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Isle roots run deep in AIDS vaccine study


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POSTED: Monday, October 19, 2009

Three U.S. military researchers from Hawaii will be in the world spotlight this week when they present the results of the largest-ever clinical trial of an AIDS vaccine at a research conference in Paris.

The initial findings, released in Thailand last month, suggested that the vaccine had a statistically significant result—reducing AIDS infection by 31 percent among more than 16,000 volunteers in Thailand.

Other AIDS researchers, however, are questioning the results after unreleased data from the study showed the vaccine was not as effective among those who got all six shots necessary for the vaccine regimen.

The three doctors in charge of the U.S. Army's HIV research program, which ran the study along with the Thai Ministry of Public Health and other collaborators, all went to high school in Hawaii.

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Col. Nelson Michael, director of the research division, is a 1975 Punahou graduate, and his father, Jerrold, is a former dean of the University of Hawaii School of Public Health. Col. Jerome Kim, the deputy director for science who led the trial, graduated from 'Iolani in 1979; and Dr. Merlin Ross, the deputy director of clinical research, is a 1973 Radford graduate.

“;How very remarkable,”; Dr. Michael said in an e-mail, “;that three people who did not know each other in Hawaii are now the top three people in the U.S. Military HIV Research Program.”;

That is not the only connection between Hawaii and the vaccine trial.

Hawaii was also a key meeting place for the Thai researchers and government officials and the Army scientists, said Dr. Kim.

Kim, who is still an associate professor at the UH medical school, said Hawaii's location provided a natural meeting place about halfway between the Walter Reed Army Institute of Research in Maryland and Thailand. The Thai visitors also felt comfortable in Hawaii's multiethnic setting and could find good Thai food here, he said.

Army doctors at Tripler also helped with the management of the study.

Dr. Tom Crabtree of the Center for Excellence in Disaster Management and Humanitarian Assistance at Tripler said the U.S. military has a long history of working with the Thai military and Thai doctors on medical research.

The University of Hawaii is also doing AIDS research in Thailand through the medical school's South East Asia Research Collaboration with Hawaii project in Bangkok, said Dr. Cecilia Shikuma, head of the Hawaii Center for AIDS at the medical school.

Kim helped set up the SEARCH effort in Bangkok, before he left UH-Manoa to oversee the vaccine clinical trial.

The vaccine trial in Thailand “;shows that there is hope for a preventative vaccine,”; Shikuma said. “;This is still the first time that anything has shown any kind of signal that this (vaccine research) might be working.”;

The presentation by Kim and the other doctors involved in the study is likely to be among the highlights of the AIDS vaccine conference. There is already heated debate over how to interpret the results.

The study used two vaccines designed to stimulate the immune system to fight HIV in different ways. The vaccines previously had been tested separately and did not show results.

A total of 16,402 volunteers participated. All were between the ages of 18 to 30 and came from the general population rather than high-risk groups.

The participants were taught how to avoid getting AIDS and offered condoms, and any participant who got infected with the disease was given free treatment.

New HIV infections occurred in 51 of the 8,197 given the vaccine and in 74 of those given the placebo.

That difference of 23 people will be among the questions raised this week about the study at the conference. The difference is even smaller when those who dropped out early and who contracted the disease before getting all six shots are taken out of the result.

This week's conference will also help determine what kind of follow-up studies might be conducted to verify the results of the clinical trial and to determine how the vaccine works or does not work.

Kim and Shikuma said there is a chance UH might participate in a future study of the vaccine, perhaps involving whether the treatment might help prevent or slow the development of AIDS among those already infected with HIV.

Star-Bulletin news services contributed to this story.