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New HIV vaccine with a 97% antibody response rate in phase I human trials
- colordrops 6y agoDoes this cure pre-existing infections
- heavyset_go 6y agoThe vaccines that I'm aware of only prevent infection in people without HIV. You can look up the vaccines on clinicaltrials.gov and find out their efficacy in different populations.
- yarg 6y agoI'd guess so? It seems to target cells outside of HIV's production pipeline (to stimulate them into becoming little antibody factories).
- elil17 6y agoAt this point, no one knows if it actually prevents HIV, just that it produces a immune response (which can be detected through blood tests) which indicates that it could. In general, it is possible that an HIV vaccine could lead to remission of pre-existing infections, but it's impossible to know yet if this one would do that.
- ransom1538 6y agoDumb question: Isn't HIV a solved problem? With current anti-virals they can't even detect HIV in blood tests.
- Daynil 6y agoIf you call requiring tens of thousands of dollars of maintenance medication treatment annually for life a solved problem, then absolutely!
- SquareWheel 6y agoThis still requires treatment for life, though. A vaccine would obviate this need, freeing up time, resources, and money for other healthcare.
- eganist 6y agoIf there was a cost-effective cure, we could consider it solved. The only (functional) cure for it involves basically taking a sledgehammer to the entire immune system and replacing it with one from a donor with CCR-5 delta 32. As far as anyone's aware, this was only done with 2(?) patients who also had blood cancers. Everyone else is popping antiviral cocktails and living with both the stigma of the disease and the risk of a relapse if they ever end up not being able to afford the drugs. So... not quite solved. Hopefully this'll get us closer.
- throw_m239339 6y agoNo it isn't. The costly treatment can have heavy side effects... for the people who can afford it, i.e. not most of people who are infected in Africa...
- heavyset_go 6y agoTreatment is both expensive and taxing on the body, the drugs can cause renal problems and even renal failure. Multiple drugs need to be taken, they'll need to be switched up, and you'll need regular blood work to make sure that they aren't destroying your organs. You're going to need to see expensive specialists regularly for the rest of your life. You aren't going to only fill a prescription and take a pill and have that be the extent of your treatment. There are several different and relatively large populations for whom complications can arise with treatment, like those with weakened immune systems, organ transplants, kidney disease, the elderly etc. If you're wealthy and in otherwise good health, then yes, HIV is a relatively solved problem for you.
- dennis_jeeves 6y agoI'll answer the question to the best of what I know. It appears that there wasn't a problem to start with. Luc Montagnier, one of the co-discoverers of the AIDS virus for which he got the noble prize, is on record saying that it is a benign virus and in Africa at least is related to malnutrition. So unless the video is doctored one can take his word to be gospel. He is a heretic, btw. Then there is Kary Mullis a noble prize winner (in chemistry) and the developer of the PCR test, who on investigation could not find any paper which indicated that the AIDS virus has been isolated, hence concluded that it's not proven that HIV causes AIDS ( or something to that effect). If you cannot find the relevant videos on you tube search bitchute.
- supernova87a 6y agoFrom NPR interviews I listened to during the early days of the mRNA vaccines showing incredible promise, I understood that one of the problems with HIV is that the human body does not naturally have strong defense mechanisms (antibodies, etc) for this type of virus. Hence, the usual vaccine path (or mRNA derived method) of accelerating the learning of the body's T-cells, etc. to manufacture its own defenses is not very effective -- they are not there to begin with. Is that not correct? What are they doing differently here?
- est31 6y agoPassive immunization with broadly neutralizing antibodies have been shown to prevent HIV infection in various animal studies. The goal is apparently to make the immune system able to manufacture such antibodies. The human immune system is fundamentally able to come up with these antibodies on its own, as some HIV positive individuals do develop them, but at least during natural infection they don't appear in everyone. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604566/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604566/ However, antibody levels won't be as high in vaccinated individuals as they are in those passive immunization animal studies, at least not forever. The body can't afford to produce full levels of antibodies for all antigens all the time. Instead, human bodies reduce produced antibody levels some time after the event that triggered the production of the antibodies. The immune system remembers the antibodies it has come up with, and can ramp up their production quickly if the antigen is re-encountered, but the question is whether this reaction is quick enough to prevent HIV infection. IIRC people with who produce broadly neutralizing antibodies naturally still eventually develop AIDS, if left untreated. Time has to tell if vaccinated individuals behave more like those animal models, or more like that subset of people who produce broadly neutralizing antibodies a few years post infection. Until now, every vaccine for HIV has failed, and there have been many attempts. But you never win if you never try :).
