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Moderna Is About to Begin Trials for HIV Vaccine

851 points by Saint_Genet 5y ago

tannhauser23 5y ago
So, umm, how do you test this vaccine? Are the participants expected to have unprotected sex with HIV-positive people?
- ProjectArcturis 5y ago
  No, you give it to 10k people, and give a placebo to another 10k, and let them live their lives, and after 5 years or so you see how many of each group have contracted HIV.
  - jdavis703 5y ago
    The participants can have unprotected sex with HIV+ people if they want. It’s like the COVID-19 vaccine trials. The study designers didn’t set any parameters around mask use, social distancing, etc. It’s up to each participant to apply harm reduction practices as they see fit.
    - koheripbal 5y ago
      Notably covid vaccines were approved early because idiots in both arms didn't wear masks, and those in the control arms got very sick and died soon after the trial began.
  - missedthecue 5y ago
    What is the statistical likelihood of someone in a 10,000 sample size of people catching HIV in any 5 year period? Probably less than 1%?
    - icegreentea2 5y ago
      Depends where you sample from. In the USA, estimated new HIV infections in 2019 35k. Assuming 350 million Americans, that gives a very rough estimate of 1 case out of 10,000 per year. You can enrich this by shifting target population. You could do this in the USA by targetting high risk communities, or by moving the trial overseas. An trial in the USA with 10k in each arm could very likely be constructed to generate at least 10 cases per year. Likely up to 50. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...
  - tannhauser23 5y ago
    They're asking for 50-ish volunteers ATM.
    - icegreentea2 5y ago
      Yeah, it's a phase 1 trial. In phase 1 they aren't even really looking at if the vaccine is effective, they're making sure that it's safe/side effects are reasonable, and maybe getting some dosage information out of it.
- JBorrow 5y ago
  What you just described is a 'Challenge Trial'. These have been avoided for COVID and would likely be avoided for other diseases too on ethical grounds. For a common cold, or other lower-impact disease, you could do a challenge trial.
- dempedempe 5y ago
  The Bug Chasers would make good volunteers. https://en.wikipedia.org/wiki/Bugchasing https://en.wikipedia.org/wiki/Bugchasing
  - cblconfederate 5y ago
    Looks like finding participants for a challenge trial won't be hard.
jcims 5y ago
Video of the lifecycle of HIV. To me it's absolutely mind-blowing to think that this entire process developed on its own, in dark, and is mindlessly progressing along so effectively that despite all of our technological capability we can barely contain it. https://vimeo.com/260291607 https://vimeo.com/260291607 (also how awesome is the music?)
- jarpschop 5y ago
  Natural selection is a very powerful process.
  - mbroncano 5y ago
    * given enough time
  - pintxo 5y ago
    when executed over millions of years
    - whimsicalism 5y ago
      Much shorter time frames than that are still powerful, especially for something like a virus.
      - est31 5y ago
        Yeah the number of generations is more important than the number of years.
      - ddingus 5y ago
        We may receive that education somewhat directly and immediately through covid, and failure to vaccinate people.
    - jcims 5y ago
      In practice this is what we observe, but the combinatorics are so ridiculously large that its hard to understand how it works. A very small protein of say 200 amino acid residues has 21^200 configurations. If every atom in the universe was another universe, and every atom in those universes was a universe, you'd still need 10^20 grandpappy universes to represent each configuration as a distinct atom in the grandchild universe. Given that these configurations confer meaningful chemical and mechanical utility, sometimes with discontinuities in effect, it's really odd to me that it all somehow works.
ChrisMarshallNY 5y ago
Very good news. I have known many people that have died of the virus. AIDS is a tough one. It has a shifting antigen. If anyone remembers Stephen King's The Stand, that was the premise for Captain Trips. If they can inoculate against AIDS, then the human race may just survive the next millennium.
- weimerica 5y ago
  > Very good news. I have known many people that have died of the virus. Unfortunate what happens when people engage in unnecessary social interaction during a pandemic.
  - xattt 5y ago
    Are you referring to the AIDS epidemic where access to care for individuals was withheld as a result of bigotry?
    - weimerica 5y ago
      Perhaps we should abolish the NIH then. They seem to have a repeated history of failing to grapple with pandemics.
      - dang 5y ago
        Would you please stop posting unsubstantive comments and/or flamebait, and stop using HN for political battle? You've been doing a lot of that, unfortunately, and we ban such accounts (regardless of what they're battling for or against). We're trying for a different sort of forum here. Also, trollish usernames aren't allowed on HN, because they end up trolling every thread the account posts to (https://hn.algolia.com/?sort=byDate&dateRange=all&type=comment&storyText=false&prefix=true&page=0&query=by:dang%20trollish%20username https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...). I've banned this account until we get some reason to believe that you will use HN as intended in the future. If you'd like to do that, emailing hn@ycombinator.com is probably best.
  - 5y ago
hanniabu 5y ago
Would this be recommended for anybody sexually active? Or just for people in higher risk like someone with a partner that has HIV or if you're homosexual?
- sschueller 5y ago
  I guess people who have a lot of partners and unprotected sex such as people who do porn or sex workers as well as people with partners that are positive.
  - koheripbal 5y ago
    Not to mention members of the gay community.
- jcims 5y ago
  As with any preventative medicine it boils down to risk/benefit and (unfortunately) economics. FDA approval process should expose most of the risk/benefit equation and the manufacturer will set the price. When all of that is said and done you will have a lot more information with which to consider your question.
- bayesian_horse 5y ago
  I think it will be rolled out to those most at risk at first, including those who are already infected. This may actually reduce the HIV infection rate to a large degree. Or people don't take the effing vaccine despite the benefits. Then yes, probably anybody sexually active should get it.
  - admiral33 5y ago
