mohamed Ali Bel Hadj Kacem,
  • Erin Kahle,
  • Pontiano Kaleebu,
  • Marcia Kalish,
  • Adeeba Kamarulzaman,
  • Chun Kang,
  • Phyllis Kanki,
  • Edward Karamov,
  • Jean-Claude Karasi,
  • Kayitesi Kayitenkore,
  • Tony Kelleher,
  • Dwip Kitayaporn,
  • Leondios G Kostrikis,
  • Claudia Kucherer,
  • Claudia Lara,
  • Thomas Leitner,
  • Kirsi Liitsola,
  • Jai Lingappa,
  • Marek Linka,
  • Ivette Lorenzana de Rivera,
  • Vladimir Lukashov,
  • Shlomo Maayan,
  • Luzia Mayr,
  • Francine McCutchan,
  • Nicolas Meda,
  • Elisabeth Menu,
  • Fred Mhalu,
  • Doreen Mloka,
  • John L Mokili,
  • Brigitte Montes,
  • Orna Mor,
  • Mariza Morgado,
  • Fausta Mosha,
  • Awatef Moussi,
  • James Mullins,
  • Rafael Najera,
  • Mejda Nasr,
  • Nicaise Ndembi,
  • Joel R Neilson,
  • Vivek R Nerurkar,
  • Florian Neuhann,
  • Claudine Nolte,
  • Vlad Novitsky,
  • Philippe Nyambi,
  • Marianna Ofner,
  • Fem J Paladin,
  • Anna Papa,
  • Jean Pape,
  • Neil Parkin,
  • Chris Parry,
  • Martine Peeters,
  • Alexandra Pelletier,
  • Lucía Pérez-Álvarez,
  • Deenan Pillay,
  • Angie Pinto,
  • Trinh Duy Quang,
  • Cecilia Rademeyer,
  • Filimone Raikanikoda,
  • Mark A. Rayfield,
  • Jean-Marc Reynes,
  • Tobias Rinke de Wit,
  • Kenneth E Robbins,
  • Morgane Rolland,
  • Christine Rousseau,
  • Jesus Salazar-Gonzales,
  • Hanan Salem,
  • Mika Salminen,
  • Horacio Salomon,
  • Paul Sandstrom,
  • Mario L Santiago,
  • Abdoulaye D Sarr,
  • Bryan Schroeder,
  • Michel Segondy,
  • Philippe Selhorst,
  • Sylvester Sempala,
  • Jean Servais,
  • Ansari Shaik,
  • Yiming Shao,
  • Amine Slim,
  • Marcelo A Soares,
  • Elijah Songok,
  • Debbie Stewart,
  • Julie Stokes,
  • Shambavi Subbarao,
  • Ruengpung Sutthent,
  • Jun Takehisa,
  • Amilcar Tanuri,
  • Kok Keng Tee,
  • Kiran Thapa,
  • Michael Thomson,
  • Tyna Tran,
  • Willy Urassa,
  • Hiroshi Ushijima,
  • Philippe van de Perre,
  • Guido van der Groen,
  • Kristel van Laethem,
  • Joep van Oosterhout,
  • Ard van Sighem,
  • Eric van Wijngaerden,
  • Anne-Mieke Vandamme,
  • Jurgen Vercauteren,
  • Nicole Vidal,
  • Lesley Wallace,
  • Carolyn Williamson,
  • Dawit Wolday,
  • Jianqing Xu,
  • Chunfu Yang,
  • Linqi Zhang,
  • Rong Zhang

DOI
https://doi.org/10.3389/fmicb.2021.690647
Journal volume & issue
Vol. 12

Abstract

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Global HIV-1 genetic diversity forms a major obstacle to the development of an HIV vaccine. It may be necessary to employ subtype-specific HIV-1 vaccines in individual countries according to their HIV-1 subtype distribution. We estimated the global and regional need for subtype-specific HIV-1 vaccines. We took into account the proportions of different HIV-1 variants circulating in each country, the genetic composition of HIV-1 recombinants, and the different genome segments (gag, pol, env) that may be incorporated into vaccines. We modeled different scenarios according to whether countries would employ subtype-specific HIV-1 vaccines against (1) the most common subtype; (2) subtypes contributing more than 5% of HIV infections; or (3) all circulating subtypes. For therapeutic vaccines targeting the most common HIV-1 subtype in each country, 16.5 million doses of subtype C vaccine were estimated globally, followed by subtypes A (14.3 million) and B (4.2 million). A vaccine based on env required 2.6 million subtype E doses, and a vaccine based on pol required 4.8 million subtype G doses. For prophylactic vaccines targeting the most common HIV-1 subtype in each country, 1.9 billion doses of subtype A vaccine were estimated globally, followed by subtype C (1.1 billion) and subtype B (1.0 billion). A vaccine based on env required 1.2 billion subtype E doses, and a vaccine based on pol required 0.3 billion subtype G doses. If subtype-specific HIV-1 vaccines are also directed against less common subtypes in each country, vaccines targeting subtypes D, F, H, and K are also needed and would require up to five times more vaccine doses in total. We conclude that to provide global coverage, subtype-specific HIV-1 vaccines need to be directed against subtypes A, B, and C. Vaccines targeting env also need to include subtype E and those targeting pol need to include subtype G.

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