- xyzzy21 6y agoWe've been down this path before with vaccines. Often what seems promising early on doesn't pan out long-term. This is why clinical trials are so lengthy. You have to operate at the time-constants of biology and the human body rather than political or business time-constants. The former are far longer than the latter. BTW if you get a COVID vaccine right now, you are literally a clinical trial subject/participant. COVID vaccine clinical trials do not end until 2023 in the US based on FDA documents.
- pfisch 6y agoList all the vaccines with negative long term side effects that don't appear within 4+ months.
- astrange 6y agoClinical trials for vaccines take a while because we don't intentionally infect people and it takes a long time for the test population to naturally catch whatever it is. They went fast for COVID because it's a pandemic and everyone was getting it.
- nickthemagicman 6y agoI don't understand this well enough to fully know how this vaccine works. But HIV integrates into the human genome so you can never really get rid of it. So I'm not sure exactly how this treatment would play out.
- olliej 6y agoWhat the hell are you talking about? It does not “integrate with the human genome”.
- nlitened 6y agoI don't know much about it, but, from my understanding, HIV is a "retrovirus", which means that it integrates into host cell's DNA: https://en.wikipedia.org/wiki/Retrovirus https://en.wikipedia.org/wiki/Retrovirus I'd really appreciate some input from someone who knows more on this topic.
- tjohns 6y agoYes, that's correct. After entering a CD4+ cell, HIV uses reverse transcriptase to copy it's RNA into DNA, enters the cell's nucleus, then uses integrase to splice that DNA into the host cell's genome. From that point on the host cell is permanently infected. This is one of the few exceptions to the "central dogma of molecular biology", which otherwise says information can't flow back into the nucleus. The reverse transcription process is notoriously error prone, which is the reason why HIV is able to mutate so easily and develop resistance to antiviral drugs. Most cells will go on to immediately begin building new HIV copies; these cells will quickly die out. A small number will go back to a resting state, only to reactivate months or years later. This "latent reservoir" of dormant cells means that even if you eradicate all the viremia from a patient, the infection will come back. This is why we can't cure HIV. There is a very small window after infection before the virus has had a chance to establish a latent resevior where it can be successfully eradicated. This is how prophylactic drugs as part of PEP can work - if given quickly enough. There's a really good animation someone posted here a few days ago that illustrates the mechanics: https://vimeo.com/260291607 https://vimeo.com/260291607
- thescribbblr 6y agoI am confuse about the working of this vaccine? Anyone, who can make me understand about the working I would be thankful.
- arrosenberg 6y agoThey developed a piece of mRNA that produces a specific type of blood protein that binds the HIV infection mechanism. The bound protein triggers your body’s antibody cascade to attack and neutralize it.
- agumonkey 6y agois that similar to what is being investigated for cancer ?
- toomuchtodo 6y agoYes! https://www.aamc.org/news-insights/mrna-technology-promises-revolutionize-future-vaccines-and-treatments-cancer-infectious-diseases https://www.aamc.org/news-insights/mrna-technology-promises-...
- deleted 6y ago[deleted]
- arrosenberg 6y agoMore or less. Insert mRNA instructions for creating or triggering antibodies that target cancer cells specifically.
- throwawayboise 6y agoIt's really interesting stuff. One issue as I understand it is getting the immune reaction to be appropriate to develop antibodies without going crazy.
- ignoramous 6y ago
- xiphias2 6y agoThis looks to be the original announcement from February: https://www.iavi.org/news-resources/press-releases/2021/first-in-human-clinical-trial-confirms-novel-hiv-vaccine-approach-developed-by-iavi-and-scripps-research https://www.iavi.org/news-resources/press-releases/2021/firs... Browsers not showing full URLs were the first bad thing, but now articles are linking to domain names, which makes those links unusable for cross-checking references.
- stunt 6y agoSo many vaccine news on HN now. Why are we discussing them here? I visit other websites for vaccine news.
- arbitrage 6y agoWhy are you complaining about an article you don't want to read on a site you don't want to read it on? Nobody's forcing you to be here.
- deleted 6y ago[deleted]
- imwillofficial 6y agoBecause as a member of the community, He is trying to shape the discourse and culture here. We all should be doing that, to maintain the high quality content.
- amznthrwaway 6y agoBe honest. He’s a bigoted right-wing conservative who doesn’t want to hear about interesting scientific developments that he views as benefiting people with lifestyles that he condemns. You’re showing your bigoted ass by defending his bigoted ass. Fuck both of you.