    > probably anybody sexually active should get it. Agree - if we can get rid of HIV we should. I looked at the exclusion criteria in the trial and it didn't mention use of a prophylactic. Widely available prophylactics have been a huge success with preventing HIV, I wonder how that will impact the trial. https://clinicaltrials.gov/ct2/show/NCT05001373 https://clinicaltrials.gov/ct2/show/NCT05001373
wayoutthere 5y ago
Thank goodness. I’m happy PrEP exists, but it gave me intense nausea for weeks before I couldn’t do it anymore. I would love to be able to date and not have to worry about HIV (I’m a trans woman who dates men, most of whom are bisexual). Not having to take another horse pill daily would be great too.
- AlgorithmicTime 5y ago
  So you're a homosexual male who dates other homosexual and bisexual males. Yeah, you're the highest risk group.
- sonicggg 5y ago
  You know condoms are a thing, right?
  - wayoutthere 5y ago
    You know that most straight cis people don’t use them either, right? Most women in my circles just have an IUD.
  - unnouinceput 5y ago
    Condoms take away 50% of the pleasure so I'd understand anyone who, in heat of the moment, would judge poorly and do it unprotected. Also, while rare, condoms, do break. I'd say, from sexual perspective, the better protection is to have a long term partner (not talking about marriage here). Also you can get HIV from other sources than sexual intercourse too, so having a vaccine that is proved by medical science is a huge relief. Here is personal story of mine: Last year, while vacationing, I was walking on the beach and I felt a slight sting and when I looked down a hypodermic needle was piercing my finger. Took it up and barely a single drop of blood formed, so the penetration barely went below the skin but that was enough to make me feel afraid. After 3 weeks took the test, found out I was HIV negative and talked with the doctor. She said that salty water is great at dismantling DNA/RNA and asked me what the needle looked like. It was all clean except for the tip where my blood was. Told me to not worry, just test again in 6 months which I did and for my great relief I was still HIV negative. Nevertheless during this entire time, in the back of my head black thoughts were daily there, worrying about "what if".
nikkinana 5y ago
Isn't that another Dr. Falsie vaccine?
slumdev 5y ago
Pray that the side effects are well-studied before the CDC decides to administer it to every infant within minutes of birth (like they did with Hep B, another sexually-transmitted disease to which most people will never even be exposed.)
- Foobar8568 5y ago
  At one point, we should stop saying that hep-* or HIV are STDs, in several countries the bulk of transmissions are from mother to infant during delivery or other means that sex transmissions. With the way the world is connected, these virus can travel easily.
  - slumdev 5y ago
    > in several countries the bulk of transmissions are from mother to infant during delivery Is this the case in the United States, where the CDC makes recommendations? And if so, why not administer it only to those children of mothers who test positive? We don't put everyone on a statin simply because most (i.e. more than half of) people will eventually develop heart disease. Instead, we test and administer statins to only those people who have heart disease risk factors. We don't give everyone bariatric surgery or weight loss drugs simply because most Americans are overweight or obese. Instead, these remedies are administered only to those who are most likely to benefit. No drug or vaccine is without side effects. It's clear that there's no such thing as informed consent in today's world. The patient cannot be informed because the side effects are hidden from him. And he definitely hasn't consented if coercion was involved in his decision to receive the treatment.
    - bluGill 5y ago
      > We don't put everyone on a statin simply because Because there are known side effects that make them not suitable to some people. Pregnant women should not take them (nor those thinking about getting pregnant). Those of Asian decent need a smaller dose. Those who drink alcohol shouldn't take them. Those who take part in extreme exercise shouldn't take them. They cannot be mixed with some other drugs. The above is off the top of my head. It probably doesn't apply to them all, there are several different statins to choose from, and many different dosages. A doctor really needs to work through the above (and probably more factors I'm not aware of) to figure out what is best for you.
spleeder 5y ago
How would this vaccine work for people who are already infected?
- lnanek2 5y ago
  It wouldn't. Their immune system already has a sample of the virus. Giving them a vaccine would give them nothing they don't already have. The idea behind a vaccine is the give the immune system a sample before it encounters the real virus, which allows it to respond quicker when the real virus arrives, which allows it to prevent the virus to replicate sufficiently to make the person sick. For someone who already has the virus, the vaccine won't do anything.
  - dagmx 5y ago
    This is somewhat incorrect. Not all vaccines include a sample of the virus they're protecting against (see the mRNA vaccines for covid-19). Also for some viruses (again see covid-19), it's still advisable to get a vaccine even if you've already been infected. The protection rate and longevity of the vaccines can outweigh infection based antibodies dramatically. In the case of HIV, it's potentially quite different, because HIV is such a unique disease, that yeah, a vaccine might not help anyway. But otherwise, your comment doesn't apply to vaccines in general (and it didn't seem like you were replying towards any specifics of HIV)
    - jonplackett 5y ago
      Also some evidence that vaccines are helping with long covid https://www.theguardian.com/society/2021/may/18/long-covid-symptoms-ease-after-vaccination-survey-finds https://www.theguardian.com/society/2021/may/18/long-covid-s... The difference with mRNA vaccines is they let your body build antibodies without it even knowing the virus itself
      - Unklejoe 5y ago
        > Also some evidence that vaccines are helping with long covid By what possible mechanism? Does this imply that long COVID is a result of some small amount of lingering virus? I was under the impression that long COVID was a result of damage caused by the initial infection - not some continuous infection of the actual virus.
steve76 5y ago
Give it only to us, then mutate it to make it go airborne.
anovikov 5y ago
It is so excruciatingly difficult to trial a HIV vaccine that we can easily expect it to take decades.
- anchpop 5y ago
  What makes it so difficult?
  - blamestross 5y ago
    At some point, somebody needs to be exposed to HIV with an unproven vaccine. Current design is just "give it to enough people to show they get HIV statistically lower than their origin populations.
- standardUser 5y ago
