Patient shares hope for therapeutic vaccine as potential HIV treatment

Between appointments Robert Wilkinson, a participant in a NIAID trial, enjoys playing the piano for visitors and other patients on the 7th floor. Above, he and a friend, played and sang during his June 2015 visit.

Vaccine or placebo? For Robert Wilkinson, either one is a win. Wilkinson is participating in a National Institute of Allergy and Infectious Diseases (NIAID) trial at the Clinical Center to see whether a therapeutic vaccine for human immunodeficiency virus (HIV) is safe and can affect how the body responds to HIV infection.

"If I could benefit from this study myself, I would be thrilled! It'd be awesome if I was taking a vaccine once a month instead of pills every day," he said. "But, the biggest thing for me, and the reason I want to be a part of the study, is so that we don't confuse movement and progress. A lot of people are like 'Well HIV isn't really a big deal. No one dies of acquired immune deficiency syndrome (AIDS) anymore.' But I always tell my friends just because we've made a lot of progress doesn't mean that we are done. And it doesn't mean we can't be a part of the reason that things continue to progress."

Wilkinson is one of about 30 patients who are participating in this Phase 1 trial led by Dr. Michael Sneller, of the NIAID Laboratory of Immunoregulation. In the vast majority of people infected with HIV, the immune system cannot control or cure the infection. Treatment with anti-HIV drugs is needed to keep the virus at a level low enough to limit the negative impact on the patient's health.

"We're in the early stages of looking at providing a therapy for HIV with a vaccine instead of medication," Sneller said. "We want to see if a series of vaccinations can sufficiently boost the immune system response to HIV to allow the infection to be controlled without the need for daily medications."

To be clear, it's not a vaccine to cure HIV or a preventative measure, but rather an updated treatment approach, Sneller said.

Wilkinson, an avid traveler for his career as a pianist, composer and off-Broadway musical director, looks forward to the potential for him and other HIV patients to cut the ties with their medications.

"I can't wait. To be perfectly honest, I'm so thrilled," he said. "Right now, when I travel, I have to worry about my medication coming with me and how much do I have and are they going to think it's weird that I have that much. The moment I don't require taking medication anymore, I have the ability to do more with my life and be more free."

In early 2016, after nearly a year of being enrolled in the trial, he will stop his HIV medications. With his health being key, he will be monitored closely and immediately go back on his medications if the level of HIV in his blood becomes too high, his CD4 lymphocyte count shows a significant decline or he develops any symptoms related to active HIV infection. Otherwise, he will remain off antiretroviral drugs for four months to determine if the vaccine was effective at boosting the immune response to HIV enough to keep the levels of virus low.

"I come from a generation of people where HIV isn't really a scary thing any longer," Wilkinson said. "One of the things that my generation of gay men don't have the opportunity to do is to fight for a cause. For myself, it was nice to be able to do something for the population of people that this affects. The research is necessary in order for things to improve. I think that one of the things that scares me as someone who has HIV is that we don't push hard when we're doing well. We don't fight for change when the change that's necessary isn't as significant as it once was. I like that the NIH has given me the option to have a voice."