- DoofusOfDeath 6y agoFrom a now-dead comment: > He’s a bigoted right-wing conservative who doesn’t want to hear about interesting scientific developments that he views as benefiting people with lifestyles that he condemns. Perhaps not here, but I think this is a view worth discussing. I'm moderately conservative, and some of that comment's criticism resonates with my own thoughts. With cases like HIV/AIDS, I find myself pulled between several competing virtues: One one side there's mercy and compassion; I'd like to minimize the suffering of hurting people. Even if someone is in dire straights because of actions that I view as unwise (extramarital sex, recreational drug use, etc.), I still want to want what's best for that person. On the other side, there's justice. I live in a society where everyone pays, to some degree, for individuals' unwise behavior. E.g., Medicare/Medicaid for smokers' lung cancer or HIV treatment for persons who chose to indulge in risky behavior. I'm not okay with forcing the community at large to cover the costs of (what I view as) individuals' selfish actions. I don't know what the right balance to this is. More generally, I'm not sure if there are any good principles for finding the right tradeoff between two virtues. I wish I knew. I want to do good, but the path is often obscure.
- dj_mc_merlin 6y agoInterested to hear from people in the know: how good does this look?
- dheera 6y agoInterested to hear the same. In particular, how easy will distribution be, considering that HIV is extremely easily preventable but it still spreads, because of lack of distribution of knowledge, I assume.
- taurath 6y agoCost is the largest factor. HIV could be nearly eliminated entirely if PREP wasn’t a cash cow for Gilead.
- fny 6y agoUhm... Last I checked many pharmaceuticals that compete with Gilead also operate in the HIV space.
- heavyset_go 6y agoNo, the only two drugs approved for PrEP in the US are Truvada and Descovy, both of which are Gilead drugs.
- fny 6y agoI stand by what I said. On a worldwide revenue basis, there are many other manufacturers that have strong incentives to develop a cure. Also, I disagree that "PrEP" would eliminate HIV. It's a prophylactic, not a cure, and one that will not be affordable globally for a looooong time. Even at $30 per month, the drug would be out of reach for many (see Africa where annual incomes hover around $1-2K annually.) 1. Gilead owns 3 of 4 top HIV drugs. GSK owns the #2, Triumeq. 2. GSK, Merk, J&J are all megacap, viable competitors with their own HIV products. Yes, its true that Merk and Gilead are in cahoots, but this was out of fear of GSKs dominance. 3. Some other US-listed names who are developing HIV drugs: ViiV (GSK subsidiary), Bristol Myers Squibb, Janssen, Mylan, Genentech, Abbvie. Yes, the US is currently dominated by one company, but that does not mean there are heavy incentives for competitors--who are already well invested in the space--to break in. [0]: https://www.statista.com/statistics/273434/revenue-of-the-worlds-most-important-aids-drugs/ https://www.statista.com/statistics/273434/revenue-of-the-wo...
- briefcomment 6y agoDoes this require everyone to get it?
- colinmhayes 6y agoHIV is sexually transmitted, so only sexually active people would be required to get a vaccine.
- nkozyra 6y agoThe high risk group is larger than that, though.
- mekster 6y agoWtf are you talking about?
- SquareWheel 6y agoDrug users are also high risk, as are any medical professionals that work around needles.
- yarg 6y agoYou left out transmission via blood.
- mike00632 6y agoThe public health community learned a hard lesson from this mentality with the HPV vaccine. Many young girls did not get the vaccine because they (or their parents) insisted they were not and would not be sexually active. The CDC recommendations for who should get the vaccine (which controls whether insurance covers it and whether military members are eligible to receive it) expanded from young girls to all people under 27, then to all people under 45. Regarding HIV, why not get vaccinated if you have easy access to it? What is the harm in being immune to HIV?
- colinmhayes 6y agoOP asks about what's required, not what makes sense. Everyone needs to be required to get vaccines like measles and Covid because the vaccine doesn't work on everyone so we need herd immunity to ensure safety. HIV does not require herd immunity in the same way as there is no way to get it if you are in a monogamous relationship/not sexually active and don't share needles. Therefore the vaccine isn't required to ensure the safety of everyone that desires it.
- paulydavis 6y agoAfrica really needs to be the target rollout for these vaccines if and when they materialize.
- qrbLPHiKpiux 6y agoWhy didn’t education work there? I’m just asking.
- tremon 6y agoWhy do you immediately conclude it hasn't? Far more likely are these factors: - education reaches only a small part of the population - condoms are unavailable - condoms are too expensive
- mkr-hn 6y agoDon't forget well-justified suspicion of westerners based on horrible and not too distant history.
- spiritplumber 6y agoBecause it got drowned out by misinformation.
- africanboy 6y agosame reason why education has not prevented covid-19 from spreading.
