AIDS vaccines

AIDS vaccines

A new AIDS vaccine tested on more than 16,000 volunteers in Thailand has protected a significant minority against infection, the first time any vaccine against the disease has even partly succeeded in a clinical trial. Scientists said they were delighted but puzzled by the result. The vaccine — a combination of two genetically engineered vaccines, neither of which had worked before in humans — protected too few people to be declared an unqualified success. And the researchers do not know why it worked.

“I don’t want to use a word like ‘breakthrough,’ but I don’t think there’s any doubt that this is a very important result,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, which is one of the trial’s backers. Over the course of three years, 74 of 8,198 people who received placebo shots became infected with HIV, compared with 51 of 8,197 people who received vaccine. So the vaccine appeared to reduce the risk of being infected by 31%. The statement from NIH, one of the sponsors of the trial, called this a “modest preventive effect.”

Patients who received the vaccine and did get infected didn’t have lower levels of virus than patients who received placebo and got infected — a puzzling finding, given that a partially effective vaccine would be expected to help a patient’s immune system fight the disease. Still, previous AIDS vaccine trials have failed miserably. A Merck AIDS vaccine study was halted in 2007, after data showed the vaccine didn’t reduce the risk of infection and may actually have left some people more susceptible to the virus. The NIH subsequently canceled plans for another major AIDS vaccine trial that would have used a similar approach.

HIV vaccine

HIV vaccine

There is nothing I would like better than to wake up and learn of a new and effective HIV vaccine (except maybe a malaria vaccine), so I was excited to hear of a successful vaccine trial this morning. Multiple news agencies reported that a vaccine reduced the risk of HIV infection by 30%. While the media loves a big story, these results were underwhelming. Although they were "statistically significant," it is way too early to declare success. A simple look at the numbers is more sobering: after vaccinating 16,000 people, there were 23 fewer new infections in patients receiving the vaccine (51 cases versus 74 cases). If one additional patient who received the vaccine became infected (52 instead of 51) the results would no longer be "statistically significant."

A misunderstanding of statistics and study design often leads to premature optimism as well as fear, when new studies come out. Today we learned that a combining multiple injections of two vaccines that proved unsuccessful in the past may reduce the chance of new infections. I remain hopeful but VERY skeptical, given the modest differences and lack of biological evidence (there was no difference in viral loads between vaccinated and non-vaccinated patients who acquired HIV). While I am encouraged by the efforts and work being done to develop a vaccine, we have yet to find a silver bullet.

We currently spend a lot of money on abstinence education programs, which have proven unsuccessful and often highlight the failures of condoms. Encouraging abstinence and faithfulness are noble goals, but they should not divert money from strategies with a stronger track record of success. While we continue to wait for more promising results of vaccine trials, we should not wait to deliver more condoms, sex education, clean needles and drugs to reduce perinatal transmission of HIV.

Mackenzie Phillips on Oprah

Mackenzie Phillips on Oprah

Mackenzie Phillips on 'Oprah': I had abortion after incest; stepmom Michelle calls her liar In the wake of Mackenzie Phillips' bombshell allegation that she had an incestuous relationship with her father, her stepmother, Michelle, is accusing her of lying, according to the Hollywood Reporter. More details of Mackenzie's story came to light as her full interview with Oprah Winfrey aired Wednesday, including that she became pregnant and had an abortion. She was uncertain whether the baby was by her father or her husband, who had no idea she was having an incestuous affair.

While her father, John Phillips of the Mamas and the Papas, raped her the first time they had sex, the relationship later became consensual, she said, and went on for nearly a decade. Michelle Phillips, John's ex-wife and Mackenzie's stepmother, denied the story in an exclusive interview with Roger Friedman for the Hollywood Reporter's Showbiz 411 blog. She told Friedman that in 1997, Mackenzie told everyone in their extended family that she and John Phillips had a sexual relationship, including Michelle.

"She told me, then she called me back and said, 'You know I'm joking,' " Michelle said. She continued, "I said it wasn't funny. Mackenzie said, 'I guess we have different senses of humor.' " Mackenzie is John's child from his marriage to heiress Susan Adams. He wed Michelle Phillips in 1962. Mackenzie's sister, Chynna, had the opposite reaction to Mackenzie's revelation. "Somebody could have dropped a piano on my head and I probably wouldn't have felt it," she told Us Weekly of her reaction to a phone call from her sister, also in 1997. "But I knew it was true. I mean, who in their right mind would make such a claim if it wasn't true?" In that instance, Mackenzie did not say her story was a joke.