[HN Gopher] New HIV vaccine with a 97% antibody response rate in...
       ___________________________________________________________________
        
       New HIV vaccine with a 97% antibody response rate in phase I human
       trials
        
       Author : MKais
       Score  : 255 points
       Date   : 2021-04-04 16:23 UTC (6 hours ago)
        
 (HTM) web link (www.europeanpharmaceuticalreview.com)
 (TXT) w3m dump (www.europeanpharmaceuticalreview.com)
        
       | paulydavis wrote:
       | Africa really needs to be the target rollout for these vaccines
       | if and when they materialize.
        
         | qrbLPHiKpiux wrote:
         | Why didn't education work there?
         | 
         | I'm just asking.
        
           | tremon wrote:
           | Why 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 wrote:
             | Don't forget well-justified suspicion of westerners based
             | on horrible and not too distant history.
        
           | spiritplumber wrote:
           | Because it got drowned out by misinformation.
        
           | africanboy wrote:
           | same reason why education has not prevented covid-19 from
           | spreading.
        
         | mxcrossb wrote:
         | > The Swazi population faces major health issues: HIV/AIDS and
         | (to a lesser extent) tuberculosis are widespread.It is
         | estimated that 26% of the adult population is HIV-positive. As
         | of 2018, Eswatini has the 12th-lowest life expectancy in the
         | world, at 58 years.
         | 
         | https://en.m.wikipedia.org/wiki/Eswatini
         | 
         | It seems countries like this could benefit massively from an
         | effective vaccine
        
       | thescribbblr wrote:
       | I am confuse about the working of this vaccine? Anyone, who can
       | make me understand about the working I would be thankful.
        
         | arrosenberg wrote:
         | They 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 wrote:
           | is that similar to what is being investigated for cancer ?
        
             | toomuchtodo wrote:
             | Yes!
             | 
             | https://www.aamc.org/news-insights/mrna-technology-
             | promises-...
        
             | arrosenberg wrote:
             | More or less. Insert mRNA instructions for creating or
             | triggering antibodies that target cancer cells
             | specifically.
        
               | throwawayboise wrote:
               | It'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 wrote:
         | From TFA to set context: _The vaccine is an immune primer, to
         | trigger the activation of naive B cells via a process called
         | germline-targeting, as the first stage in a multi-step vaccine
         | regimen to elicit the production of many different types of
         | broadly neutralizing antibodies (bnAbs). Stimulating the
         | production of bnAbs has been pursued as a holy grail in HIV for
         | decades._
         | 
         | That is, the vaccine triggers generation of bnAbs successfully,
         | turning a "passive immunization" HIV/AIDS treatment in to
         | "active immunization".
         | 
         | More on bnAbs:
         | 
         | > _Antibodies are proteins that immune cells make to block
         | viruses and other infectious agents. In the case of HIV, people
         | who are infected typically produce antibodies to the virus. But
         | because the virus mutates and replicates rapidly, antibodies
         | are largely ineffective at controlling the virus. After years
         | of infection, though, some people produce highly potent
         | antibodies called broadly neutralizing antibodies (bnAbs) that,
         | in laboratory tests, are able to neutralize a wide variety of
         | HIV strains. The identification of such antibodies has
         | transformed the field of HIV prevention research for two
         | reasons: it provides information to guide the design of
         | vaccines that could elicit bnAbs for protection, and it has
         | opened the door to a new prevention modality: the
         | administration of HIV bnAbs to prevent infection._
         | 
         | > _The administration of antibodies to prevent infection is
         | known as passive immunization, in contrast to active
         | immunization, which occurs as a result of vaccination (see
         | graphic, below). While a vaccine "trains" the immune system to
         | generate antibodies and other immune responses, passive
         | immunization requires that the antibodies be delivered directly
         | into the body through infusions or injections. This protection
         | is temporary, and, in the case of HIV prevention, would need to
         | be administered periodically as long as the subject was still
         | at risk._
         | 
         | From: https://www.iavi.org/our-science/bnabs-for-hiv-prevention
        
         | [deleted]
        
       | colordrops wrote:
       | Does this cure pre-existing infections
        
       | xiphias2 wrote:
       | This looks to be the original announcement from February:
       | 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.
        
       | ransom1538 wrote:
       | Dumb question: Isn't HIV a solved problem? With current anti-
       | virals they can't even detect HIV in blood tests.
        
         | Daynil wrote:
         | If you call requiring tens of thousands of dollars of
         | maintenance medication treatment annually for life a solved
         | problem, then absolutely!
        
         | SquareWheel wrote:
         | This still requires treatment for life, though. A vaccine would
         | obviate this need, freeing up time, resources, and money for
         | other healthcare.
        
         | eganist wrote:
         | If 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 wrote:
         | No 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...
        
       | dj_mc_merlin wrote:
       | Interested to hear from people in the know: how good does this
       | look?
        
         | dheera wrote:
         | Interested 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.
        