  According to the article, the Phase 1 clinical trail will take under 2 years. "Moderna is seeking 56 individuals, aged 18 to 50 and who are HIV-negative, for the trial, which is estimated to begin on August 19 and conclude in spring 2023" I would imagine that larger trials would be conducted in places with rampant HIV spread, right? Which shouldn't take an inordinate amount of time.
  - whimsicalism 5y ago
    Phase 1 is not the difficulty here....
    - standardUser 5y ago
      With the COVID vaccines, the locations of the clinical trials were chosen for how rapidly the virus was spreading. Some trials even added new geographic areas with high transmission rates while they were still ongoing. Why wouldn't any large scale HIV trial not choose one of the many countries with a high transmission rate?
      - MagnumOpus 5y ago
deleted 5y ago
[deleted]
treyhuffine 5y ago
Will the microchips in this be better than the ones in the Covid vaccine?
- arsome 5y ago
  I hear this one might be 6G compatible. Personally I'm just hoping for Bluetooth LE support.
rubyist5eva 5y ago
Did they make this one in a weekend like they did the Covid vaccine? Luckily I’m monogamous and committed so I don’t have to worry about catching degenerate diseases.
ionwake 5y ago
My friend had a HIV vaccine about 5 years from some London kings college trial - has always been fine. On a related coincidence I had the moderna vaccine today.
at_a_remove 5y ago
The graveyard of HIV vaccines that failed at Phase II is unfortunately large, and this isn't even there yet. I won't be holding my breath on this one. HIV is tricky.
- vibrio 5y ago
  I came here to say make this (lonely) comment. HIV and CoV are very different viruses. Different pathogenesis, different tropism, different social drivers for transmission... mRNA technology did well in 2020, but it was a very well-funded technology in clinical development for ~10 years before SARS-CoV2 arrived. HIV and Cancer are not low-hanging fruit. I wish them the best, as I hate both those diseases, but I'm not aware that there is anything in the technology that uniquely provides a solution to the problem.
  - sterlind 5y ago
    from what I've read, it's not really mRNA that gives Moderna any advantage, as much as being able to raise broadly-neutralizing antibodies (BNAbs) against HIV membrane protein. but.. it's still not a polyvalent vaccine, it's only targeting one such highly-conserved region, and there's HIV out there that evades BNAbs (5% of HIV+ patients have BNAbs after all, and they eventually progress.. though maybe after changing tropism or something.) so it may not be all that effective as a strategy, but there's at least some monkey data suggesting it delays or sometimes prevents infection. More info here: https://www.aidsmap.com/news/mar-2020/hiv-vaccine-generates-broadly-neutralising-antibodies-passes-first-safety-and-proof https://www.aidsmap.com/news/mar-2020/hiv-vaccine-generates-...
Zamicol 5y ago
This would be huge news for Africa. (I'm always surprised at how many people are generally unaware of the rates of HIV in Africa. https://en.wikipedia.org/wiki/HIV/AIDS_in_South_Africa https://en.wikipedia.org/wiki/HIV/AIDS_in_South_Africa)
throwaway59553 5y ago
Beyond mother-to-child transmission, and some negligent medical malpractice in let's say a blood transfusion, how do you even get HIV, in the developed world? I can understand high rates of infection in the most illiterate places of the world, but is it too much to ask certain demographics to not have sex with random strangers in some toilet of some gas station or bath house?
epmatsw 5y ago
It's amazing how many awful comments this is drawing. Is this just bots getting autotriggered on keywords or something?
- seattle_spring 5y ago
  I doubt it's bots. Unfortunately being a tech enthusiast doesn't preclude one from being an awful person. Spend some time on Blind for additional proof.
cletus 5y ago
HIV is incredibly sophisticated. It's actually kind of amazing how effective it is. I mean obviously the resulting disease is bad, no question. You can still appreciate the sophistication. HIV has resisted efforts to develop a vaccine for 30+ years at this point. I am already beginning to wonder if the 2020s will be the story of the social transformation caused by mRNA vaccines. An effective and relatively cheap HIV vaccine will be huge. Apart from Covid and HIV, mRNA is going to have a huge effect on the flu vaccine too. For anyone who doesn't know, predictions are made about what flu strains will dominate the coming winter 4-6+ months ahead of time and the vaccine is made from that. Those predictions may not be accurate, which largely explains the variance of efficacy. mRNA has the potential to reduce that down to 1-2 months so you can potentially react to the actual dominant strains. Cancer of course isn't a single disease. Even something like lung cancer are a collection of different diseases. But some cancers are caused by viruses. A notable example is cervical cancer where it seems like most cases are caused by HPV strains. Australia is on track to essentially eliminate cervical cancer by 2035 [1]. To be clear, this isn't an mRNA vaccine. But mRNA vaccines may greatly reduce the time required to develop a vaccine and make it possible to eliminate whole classes of diseases. This is all super-exciting. [1]: https://www.vcs.org.au/blog/our-impact/news/australia-can-continue-to-pave-the-way-for-cervical-cancer-elimination/#:~:text=As%20a%20result%20of%20its,are%20down%20across%20the%20country https://www.vcs.org.au/blog/our-impact/news/australia-can-co....
- athenot 5y ago
  Agreed this very exciting. Malaria is also being targeted using the same technology. BioNTech announced they were working on it last month and some results[1] in mice are already looking promising. [1] Messenger RNA expressing PfCSP induces functional, protective immune responses against malaria in mice. https://www.nature.com/articles/s41541-021-00345-0 https://www.nature.com/articles/s41541-021-00345-0
- vanadium 5y ago
  It's worth posting Moderna's research pipeline to understand the breadth and depth of where they plan to take mRNA vaccines: https://www.modernatx.com/pipeline https://www.modernatx.com/pipeline
jmnicolas 5y ago
Given the track record of the COVID vaccines (take a look at current Israel stats) I'm not optimistic about an HIV vaccine.
- whafro 5y ago
  This is quite cynical. I think the vaccines are doing pretty dang well considering they were developed in a matter of weeks following discovery of the virus, and work very robustly against not only the variants that were targeted, but also many that were not. HIV has decades of study and literature behind it, so why not be more optimistic about the prospects for progress?
  - jmnicolas 5y ago
