Acquired Immunodeficiency Syndrome (AIDS), caused by the Human Immunodeficiency Virus (HIV), remains one of the most significant global health challenges despite decades of scientific progress. Since its identification in the early 1980s, HIV/AIDS has claimed over 40 million lives and continues to affect millions worldwide. While antiretroviral therapies (ART) have transformed HIV from a fatal diagnosis to a manageable chronic condition, the ultimate goal remains the development of a safe, effective, and widely accessible vaccine. This blog explores the progress, potential, and persistent hurdles associated with AIDS vaccine development, presenting a comprehensive view of hope and challenges in this crucial field of biomedical research.
WHAT IS HIV?
HIV (that is also referred to as a retrovirus) stealthily attacks cells of the immune system and inserts its genetic blueprint into them. It weakens the immune system by affecting the T-cells of the body, until one is unable to fight off any disease in the body. When HIV has severely weakened the immune system, it can lead to what is known as ‘AIDS.’ Moreover, to control and ultimately end HIV globally, we need a powerful array of HIV prevention tools that are widely accessible to all who would benefit from them. Additionally, scientists these days are developing next-generation HIV vaccines to address the complexities of HIV vaccine design. Coming to India, it still has the third-largest population of people living with HIV in the world. With nearly 2.4 million people affected as per recent estimates, the fight against HIV/AIDS in India is far from over.
WHAT IS AIDS?
AIDS is the final and most serious stage of an HIV Infection. People with AIDS have very low counts of certain white blood cells and severely damaged immune systems. They may have additional illnesses that indicate that they have progressed to AIDS. Without treatment, HIV progresses to AIDS and can even cause death.
IS THERE A DIFFERENCE BETWEEN HIV AND AIDS?
The main difference between HIV and AIDS is that HIV is a virus that weakens the white blood cells (known as CD4 cells) or the immune system of the human body, whereas AIDS is a condition that can arise as an outcome of HIV infection when the immune system is severely weakened or compromised. Moreover, one cannot catch AIDS if one is not infected with HIV.
SYMPTOMS OF HIV AND AIDS:
- Flu-like symptoms such as sore throat, fever, cough, and cold.
- Muscle aches.
- Night sweats.
- Swollen lymph nodes.
- Mouth sores, including yeast infection.
- Sudden weight loss
CAUSES OF HIV AND AIDS:
The virus is transmitted from one person to another through certain bodily fluids such as –
- Blood
- Semen and preseminal fluid
- Rectal fluids
- Vaginal fluids
- Breast milk
- Mucous membranes
- The bloodstream by injection or needle stick that is contaminated with HIV
- Damaged tissue
WHAT ARE THE STAGES OF HIV AND AIDS?
There are three main stages of HIV and AIDS:
- Acute HIV – For instance, some people get flu-like symptoms within a month or two, such as fever, cold, cough, sore throat, including mouth ulcers. These symptoms go away within a month or weeks.
- Chronic stage – after the acute stage, one can have HIV for many years without feeling sick.
- Progression to AIDS – this is the most severe stage of HIV infection. In this stage, HIV has severely weakened and damaged the immune system to the point that the body is easily attacked by a variety of infections. One must also keep in mind that those infected with AIDS can also get infected with certain types of cancers. These certain type of cancers along with certain opportunistic infections, can cause ‘AIDS-defining illnesses’ such as burkitt lymphoma, candidiasis, chronic intestinal isosporiasis, coccidioidomycosis (lungs getting affected), cytomegalovirus, encephalopathy, herpes simplex ulcers, and histoplasmosis, HIV wasting syndrome, cervical cancer, recurrent bacterial infections and so on.
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THE IMPORTANCE OF HIV VACCINE IN TODAY’S WORLD
Despite advancements in prevention and treatment, HIV remains a global pandemic. Approximately 39 million people were living with HIV in 2023, and many regions, particularly sub-Saharan Africa, bear a disproportionate burden of the disease. ART, pre-exposure prophylaxis (PrEP), and harm-reduction strategies have curbed transmission, but these approaches depend on adherence, long-term funding, and healthcare access—factors which are universally not available. A vaccine would provide a sustainable and cost-effective strategy for preventing new infections, reducing the long-term need for ART, and ultimately curbing the epidemic. Unlike many infectious diseases, however, developing a vaccine for HIV presents unique and formidable scientific challenges.
Scientific Challenges in HIV Vaccine Development:
- Genetic Diversity of HIV: HIV is one of the most variable viruses known. It mutates rapidly and exists as numerous subtypes across different regions, making it difficult to create a one-size-fits-all vaccine.
- Immune Evasion: HIV has evolved sophisticated mechanisms to evade the human immune system. It integrates into the host genome and can remain latent, making detection and elimination by immune cells extremely difficult.
- Lack of Natural Immunity: Most vaccines are modelled on the body’s natural ability to overcome infection. However, no individual has ever naturally cleared HIV, offering limited biological precedent to mimic.
- Targeting the Right Immune Response: HIV primarily targets CD4+ T-cells—the very cells that handle the immune responses. This complicates efforts to stimulate immunity without inadvertently aiding the virus.