- deleted 6y ago[deleted]
- dang 6y agoIf you continue to post unsubstantive and/or flamebait comments to HN, we will have to ban you. You've been doing it a lot, and it's not what this site is for. Please review https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and fix this. Actually your account appears to be using HN primarily for political/ideological battle. We ban that sort of account, so please don't.
- williesleg 6y agoBill Gates is pissed. No more eugenics.
- eli 6y agoHaven’t there been multiple HIV vaccines that cleared initial trials but did not actually work? Is antibody response rate a meaningful metric? Phase 1 is only designed to test safety. This is great news, but way way too early to celebrate.
- koheripbal 6y agoThe title seems to over-promise. > ...the vaccine successfully stimulated the production of the rare immune cells needed to generate antibodies against HIV in 97 percent of participants. This is not the same as creating a 97% antibody response. The article goes on to say that it's part of a mutli-step process to create immunity, so it seems this initial shot is not enough. This needs more clarity from someone with expertise in the field.
- amluto 6y agoLink with a bit more actual information: https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(21)00042-2/fulltext https://www.thelancet.com/journals/lanmic/article/PIIS2666-5... As far as I can tell, what's going on here is that there are multiple stages of antibody development. People have circulating B cells, and these cells have their genomes modified by the the VD(J) recombination process [0] from the genome in the human germline (i.e. what your germline cells and most of the non-B cells in your body have). There are a large number, but nowhere near infinite number, of B cells and corresponding antibodies that can be produced in this process, and I think these are what the authors call "germline" cells. Once a naive B cell decides that it encodes a useful antibody (which is a complicated process), it starts to divide. Some of the daughter cells further mutate in a process called affinity maturation [1] to produce what are hopefully even better antibodies. I think that the idea behind this research is that there are certain antibodies that can be produced by affinity maturation that are very useful against HIV, but that the "germline" B cells that lead to these antibodies are not particularly likely to be selected by the immune system when exposed to natural HIV antigens. Instead, the researchers have developed customized antigens intended to target specific germline cells which are known to be able to mature into cells that can produce the desired antibodies. If this works, the next step would be a series of additional vaccines (which are not the same as dose 1) that will try to encourage maturation into the useful antibodies. The takeaway is that this result is very promising and that there is (so far?) no reason to expect the trial participants to be immune to HIV. For the ML crowd, another way to think about this is that, when your body is exposed to an antigen, it runs a massively parallel search algorithm to find good antibodies in a truly massive space of possible antibodies. Unfortunately, most people, when exposed to real HIV or to prior vaccine attempts, get stuck in a bunch of not-fantastic local minima. The idea is to specifically aim the search in the right direction so, after a few rounds, it can find a better solution. [0] https://en.wikipedia.org/wiki/V(D)J_recombination https://en.wikipedia.org/wiki/V(D)J_recombination [1] https://en.wikipedia.org/wiki/Affinity_maturation https://en.wikipedia.org/wiki/Affinity_maturation
- laplacesdemon48 6y agoAlso from the Lancet link: * VRC01 was shown around a decade ago to be one of several antibodies generated...that achieves broad neutralisation of several HIV strains * 97% of participants who received an HIV vaccine immunogen candidate developed VRC01-class IgG B cells, precursors to broadly neutralising VRC01-class antibodies * Results from another set of studies presented at HIVR4P (the Antibody Mediated Prevention [AMP] trials) showed that although intravenous administration of the VRC01 antibody at 8-week intervals did prevent infections with some strains of HIV, only 30% of the strains circulating in the trial regions of sub-Saharan Africa, South America, Switzerland, and the USA were sensitive to VRC01 To me this appears to be a great breakthrough but doesn't seem like a silver bullet.
- argonaut 6y agoMy understanding is that many HIV vaccine candidates have showed promising Phase I results but so far they have all failed in later trials. https://en.wikipedia.org/wiki/HIV_vaccine_development https://en.wikipedia.org/wiki/HIV_vaccine_development lists five vaccines that made it to Phase 2-3 (and all failed). Two of them appeared to increase the risk of contracting HIV. The strongest candidate appears to have been ~30% effective.
- djmips 6y agoInteresting that there was some warnings given about using the same vectored technique on a Covid vaccine (AstraZeneca is an example) could also potentially increase the risk of contracting HIV? https://www.ajmc.com/view/researchers-warn-of-heightened-risk-of-hiv-with-certain-covid-19-vaccines https://www.ajmc.com/view/researchers-warn-of-heightened-ris... Note that Johnson & Johnson and AstraZeneca use different adenoviruses as vectors than Merck’s failed Ad5 vaccine.