AUTHOR=Elangovan Ramyiadarsini , Jenks Michael , Yun Jason , Dickson-Tetteh Leslie , Kirtley Shona , Hemelaar Joris , WHO-UNAIDS Network for HIV Isolation and Characterisation , Abimiku Alash’le G , Agwale Simon , Archibald Chris , Avidor Boaz , Barbás María Gabriela , Barre-Sinoussi Francoise , Barugahare Banson , Belabbes El Hadj , Bertagnolio Silvia , Birx Deborah , Bobkov Aleksei F , Brandful James , Bredell Helba , Brennan Catherine A , Brooks James , Bruckova Marie , Buonaguro Luigi , Buonaguro Franco , Buttò Stefano , Buvé Anne , Campbell Mary , Carr Jean , Carrera Alex , Carrillo Manuel Gómez , Celum Connie , Chaplin Beth , Charles Macarthur , Chatzidimitriou Dimitrios , Chen Zhiwei , Chijiwa Katsumi , Cooper David , Cunningham Philip , Dagnra Anoumou , Gascun Cillian F de , Amo Julia Del , Delgado Elena , Dietrich Ursula , Dwyer Dominic , Ellenberger Dennis , Ensoli Barbara , Essex Max , Fleury Hervé , Fonjungo Peter N , Foulongne Vincent , Gadkari Deepak A , Gao Feng , García Federico , Garsia Roger , Gershy-Damet Guy Michel , Glynn Judith R , Goodall Ruth , Grossman Zehava , Guimarães Monick Lindenmeyer , Hahn Beatrice , Hamers Raph L , Hamouda Osamah , Handema Ray , He Xiang , Herbeck Joshua , Ho David D , Holguin Africa , Hosseinipour Mina , Hunt Gillian , Ito Masahiko , Kacem Mohamed Ali Bel Hadj , Kahle Erin , Kaleebu Pontiano , Kalish Marcia , Kamarulzaman Adeeba , Kang Chun , Kanki Phyllis , Karamov Edward , Karasi Jean-Claude , Kayitenkore Kayitesi , Kelleher Tony , Kitayaporn Dwip , Kostrikis Leondios G , Kucherer Claudia , Lara Claudia , Leitner Thomas , Liitsola Kirsi , Lingappa Jai , Linka Marek , Rivera Ivette Lorenzana de , Lukashov Vladimir , Maayan Shlomo , Mayr Luzia , McCutchan Francine , Meda Nicolas , Menu Elisabeth , Mhalu Fred , Mloka Doreen , Mokili John L , Montes Brigitte , Mor Orna , Morgado Mariza , Mosha Fausta , Moussi Awatef , Mullins James , Najera Rafael , Nasr Mejda , Ndembi Nicaise , Neilson Joel R , Nerurkar Vivek R , Neuhann Florian , Nolte Claudine , Novitsky Vlad , Nyambi Philippe , Ofner Marianna , Paladin Fem J , Papa Anna , Pape Jean , Parkin Neil , Parry Chris , Peeters Martine , Pelletier Alexandra , Pérez-Álvarez Lucía , Pillay Deenan , Pinto Angie , Quang Trinh Duy , Rademeyer Cecilia , Raikanikoda Filimone , Rayfield Mark A. , Reynes Jean-Marc , Wit Tobias Rinke de , Robbins Kenneth E , Rolland Morgane , Rousseau Christine , Salazar-Gonzales Jesus , Salem Hanan , Salminen Mika , Salomon Horacio , Sandstrom Paul , Santiago Mario L , Sarr Abdoulaye D , Schroeder Bryan , Segondy Michel , Selhorst Philippe , Sempala Sylvester , Servais Jean , Shaik Ansari , Shao Yiming , Slim Amine , Soares Marcelo A , Songok Elijah , Stewart Debbie , Stokes Julie , Subbarao Shambavi , Sutthent Ruengpung , Takehisa Jun , Tanuri Amilcar , Tee Kok Keng , Thapa Kiran , Thomson Michael , Tran Tyna , Urassa Willy , Ushijima Hiroshi , Perre Philippe van de , Groen Guido van der , Laethem Kristel van , Oosterhout Joep van , Sighem Ard van , Wijngaerden Eric van , Vandamme Anne-Mieke , Vercauteren Jurgen , Vidal Nicole , Wallace Lesley , Williamson Carolyn , Wolday Dawit , Xu Jianqing , Yang Chunfu , Zhang Linqi , Zhang Rong TITLE=Global and Regional Estimates for Subtype-Specific Therapeutic and Prophylactic HIV-1 Vaccines: A Modeling Study JOURNAL=Frontiers in Microbiology VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2021.690647 DOI=10.3389/fmicb.2021.690647 ISSN=1664-302X ABSTRACT=

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.