From Arthur Chance
The idea of making an HIV vaccine from live HIV that can only replicate in
the presence of a trigger substance is an interesting one
(26 May, p 17), but
the choice of doxycycline for the trigger is somewhat unfortunate.
As I learned when visiting my travel clinic a fortnight ago, doxycycline is
the WHO’s drug of choice for protecting people against malaria in areas where it
is resistant to mefloquine, and for people for whom mefloquine is
unsuitable.
As many areas with high HIV infection rates also have endemic malaria, the
idea of an HIV vaccine that converts to active HIV when exposed to a standard
antimalarial is less than appealing.
It might be of use in the poorer countries which cannot afford prophylaxis
and rely instead on childhood-acquired immunity to malaria, but realistically
these are the countries least able to afford any HIV treatment.
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One hopes the University of Amsterdam team can find an alternative trigger
substance that is not liable to be used for any other purpose in the areas where
the vaccine would potentially be deployed.
Cambridge