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However, despite these hurdles, the past two decades have witnessed notable progress in HIV vaccine research, with the help of technological innovations and a deeper understanding of immunology.
- Broadly Neutralizing Antibodies (bNAbs): A breakthrough has come from the discovery of bNAbs—antibodies that can neutralize multiple HIV strains. Vaccine candidates are now being designed to stimulate production of bNAbs, guiding the immune system toward effective, long-lasting protection.
- mRNA Technology: Following the success of mRNA vaccines for COVID-19, researchers are exploring similar platforms for HIV. Companies like Moderna and collaborations like the International AIDS Vaccine Initiative (IAVI) are actively testing mRNA-based HIV vaccines in clinical trials.
- Prime-Boost Strategies: These involve using one type of vaccine to “prime” the immune system and another to “boost” the response. This approach has shown promise in enhancing both antibody and T-cell responses.
- Therapeutic Vaccines: While preventive vaccines aim to stop infection, therapeutic vaccines seek to strengthen the immune system of already infected individuals. These vaccines may reduce dependence on ART and offer a path to a functional cure.
Numerous HIV vaccine candidates have entered clinical trials over the years, with mixed outcomes. The RV144 trial in Thailand (2009) was the first to demonstrate modest efficacy (~31%), providing valuable insights into immune correlates of protection. More recently, the HVTN 702 trial in South Africa was halted in 2020 due to a lack of efficacy, underscoring the complexity of translating scientific promise into real-world success.
Each setback, however, contributes critical data that informs future efforts. Learning from failures is a defining characteristic of long-term vaccine development, particularly in such an intricate and adaptive pathogen as HIV.
Now coming to the Indian context, like the rest of the world, Indian researchers too face several scientific barriers in developing an effective HIV vaccine:
- Viral Diversity in Indian Clades: HIV subtype C is most prevalent in India. This strain is genetically different from others circulating globally, requiring vaccine strategies tailored specifically for Indian populations.
- Immune Evasion: HIV’s rapid mutation rate and ability to hide in host cells make it hard for the immune system to clear the virus naturally, an obstacle for vaccine design.
- Limited Natural Immunity Models: Since no individual has ever been known to naturally eliminate HIV, researchers cannot rely on typical vaccine development methods.
- Infrastructure and Funding: Vaccine research is resource-intensive. While India has built considerable biotechnological capacity, sustained investment in HIV vaccine R&D is still limited compared to diseases like tuberculosis or COVID-19.
However, despite the challenges and obstacles it is worth mentioning that India’s National AIDS Control Programme (NACP), run by the National AIDS Control Organisation (NACO), has made major progress in reducing infection rates and expanding ART coverage. Still, challenges remain, such as:
- Adherence to daily medication can be inconsistent, especially in rural areas.
- Stigma and discrimination discourage many from getting tested or seeking treatment.
- The economic burden of managing a lifelong chronic illness affects both individuals and public health systems.
A proper vaccine would offer a one-time or short-term intervention with long-term protective benefits, drastically changing the landscape of HIV prevention in India.
SOCIO–ECONOMIC CHALLENGES OF AIDS IN INDIA:
- Stigma and Awareness: Despite public health campaigns, HIV/AIDS is still heavily stigmatized in Indian society. Any vaccine rollout must be paired with strong awareness and de-stigmatization efforts.
- Accessibility and Equity: A vaccine must be affordable and accessible to vulnerable populations. Government support, inclusion in public health programs, and possibly free distribution through schemes like Ayushman Bharat would be essential.
- Regulatory and Ethical Oversight: Ensuring ethical standards in clinical trials, especially among marginalized communities, is crucial. India’s regulatory bodies must maintain transparency and accountability throughout the vaccine development process.
CURRENT STATUS OF HIV VACCINES IN INDIA:
As of 2025, there is no approved HIV/AIDS vaccine available in India or globally for general use. Moreover, India has been actively involved in research, clinical trials, and collaborations aimed at developing an HIV vaccine. Furthermore, inspired by the success of mRNA technology in COVID-19 vaccines, Indian biotechnology firms such as Gennova Biopharmaceuticals are exploring the potential of mRNA-based HIV vaccines. While this work is still in early stages, it represents a significant step forward.
HOPE FOR THE FUTURE:
The journey to an HIV vaccine is long, but not hopeless. India’s biotech ecosystem, which successfully manufactured affordable vaccines for the world during the COVID-19 crisis, can play a similar role in HIV. A preventive vaccine, when developed, would not only safeguard millions in India but could be exported to other high-burden regions.
Public-private partnerships, community engagement, and political will are key to making this vision a reality. The government’s commitment to “End AIDS by 2030,” aligned with the UN Sustainable Development Goals, will remain incomplete without a vaccine as a cornerstone of the prevention strategy.
CONCLUSION:
In conclusion, it can be stated that currently, there is no licensed HIV vaccine available in India, but research and clinical trials are actively ongoing. The path to an effective HIV vaccine is long and complex, but India’s growing research capabilities, public health infrastructure, and global partnerships position it well to play a leading role in this global quest. The development of an HIV vaccine would not only mark a major scientific breakthrough but also bring us closer to the vision of an AIDS-free India.
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