    First think that poped in DDG: >Israel reinstates some virus restrictions to avoid a full lockdown. https://www.nytimes.com/2021/08/04/world/israel-covid-restrictions-lockdown.html https://www.nytimes.com/2021/08/04/world/israel-covid-restri... Sorry it's a paywall but the title is enough. Doesn't scream vaccine efficacy to me since they are in the top vaccinated country list.
    - jmnicolas 5y ago
      I'd like to know what the downvoters think. Those vaccines have become a kind of dogma...
      - FartyMcFarter 5y ago
        Israel has vaccinated 60-70% of its population, which isn't enough for herd immunity. As for your comment specifically, "the title is enough" isn't a very convincing argument for anything.
        native_samples 5y ago
        That is the exact threshold that was previously being presented as good enough for herd immunity. But herd immunity stats are all made up anyway. Fauci admitted the US value for herd immunity threshold was being picked based on opinion polling, not science.
elromulous 5y ago
Can someone with a better understanding talk about the specifics of how/why a vaccine like this might end up not being effective against HIV (i.e. what makes HIV so good at evading our efforts)? I suspect we've been in this boat many times in the past 40 years: a promising cure is just around the corner.
- vibrio 5y ago
  Two half-baked comments off the top of my head: -HIV targets, infects and cripples the immune system. While CoV2 infects and replicated aggressively, causing inflammation and fibrosis, HIV goes in, gets a foothold, hides and lingers like an insurgent, slowly exhausting the immune system. Very different approaches and how they are impacted by vaccines may be very different. -Convincing people to take the vaccine would be hard. Look how hard it is with a respiratory pandemic. It's "easy" to be non-high risk for HIV and people probably believe they can't get it, but people seem to continue getting it.
34679 5y ago
Go to any website of a mRNA COVID vaccine manufacturer and it will plainly state it is not meant to prevent infection. It is highly effective, for a period unknown, at preventing the disease caused by the infection. AIDs is the disease caused by an HIV infection. COVID-19 is the disease caused by a SARS-COV-2 infection.
- t0rt01se 5y ago
  So long Moderna, short condom manufacturers isn't a good idea?
  - 34679 5y ago
    HIV/AIDs is a perfect example of why it's dangerous to not distinguish between the two. If you are vaccinated and exposed to SARS-COV-2, you still have a high risk of infection, but because of the vaccine, you have a low risk of that infection developing into the disease known as COVID-19. If a successful mRNA vaccine is developed to prevent AIDs, it would be extremely important for the vaccinated to know they can still be infected with and spread HIV. It's not any different for SARS-COV-2/COVID-19. The talk in this thread about an mRNA vaccine eradicating HIV is nonsense.
    - t0rt01se 5y ago
      I know and I appreciate your effort to educate / warn. But you do realize that most of these posts are made by shills ?
bananapub 5y ago
(some strains of) HPV already have vaccines, social conservatism is what is allowing much of cervical cancer to continue in the rich world.
- portpecos 5y ago
  Right, blame it on social conservatism when the HPV vaccine costs $1000 even if you have Medicaid or ACA. In fact, Medicaid and ACA don’t even cover it. The cheapest price for the HPV vaccine in rural America is at the nearby Walmart. But it is $330 per shot, and you have to take 3 shots, and Medicaid and ACA won’t even cover it. If you’re blaming social conservatism, then I’m calling you out for an out-of-touch liberal.
  - bananapub 5y ago
    what are you talking about? Australia negotiated some deal with the manufacturer and immunises every child and found it to be a great deal: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223658 https://journals.plos.org/plosone/article?id=10.1371/journal... I don't know or care about the US's inability to negotiate drug prices or unwillingness to fund useful programs - which is a choice. > I’m calling you out for an out-of-touch liberal. lol this site is amazing sometimes. people have the knowledge of the world available at their fingertips, can read the experiences of people from all around the world and still end up making some strongly worded reply about how the important thing is how much you can buy an HPV vaccine at a discount retail chain in the countryside after a country failed to work towards an obvious public good? what a time to be alive.
    - s5300 5y ago
      >>this site is amazing sometimes. people have the knowledge of the world available at their fingertips, can read the experiences of people from all around the world and still end up making some strongly worded reply about how the important thing is how much you can buy an HPV vaccine at a discount retail chain in the countryside after a country failed to work towards an obvious public good? what a time to be alive. Their typical reply to this is that all of that information is fake subterfuge by Big Tech^tm It's just like... damn dude. What went wrong in these people's lives to make them so stupid and angry at data/information
temptemptemp111 5y ago
Amazing how every retard in this thread thinks that they are better at virology & biology than Peter Duesberg.
deleted 5y ago
[deleted]
leroy_masochist 5y ago
> Moderna is seeking 56 individuals, aged 18 to 50 and who are HIV-negative, for the trial, which is estimated to begin on August 19 and conclude in spring 2023. Probably a dumb question given that I have little domain knowledge here, but are they really going to get valuable data from 56 individuals? Like, isn't that N really small? How many of them would be expected to contract HIV? And, I'd imagine that if they are selecting a high-risk population for the trials (e.g., sexually active young gay men), wouldn't a lot of the individuals already be on PREP? Would they have to go off of PREP, and run a potentially much greater risk of contracting HIV if the vaccine doesn't actually work?
- tuankiet65 5y ago
  From the trial page (https://clinicaltrials.gov/ct2/show/NCT05001373 https://clinicaltrials.gov/ct2/show/NCT05001373), it's a just phase one study to figure out the safety of the vaccine: > A Phase 1, Randomized, First-in-human, Open-label Study to Evaluate the Safety and Immunogenicity
lvl100 5y ago
This is going to be similar to COVID where you have to take multiple shots per year? Should that even be called a vaccine?
- deleted 5y ago
  [deleted]
drited 5y ago
Having taken the Moderna mRNA Covid-19 vaccine I'd be curious to hear HN'ers thoughts on this part of the article which I wasn't aware of until reading just now: 'Moncef Slaoui, head of Operation Warp Speed until January 2021, was formerly a board member of Moderna and only sold his stake in the company days after his appointment by former President Donald Trump for an estimated $10 million, prompting concerns about the program’s neutrality.'

