Fuller results from HIV vaccine trial suggest marginal benefit

That's the bottom line coming out of the AIDS Vaccine 2009 conference in Paris this morning, where detailed information was released on the results of the HIV vaccine trial in the news earlier this month. The announcement was timed with the online release of a paper and accompanying editorial in the New England Journal of Medicine.

Two stories written about today's news present sharply different perspectives about how to interpret the trial results. Marilynn Marchione of the Associated Press describes the findings at "exciting to scientists," and her story is peppered with quotes from the researchers and boosters of HIV vaccine research touting the study as a "landmark" in the long road toward a viable HIV vaccine.

A much more cautious tone is seen in a story by Gautam Naik of the Wall Street Journal. Naik writes:

"Now, two other analyses of the trial data suggests that the results could have been due to pure chance, and therefore the vaccine may not have conferred protection to people after all."

Naik's story looks closely at the various statistical analyses used to assess the benefit (if any) of the vaccine candidate being tested and the seemingly conflicting results that emerge from them. While digging into the finer points of study design and biostatistics, the story reveals the frequent difficulty in distinguishing meaningful research results from statistical flukes, a boundary that is often criticized as arbitrary. The research group involved in this study has been criticized by some for glossing over this ambiguity while initially publicizing their positive results earlier this month.

Two stories currently on the website of the BBC underscore the difficulty of interpreting scientific research results and conveying them to the public in an accessible way. One headline says, "HIV vaccine trial was significant," while another is titled "HIV vaccine: Doubts over trial." Despite seemingly contradicting themselves, both offer reasonable summaries of today's news and the reactions from experts.

In his New England Journal editorial, Raphael Dolin strikes a measured tone about what to take from the research results and its implications for future work toward an HIV vaccine:

"The clinical trial reported here represents an enormous effort by investigators, sponsoring institutions, and participants in the community. The findings raise a number of questions that have important implications for future directions in vaccine research. The answers to these and related questions will require the application of a balanced and coordinated research approach to the complex and difficult problem of the development of an HIV vaccine. This balanced approach includes fundamental laboratory and experimental-model studies, as well as rigorously designed and conducted clinical trials, such as the one reported on here."