Kathie Ferbas has wanted to find a vaccine for AIDS since she was a college intern at a Manhattan hospital and watched helplessly as scores of gay men succumbed to a killer disease without a name. Now 36, Ferbas sees her dream within reach.
Ferbas, a virologist, and her colleagues at the UCLA AIDS Institute recently became the first team to create an experimental vaccine with the potential to wield a double-edged sword against HIV, the deadly virus that causes AIDS.
Not only might the vaccine prevent people from contracting HIV, their findings suggest, it may also help the immune systems of those who are already infected to cleanse the virus from their cells. Since the Journal of Virology published Ferbas’ study in July — provoking a frenzy of media coverage — she’s shifted her focus to testing the vaccine on mice, where it demonstrates promising results.
More than 100 people — many of them HIV-positive and some from as far away as Brazil — have flooded the university with ecstatic e-mails and phone calls offering to volunteer for the vaccine trial. One young man even declared her as “the goddess of West Hollywood” and promised her a seat on the front float of the Gay Pride Parade.
Ferbas, a fast-talking New Yorker with a riot of dark curls and enormous hazel eyes, is quick to point out that her laboratory findings are one step down a long road and much work remains to be done. The UCLA vaccine faces at least five to 10 years of testing before the Food and Drug Administration will consider stamping it for public use. But even with that long horizon in front of her, there’s no disguising her excitement.
“To work, a vaccine must stimulate antibodies to fight off new infection — then prompt a cellular reaction to help clear the cells that HIV has already invaded,” explains Ferbas, an adjunct assistant professor of hematology and oncology. “Our vaccine is the first from a killed AIDS virus to do both.”
Ferbas’ quest for a dead-HIV vaccine began when Irvin Chen, director of the UCLA AIDS Institute, approached her about a cellular response test she’d developed with her husband, John, an immunologist. Ferbas, Chen’s postdoctoral fellow at the time, jumped at the chance to work with him on the project. J.F. Hsu, a UCLA scientist with vast experience designing and testing veterinary vaccines, completed the team.
Charting a new direction, Chen, Ferbas and Hsu crafted their vaccine from a whole AIDS virus that they literally pasteurized like milk, with heat, until it died. Their bold strategy hinged on hurdling two tricky obstacles. First, they had to apply enough heat to kill the virus without destroying its outer armor, or viral envelope — something earlier studies had never managed. Second, they needed to expose hidden regions of the envelope that summon the body to make antibodies to attack HIV.
“It’s like adding hot water to a package of dry Top Ramen noodles,” Chen explains. “The heat softens and uncoils the virus’ envelope, exposing pieces of it we can’t ordinarily see.”
When the dead virus was examined, Ferbas and Chen discovered they’d cracked both quandaries. “We were so excited,” Ferbas recalls. “Irvin is known for safeguarding his time, but our meetings never ran less than two-and-a-half hours. We were kind of giddy.”
Her initial excitement doubled when the experimental vaccine also triggered a cellular immune reaction to HIV — offering promise for restoring the immune systems of people already infected with the disease.
Chen originally intended to develop a preventive vaccine. But Ferbas unknowingly set the wheels in motion for a therapeutic vaccine when she presented her first set of data at the AIDS Institute’s annual symposium in 1997. After hearing Ferbas’ report, UCLA physician Dr. Judith Currier offered her help on a clinical trial to explore the vaccine’s benefit for people who are living with HIV.
“It’s a perfect example of how the AIDS Institute encourages collaboration,” Ferbas observes. Dr. Yvonne Bryson of pediatrics later joined the scientific team to launch a trial for children.
Ferbas and her colleagues must triumph over a number of daunting scientific challenges before bringing their vaccine to a waiting public. These include proving that the dead virus can’t grow, even fractionally, and pinpointing the vaccine’s proper dosage, scheduling and span of effectiveness. First, however, they must show that it works in humans, something that animal studies can’t predict.
“No one knows if we can prevent HIV infection completely,” Ferbas says. “Most vaccines — like the immunization we receive against childhood diseases — rely on a series of injections to introduce a small level of infection, then rapidly clear the virus from our immune systems. In reality, we’ll probably need a combination of approaches to produce immunity.
“For people already living with HIV, we hope the vaccine will enhance the effectiveness of AIDS medications and wean patients off these costly drugs and their side effects,” she adds. “We’ll need to learn how many injections to give people, the dosage of each shot, their timing and how long their effect will last.”
Ferbas also must surmount more practical obstacles. “These trials are expensive,” she says bluntly. “To be successful, we’ll need private support as well as research grants.”
Ferbas’ passion to create a vaccine has increased exponentially since her college days. Every day, doctors diagnose 16,000 new HIV infections. Ninety percent of these cases occur in the developing world, which can’t afford drugs to stop HIV from escalating to full-blown AIDS. A staggering 16 million adults and children have died of AIDS, and more than twice that number live with HIV. AIDS has become the world’s No. 1 infectious — and preventable — killer. Los Angeles remains the second-largest epicenter for the epidemic.
“Now that we’re putting this clinical trial together, I don’t sleep at night,” Ferbas admits. “We have to find an HIV vaccine and do it soon. We can’t afford not to.”