851 points by Saint_Genet 5y ago

tannhauser23 5y ago

So, umm, how do you test this vaccine? Are the participants expected to have unprotected sex with HIV-positive people?

ProjectArcturis 5y ago
No, you give it to 10k people, and give a placebo to another 10k, and let them live their lives, and after 5 years or so you see how many of each group have contracted HIV.
- jdavis703 5y ago
  The participants can have unprotected sex with HIV+ people if they want. It’s like the COVID-19 vaccine trials. The study designers didn’t set any parameters around mask use, social distancing, etc. It’s up to each participant to apply harm reduction practices as they see fit.
  - koheripbal 5y ago
    Notably covid vaccines were approved early because idiots in both arms didn't wear masks, and those in the control arms got very sick and died soon after the trial began.
- missedthecue 5y ago
  What is the statistical likelihood of someone in a 10,000 sample size of people catching HIV in any 5 year period? Probably less than 1%?
  - icegreentea2 5y ago
    Depends where you sample from. In the USA, estimated new HIV infections in 2019 35k. Assuming 350 million Americans, that gives a very rough estimate of 1 case out of 10,000 per year. You can enrich this by shifting target population. You could do this in the USA by targetting high risk communities, or by moving the trial overseas. An trial in the USA with 10k in each arm could very likely be constructed to generate at least 10 cases per year. Likely up to 50. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...
- tannhauser23 5y ago
  They're asking for 50-ish volunteers ATM.
  - icegreentea2 5y ago
    Yeah, it's a phase 1 trial. In phase 1 they aren't even really looking at if the vaccine is effective, they're making sure that it's safe/side effects are reasonable, and maybe getting some dosage information out of it.
JBorrow 5y ago
What you just described is a 'Challenge Trial'. These have been avoided for COVID and would likely be avoided for other diseases too on ethical grounds. For a common cold, or other lower-impact disease, you could do a challenge trial.
dempedempe 5y ago
The Bug Chasers would make good volunteers. https://en.wikipedia.org/wiki/Bugchasing https://en.wikipedia.org/wiki/Bugchasing
- cblconfederate 5y ago
  Looks like finding participants for a challenge trial won't be hard.

jcims 5y ago

Video of the lifecycle of HIV. To me it's absolutely mind-blowing to think that this entire process developed on its own, in dark, and is mindlessly progressing along so effectively that despite all of our technological capability we can barely contain it. https://vimeo.com/260291607 https://vimeo.com/260291607 (also how awesome is the music?)

jarpschop 5y ago
Natural selection is a very powerful process.
- mbroncano 5y ago
  * given enough time
- pintxo 5y ago
  when executed over millions of years
  - whimsicalism 5y ago
    Much shorter time frames than that are still powerful, especially for something like a virus.
    - est31 5y ago
      Yeah the number of generations is more important than the number of years.
    - ddingus 5y ago
      We may receive that education somewhat directly and immediately through covid, and failure to vaccinate people.
  - jcims 5y ago
    In practice this is what we observe, but the combinatorics are so ridiculously large that its hard to understand how it works. A very small protein of say 200 amino acid residues has 21^200 configurations. If every atom in the universe was another universe, and every atom in those universes was a universe, you'd still need 10^20 grandpappy universes to represent each configuration as a distinct atom in the grandchild universe. Given that these configurations confer meaningful chemical and mechanical utility, sometimes with discontinuities in effect, it's really odd to me that it all somehow works.

ChrisMarshallNY 5y ago

Very good news. I have known many people that have died of the virus. AIDS is a tough one. It has a shifting antigen. If anyone remembers Stephen King's The Stand, that was the premise for Captain Trips. If they can inoculate against AIDS, then the human race may just survive the next millennium.

weimerica 5y ago
> Very good news. I have known many people that have died of the virus. Unfortunate what happens when people engage in unnecessary social interaction during a pandemic.
- xattt 5y ago
  Are you referring to the AIDS epidemic where access to care for individuals was withheld as a result of bigotry?
  - weimerica 5y ago
    Perhaps we should abolish the NIH then. They seem to have a repeated history of failing to grapple with pandemics.
    - dang 5y ago
      Would you please stop posting unsubstantive comments and/or flamebait, and stop using HN for political battle? You've been doing a lot of that, unfortunately, and we ban such accounts (regardless of what they're battling for or against). We're trying for a different sort of forum here. Also, trollish usernames aren't allowed on HN, because they end up trolling every thread the account posts to (https://hn.algolia.com/?sort=byDate&dateRange=all&type=comment&storyText=false&prefix=true&page=0&query=by:dang%20trollish%20username https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...). I've banned this account until we get some reason to believe that you will use HN as intended in the future. If you'd like to do that, emailing hn@ycombinator.com is probably best.
- 5y ago

hanniabu 5y ago

Would this be recommended for anybody sexually active? Or just for people in higher risk like someone with a partner that has HIV or if you're homosexual?

sschueller 5y ago
I guess people who have a lot of partners and unprotected sex such as people who do porn or sex workers as well as people with partners that are positive.
- koheripbal 5y ago
  Not to mention members of the gay community.
jcims 5y ago
As with any preventative medicine it boils down to risk/benefit and (unfortunately) economics. FDA approval process should expose most of the risk/benefit equation and the manufacturer will set the price. When all of that is said and done you will have a lot more information with which to consider your question.
bayesian_horse 5y ago
I think it will be rolled out to those most at risk at first, including those who are already infected. This may actually reduce the HIV infection rate to a large degree. Or people don't take the effing vaccine despite the benefits. Then yes, probably anybody sexually active should get it.
- admiral33 5y ago
  > probably anybody sexually active should get it. Agree - if we can get rid of HIV we should. I looked at the exclusion criteria in the trial and it didn't mention use of a prophylactic. Widely available prophylactics have been a huge success with preventing HIV, I wonder how that will impact the trial. https://clinicaltrials.gov/ct2/show/NCT05001373 https://clinicaltrials.gov/ct2/show/NCT05001373

wayoutthere 5y ago

Thank goodness. I’m happy PrEP exists, but it gave me intense nausea for weeks before I couldn’t do it anymore. I would love to be able to date and not have to worry about HIV (I’m a trans woman who dates men, most of whom are bisexual). Not having to take another horse pill daily would be great too.

