{"doi":"10.3389/fmicb.2021.690647","title":"Global and Regional Estimates for Subtype-Specific Therapeutic and Prophylactic HIV-1 Vaccines: A Modeling Study","abstract":"<jats:p>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 (<jats:italic>gag</jats:italic>, <jats:italic>pol</jats:italic>, <jats:italic>env</jats:italic>) 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 <jats:italic>env</jats:italic> required 2.6 million subtype E doses, and a vaccine based on <jats:italic>pol</jats:italic> 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 <jats:italic>env</jats:italic> required 1.2 billion subtype E doses, and a vaccine based on <jats:italic>pol</jats:italic> 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 <jats:italic>env</jats:italic> also need to include subtype E and those targeting <jats:italic>pol</jats:italic> need to include subtype G.</jats:p>","journal":"Frontiers in Microbiology","year":2021,"id":594574,"datarank":0.5050943744979712,"base_score":3.367295829986474,"endowment":3.367295829986474,"self_citation_contribution":0.5050943744979712,"citation_network_contribution":0.0,"self_endowment_contribution":0.5050943744979712,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":28,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1522128,"name":"Michael Jenks","orcid":null,"position":1,"is_corresponding":false},{"id":1522129,"name":"Jason Yun","orcid":null,"position":2,"is_corresponding":false},{"id":1522130,"name":"Leslie Dickson-Tetteh","orcid":null,"position":3,"is_corresponding":false},{"id":614189,"name":"Shona Kirtley","orcid":"0000-0002-7801-5777","position":4,"is_corresponding":false},{"id":1522131,"name":"Joris Hemelaar","orcid":null,"position":5,"is_corresponding":false},{"id":1522127,"name":"Ramyiadarsini Elangovan","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Global and Regional Estimates for Subtype-Specific Therapeutic and Prophylactic HIV-1 Vaccines: A Modeling Study","abstract":"<jats:p>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 (<jats:italic>gag</jats:italic>, <jats:italic>pol</jats:italic>, <jats:italic>env</jats:italic>) 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 <jats:italic>env</jats:italic> required 2.6 million subtype E doses, and a vaccine based on <jats:italic>pol</jats:italic> 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 <jats:italic>env</jats:italic> required 1.2 billion subtype E doses, and a vaccine based on <jats:italic>pol</jats:italic> 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 <jats:italic>env</jats:italic> also need to include subtype E and those targeting <jats:italic>pol</jats:italic> need to include subtype G.</jats:p>","is_dataset_classified":null,"base_score":3.367295829986474,"endowment":3.367295829986474,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"34335516","pmcid":"PMC8320730","openalex_id":"https://openalex.org/W3172641078","authors":[],"funders":[{"funder_name":"NIAID NIH HHS","grant_id":"R01 AI087520","title":null},{"funder_name":"NIAID NIH HHS","grant_id":"R01 AI135946","title":null},{"funder_name":"Medical Research Council","grant_id":"MC_UU_00027/1","title":null}],"total_grants":3,"fwci":2.6012,"citation_percentile":0.90635867,"influential_citations":0,"citation_trend":[{"year":2022,"count":5},{"year":2023,"count":8},{"year":2024,"count":6},{"year":2025,"count":6},{"year":2026,"count":3}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.frontiersin.org/articles/10.3389/fmicb.2021.690647/pdf","host_type":"journal"},{"url":"https://www.frontiersin.org/articles/10.3389/fmicb.2021.690647/pdf","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fmicb.2021.690647/full","host_type":"publisher"},{"url":"https://doi.org/10.3389/fmicb.2021.690647","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/34335516","host_type":"repository"},{"url":"https://hal.science/hal-03649247","host_type":"repository"},{"url":"https://doaj.org/article/214482c4725b4d16826d2cb6a27bcb1f","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/8320730","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC8320730","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC8320730?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["HIV Research and Treatment","HIV/AIDS Research and Interventions","HIV/AIDS drug development and treatment"],"mesh_terms":[],"keywords":["HIV vaccine","Virology","Human immunodeficiency virus (HIV)","AIDS Vaccines","Medicine","Lentivirus","Immunology","Biology","Vaccine trial","Viral disease","Recombinant","Vaccine","HIV","Subtype","CRF","Urf"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-27T14:56:46.429505Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}