AlgorithmicTime 5y ago
So you're a homosexual male who dates other homosexual and bisexual males. Yeah, you're the highest risk group.
sonicggg 5y ago
You know condoms are a thing, right?
- wayoutthere 5y ago
  You know that most straight cis people don’t use them either, right? Most women in my circles just have an IUD.
- unnouinceput 5y ago
  Condoms take away 50% of the pleasure so I'd understand anyone who, in heat of the moment, would judge poorly and do it unprotected. Also, while rare, condoms, do break. I'd say, from sexual perspective, the better protection is to have a long term partner (not talking about marriage here). Also you can get HIV from other sources than sexual intercourse too, so having a vaccine that is proved by medical science is a huge relief. Here is personal story of mine: Last year, while vacationing, I was walking on the beach and I felt a slight sting and when I looked down a hypodermic needle was piercing my finger. Took it up and barely a single drop of blood formed, so the penetration barely went below the skin but that was enough to make me feel afraid. After 3 weeks took the test, found out I was HIV negative and talked with the doctor. She said that salty water is great at dismantling DNA/RNA and asked me what the needle looked like. It was all clean except for the tip where my blood was. Told me to not worry, just test again in 6 months which I did and for my great relief I was still HIV negative. Nevertheless during this entire time, in the back of my head black thoughts were daily there, worrying about "what if".

nikkinana 5y ago

Isn't that another Dr. Falsie vaccine?

slumdev 5y ago

Pray that the side effects are well-studied before the CDC decides to administer it to every infant within minutes of birth (like they did with Hep B, another sexually-transmitted disease to which most people will never even be exposed.)

Foobar8568 5y ago
At one point, we should stop saying that hep-* or HIV are STDs, in several countries the bulk of transmissions are from mother to infant during delivery or other means that sex transmissions. With the way the world is connected, these virus can travel easily.
- slumdev 5y ago
  > in several countries the bulk of transmissions are from mother to infant during delivery Is this the case in the United States, where the CDC makes recommendations? And if so, why not administer it only to those children of mothers who test positive? We don't put everyone on a statin simply because most (i.e. more than half of) people will eventually develop heart disease. Instead, we test and administer statins to only those people who have heart disease risk factors. We don't give everyone bariatric surgery or weight loss drugs simply because most Americans are overweight or obese. Instead, these remedies are administered only to those who are most likely to benefit. No drug or vaccine is without side effects. It's clear that there's no such thing as informed consent in today's world. The patient cannot be informed because the side effects are hidden from him. And he definitely hasn't consented if coercion was involved in his decision to receive the treatment.
  - bluGill 5y ago
    > We don't put everyone on a statin simply because Because there are known side effects that make them not suitable to some people. Pregnant women should not take them (nor those thinking about getting pregnant). Those of Asian decent need a smaller dose. Those who drink alcohol shouldn't take them. Those who take part in extreme exercise shouldn't take them. They cannot be mixed with some other drugs. The above is off the top of my head. It probably doesn't apply to them all, there are several different statins to choose from, and many different dosages. A doctor really needs to work through the above (and probably more factors I'm not aware of) to figure out what is best for you.

spleeder 5y ago

How would this vaccine work for people who are already infected?

lnanek2 5y ago
It wouldn't. Their immune system already has a sample of the virus. Giving them a vaccine would give them nothing they don't already have. The idea behind a vaccine is the give the immune system a sample before it encounters the real virus, which allows it to respond quicker when the real virus arrives, which allows it to prevent the virus to replicate sufficiently to make the person sick. For someone who already has the virus, the vaccine won't do anything.
- dagmx 5y ago
  This is somewhat incorrect. Not all vaccines include a sample of the virus they're protecting against (see the mRNA vaccines for covid-19). Also for some viruses (again see covid-19), it's still advisable to get a vaccine even if you've already been infected. The protection rate and longevity of the vaccines can outweigh infection based antibodies dramatically. In the case of HIV, it's potentially quite different, because HIV is such a unique disease, that yeah, a vaccine might not help anyway. But otherwise, your comment doesn't apply to vaccines in general (and it didn't seem like you were replying towards any specifics of HIV)
  - jonplackett 5y ago
    Also some evidence that vaccines are helping with long covid https://www.theguardian.com/society/2021/may/18/long-covid-symptoms-ease-after-vaccination-survey-finds https://www.theguardian.com/society/2021/may/18/long-covid-s... The difference with mRNA vaccines is they let your body build antibodies without it even knowing the virus itself
    - Unklejoe 5y ago
      > Also some evidence that vaccines are helping with long covid By what possible mechanism? Does this imply that long COVID is a result of some small amount of lingering virus? I was under the impression that long COVID was a result of damage caused by the initial infection - not some continuous infection of the actual virus.

steve76 5y ago

Give it only to us, then mutate it to make it go airborne.

anovikov 5y ago

It is so excruciatingly difficult to trial a HIV vaccine that we can easily expect it to take decades.

anchpop 5y ago
What makes it so difficult?
- blamestross 5y ago
  At some point, somebody needs to be exposed to HIV with an unproven vaccine. Current design is just "give it to enough people to show they get HIV statistically lower than their origin populations.
standardUser 5y ago
According to the article, the Phase 1 clinical trail will take under 2 years. "Moderna is seeking 56 individuals, aged 18 to 50 and who are HIV-negative, for the trial, which is estimated to begin on August 19 and conclude in spring 2023" I would imagine that larger trials would be conducted in places with rampant HIV spread, right? Which shouldn't take an inordinate amount of time.
- whimsicalism 5y ago
  Phase 1 is not the difficulty here....
  - standardUser 5y ago
    With the COVID vaccines, the locations of the clinical trials were chosen for how rapidly the virus was spreading. Some trials even added new geographic areas with high transmission rates while they were still ongoing. Why wouldn't any large scale HIV trial not choose one of the many countries with a high transmission rate?
    - MagnumOpus 5y ago

deleted 5y ago

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treyhuffine 5y ago

Will the microchips in this be better than the ones in the Covid vaccine?

arsome 5y ago
I hear this one might be 6G compatible. Personally I'm just hoping for Bluetooth LE support.

rubyist5eva 5y ago

Did they make this one in a weekend like they did the Covid vaccine? Luckily I’m monogamous and committed so I don’t have to worry about catching degenerate diseases.

ionwake 5y ago

My friend had a HIV vaccine about 5 years from some London kings college trial - has always been fine. On a related coincidence I had the moderna vaccine today.

at_a_remove 5y ago

The graveyard of HIV vaccines that failed at Phase II is unfortunately large, and this isn't even there yet. I won't be holding my breath on this one. HIV is tricky.

vibrio 5y ago
I came here to say make this (lonely) comment. HIV and CoV are very different viruses. Different pathogenesis, different tropism, different social drivers for transmission... mRNA technology did well in 2020, but it was a very well-funded technology in clinical development for ~10 years before SARS-CoV2 arrived. HIV and Cancer are not low-hanging fruit. I wish them the best, as I hate both those diseases, but I'm not aware that there is anything in the technology that uniquely provides a solution to the problem.
- sterlind 5y ago
  from what I've read, it's not really mRNA that gives Moderna any advantage, as much as being able to raise broadly-neutralizing antibodies (BNAbs) against HIV membrane protein. but.. it's still not a polyvalent vaccine, it's only targeting one such highly-conserved region, and there's HIV out there that evades BNAbs (5% of HIV+ patients have BNAbs after all, and they eventually progress.. though maybe after changing tropism or something.) so it may not be all that effective as a strategy, but there's at least some monkey data suggesting it delays or sometimes prevents infection. More info here: https://www.aidsmap.com/news/mar-2020/hiv-vaccine-generates-broadly-neutralising-antibodies-passes-first-safety-and-proof https://www.aidsmap.com/news/mar-2020/hiv-vaccine-generates-...

Zamicol 5y ago

This would be huge news for Africa. (I'm always surprised at how many people are generally unaware of the rates of HIV in Africa. https://en.wikipedia.org/wiki/HIV/AIDS_in_South_Africa https://en.wikipedia.org/wiki/HIV/AIDS_in_South_Africa)

throwaway59553 5y ago

Beyond mother-to-child transmission, and some negligent medical malpractice in let's say a blood transfusion, how do you even get HIV, in the developed world? I can understand high rates of infection in the most illiterate places of the world, but is it too much to ask certain demographics to not have sex with random strangers in some toilet of some gas station or bath house?

epmatsw 5y ago

It's amazing how many awful comments this is drawing. Is this just bots getting autotriggered on keywords or something?

seattle_spring 5y ago
I doubt it's bots. Unfortunately being a tech enthusiast doesn't preclude one from being an awful person. Spend some time on Blind for additional proof.

cletus 5y ago

HIV is incredibly sophisticated. It's actually kind of amazing how effective it is. I mean obviously the resulting disease is bad, no question. You can still appreciate the sophistication. HIV has resisted efforts to develop a vaccine for 30+ years at this point. I am already beginning to wonder if the 2020s will be the story of the social transformation caused by mRNA vaccines. An effective and relatively cheap HIV vaccine will be huge. Apart from Covid and HIV, mRNA is going to have a huge effect on the flu vaccine too. For anyone who doesn't know, predictions are made about what flu strains will dominate the coming winter 4-6+ months ahead of time and the vaccine is made from that. Those predictions may not be accurate, which largely explains the variance of efficacy. mRNA has the potential to reduce that down to 1-2 months so you can potentially react to the actual dominant strains. Cancer of course isn't a single disease. Even something like lung cancer are a collection of different diseases. But some cancers are caused by viruses. A notable example is cervical cancer where it seems like most cases are caused by HPV strains. Australia is on track to essentially eliminate cervical cancer by 2035 [1]. To be clear, this isn't an mRNA vaccine. But mRNA vaccines may greatly reduce the time required to develop a vaccine and make it possible to eliminate whole classes of diseases. This is all super-exciting. [1]: https://www.vcs.org.au/blog/our-impact/news/australia-can-continue-to-pave-the-way-for-cervical-cancer-elimination/#:~:text=As%20a%20result%20of%20its,are%20down%20across%20the%20country https://www.vcs.org.au/blog/our-impact/news/australia-can-co....

athenot 5y ago
Agreed this very exciting. Malaria is also being targeted using the same technology. BioNTech announced they were working on it last month and some results[1] in mice are already looking promising. [1] Messenger RNA expressing PfCSP induces functional, protective immune responses against malaria in mice. https://www.nature.com/articles/s41541-021-00345-0 https://www.nature.com/articles/s41541-021-00345-0
vanadium 5y ago
It's worth posting Moderna's research pipeline to understand the breadth and depth of where they plan to take mRNA vaccines: https://www.modernatx.com/pipeline https://www.modernatx.com/pipeline

jmnicolas 5y ago

Given the track record of the COVID vaccines (take a look at current Israel stats) I'm not optimistic about an HIV vaccine.

whafro 5y ago
This is quite cynical. I think the vaccines are doing pretty dang well considering they were developed in a matter of weeks following discovery of the virus, and work very robustly against not only the variants that were targeted, but also many that were not. HIV has decades of study and literature behind it, so why not be more optimistic about the prospects for progress?
- jmnicolas 5y ago
  First think that poped in DDG: >Israel reinstates some virus restrictions to avoid a full lockdown. https://www.nytimes.com/2021/08/04/world/israel-covid-restrictions-lockdown.html https://www.nytimes.com/2021/08/04/world/israel-covid-restri... Sorry it's a paywall but the title is enough. Doesn't scream vaccine efficacy to me since they are in the top vaccinated country list.
  - jmnicolas 5y ago
    I'd like to know what the downvoters think. Those vaccines have become a kind of dogma...
    - FartyMcFarter 5y ago
      Israel has vaccinated 60-70% of its population, which isn't enough for herd immunity. As for your comment specifically, "the title is enough" isn't a very convincing argument for anything.
      - native_samples 5y ago
        That is the exact threshold that was previously being presented as good enough for herd immunity. But herd immunity stats are all made up anyway. Fauci admitted the US value for herd immunity threshold was being picked based on opinion polling, not science.

elromulous 5y ago

Can someone with a better understanding talk about the specifics of how/why a vaccine like this might end up not being effective against HIV (i.e. what makes HIV so good at evading our efforts)? I suspect we've been in this boat many times in the past 40 years: a promising cure is just around the corner.

vibrio 5y ago
Two half-baked comments off the top of my head: -HIV targets, infects and cripples the immune system. While CoV2 infects and replicated aggressively, causing inflammation and fibrosis, HIV goes in, gets a foothold, hides and lingers like an insurgent, slowly exhausting the immune system. Very different approaches and how they are impacted by vaccines may be very different. -Convincing people to take the vaccine would be hard. Look how hard it is with a respiratory pandemic. It's "easy" to be non-high risk for HIV and people probably believe they can't get it, but people seem to continue getting it.

34679 5y ago

Go to any website of a mRNA COVID vaccine manufacturer and it will plainly state it is not meant to prevent infection. It is highly effective, for a period unknown, at preventing the disease caused by the infection. AIDs is the disease caused by an HIV infection. COVID-19 is the disease caused by a SARS-COV-2 infection.

t0rt01se 5y ago
So long Moderna, short condom manufacturers isn't a good idea?
- 34679 5y ago
  HIV/AIDs is a perfect example of why it's dangerous to not distinguish between the two. If you are vaccinated and exposed to SARS-COV-2, you still have a high risk of infection, but because of the vaccine, you have a low risk of that infection developing into the disease known as COVID-19. If a successful mRNA vaccine is developed to prevent AIDs, it would be extremely important for the vaccinated to know they can still be infected with and spread HIV. It's not any different for SARS-COV-2/COVID-19. The talk in this thread about an mRNA vaccine eradicating HIV is nonsense.
  - t0rt01se 5y ago
    I know and I appreciate your effort to educate / warn. But you do realize that most of these posts are made by shills ?

bananapub 5y ago

(some strains of) HPV already have vaccines, social conservatism is what is allowing much of cervical cancer to continue in the rich world.

portpecos 5y ago
Right, blame it on social conservatism when the HPV vaccine costs $1000 even if you have Medicaid or ACA. In fact, Medicaid and ACA don’t even cover it. The cheapest price for the HPV vaccine in rural America is at the nearby Walmart. But it is $330 per shot, and you have to take 3 shots, and Medicaid and ACA won’t even cover it. If you’re blaming social conservatism, then I’m calling you out for an out-of-touch liberal.
- bananapub 5y ago
  what are you talking about? Australia negotiated some deal with the manufacturer and immunises every child and found it to be a great deal: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223658 https://journals.plos.org/plosone/article?id=10.1371/journal... I don't know or care about the US's inability to negotiate drug prices or unwillingness to fund useful programs - which is a choice. > I’m calling you out for an out-of-touch liberal. lol this site is amazing sometimes. people have the knowledge of the world available at their fingertips, can read the experiences of people from all around the world and still end up making some strongly worded reply about how the important thing is how much you can buy an HPV vaccine at a discount retail chain in the countryside after a country failed to work towards an obvious public good? what a time to be alive.
  - s5300 5y ago
    >>this site is amazing sometimes. people have the knowledge of the world available at their fingertips, can read the experiences of people from all around the world and still end up making some strongly worded reply about how the important thing is how much you can buy an HPV vaccine at a discount retail chain in the countryside after a country failed to work towards an obvious public good? what a time to be alive. Their typical reply to this is that all of that information is fake subterfuge by Big Tech^tm It's just like... damn dude. What went wrong in these people's lives to make them so stupid and angry at data/information

temptemptemp111 5y ago

Amazing how every retard in this thread thinks that they are better at virology & biology than Peter Duesberg.

deleted 5y ago

[deleted]

leroy_masochist 5y ago

> Moderna is seeking 56 individuals, aged 18 to 50 and who are HIV-negative, for the trial, which is estimated to begin on August 19 and conclude in spring 2023. Probably a dumb question given that I have little domain knowledge here, but are they really going to get valuable data from 56 individuals? Like, isn't that N really small? How many of them would be expected to contract HIV? And, I'd imagine that if they are selecting a high-risk population for the trials (e.g., sexually active young gay men), wouldn't a lot of the individuals already be on PREP? Would they have to go off of PREP, and run a potentially much greater risk of contracting HIV if the vaccine doesn't actually work?

tuankiet65 5y ago
From the trial page (https://clinicaltrials.gov/ct2/show/NCT05001373 https://clinicaltrials.gov/ct2/show/NCT05001373), it's a just phase one study to figure out the safety of the vaccine: > A Phase 1, Randomized, First-in-human, Open-label Study to Evaluate the Safety and Immunogenicity

lvl100 5y ago

This is going to be similar to COVID where you have to take multiple shots per year? Should that even be called a vaccine?

deleted 5y ago
[deleted]

drited 5y ago

Having taken the Moderna mRNA Covid-19 vaccine I'd be curious to hear HN'ers thoughts on this part of the article which I wasn't aware of until reading just now: 'Moncef Slaoui, head of Operation Warp Speed until January 2021, was formerly a board member of Moderna and only sold his stake in the company days after his appointment by former President Donald Trump for an estimated $10 million, prompting concerns about the program’s neutrality.'