           | heavyset_go wrote:
           | > _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._
           | 
           | This is a huge problem in the US. Truvada must be taken
           | everyday to prevent HIV, and in 2015, it cost $1400 for a 30
           | day supply. In 2021, it costs between $1900 and $2500+ for a
           | 30 day supply in the US.
           | 
           | Elsewhere in the world, Truvada might cost $40. In Australia,
           | Truvada costs $8 for a 30 day supply[1].
           | 
           | The only other drug approved for PrEP in the US is Descovy,
           | which is manufactured by Gilead, too, and costs $2300+
           | minimum for a 30 day supply.
           | 
           | HIV could virtually eliminated in the US if PrEP was made
           | available and affordable to at-risk populations.
           | 
           | [1] https://www.independent.co.uk/news/world/americas/us-
           | politic...
        
           | taurath wrote:
           | Cost is the largest factor. HIV could be nearly eliminated
           | entirely if PREP wasn't a cash cow for Gilead.
        
             | fny wrote:
             | Uhm... Last I checked many pharmaceuticals that compete
             | with Gilead also operate in the HIV space.
        
               | heavyset_go wrote:
               | No, the only two drugs approved for PrEP in the US are
               | Truvada and Descovy, both of which are Gilead drugs.
        
               | [deleted]
        
             | tjohns wrote:
             | Gilead's patent on Truvada (the most common drug used for
             | PREP) just expired. As of a few months ago it's available
             | as a generic.
        
             | ChickeNES wrote:
             | Why does this falsehood keep being repeated as the truth?
        
       | supernova87a wrote:
       | From 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?
        
       | briefcomment wrote:
       | Does this require everyone to get it?
        
         | jason0597 wrote:
         | I presume it would only be recommended for those who are
         | sexually active (particularly homosexuals like me) and those
         | who regularly use needles.
        
           | floatingatoll wrote:
           | Many who are 'sexually active' are also unwillingly so. By
           | that criteria, it would be best to recommended it to _all_
           | women and _all_ prisoners in the United States, due to how
           | common rape is among those populations here. I 'd like to say
           | "we are better as a society" but that's not true yet, and in
           | the meantime, at least I won't have to worry about AIDS when
           | it's my turn to be raped.
        
         | colinmhayes wrote:
         | HIV is sexually transmitted, so only sexually active people
         | would need the vaccine.
        
           | nkozyra wrote:
           | The high risk group is larger than that, though.
        
           | mekster wrote:
           | Wtf are you talking about?
        
           | SquareWheel wrote:
           | Drug users are also high risk, as are any medical
           | professionals that work around needles.
           | 
           | Of course many couples have one partner who is infected, too.
           | Such a vaccine would do wonders for their peace of mind.
        
       | nickthemagicman wrote:
       | I 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.
        
         | zizee wrote:
         | Vaccines trigger an immune response, preparing the body to
         | fight of the infection. This allows the body to "beat" the
         | infection before it takes hold.
         | 
         | Afaik vaccines are not useful after the fact. I.e. this HIV
         | vaccine won't be given to people already infected.
        
           | nickthemagicman wrote:
           | Right but for a virus that integrates into the genome once it
           | takes hold it's game over.
           | 
           | And even vaccine mediated immune responses are via memory
           | cells and take time to ramp up to generate the antibodies to
           | attack the virus.
           | 
           | So I guess my question is: Is the window of opportunity while
           | ramping up the immune system for a vaccine big enough for HIV
           | to take root in a body.
           | 
           | Does your knowledge stop at "Vaccine stop infection?" Isnt
           | that just common knowledge?
        
             | XzAeRosho wrote:
             | >Right but for a virus that integrates into the genome once
             | it takes hold it's game over.
             | 
             | The same could be said about any other successful vaccine,
             | like Polio and Measles vaccines. Not that those diseases
             | behave like HIV, but the way we handle vaccination against
             | them.
             | 
             | >And even vaccine mediated immune responses are via memory
             | cells and take time to ramp up to generate the antibodies
             | to attack the virus.
             | 
             | That's why there are vaccination campaigns, to immunize
             | target groups before they contract the aforementioned
             | sickness.
             | 
             | >Is the window of opportunity while ramping up the immune
             | system for a vaccine I mean unresponse big enough for HIV
             | to take root in a body.
             | 
             | A vaccine is always a good opportunity to prevent adverse
             | effects, even "if takes time" to ramp up your immune
             | system.
        
             | jacoblambda wrote:
             | Like previously stated, HIV hides inside of cells for an
             | indeterminate amount of time. As you mentioned immune
             | memory can take a little bit of time to kick in. Once it
             | kicks in however, it is extraordinarily effective at
             | hunting down viruses and actively (non-dormant) infected
             | cells. With a small enough viral load however, the immune
             | system can fend off HIV well enough.
             | 
             | During an initial infection either the immune system will
             | fight off the virus if the load is small enough and it gets
             | lucky or the virus takes hold of some cells and starts
             | reproducing. In this latter case, the immune memory allows
             | the immune system to effectively fight off the virus before
             | it can properly take hold. Of course some of the virus may
             | lay dormant in a few cells but since it never gets a chance
             | to take hold of the body the quantity of dormant infected
             | cells is relatively low.
             | 
             | Now due to the low quantity of dormant infected cells, it
             | is extremely unlikely that there will be enough "activated"
             | cells at any given time that the immune system is not able
             | to handle the threat before it escalates. Over time you can
             | expect the dormant HIV to slowly be exterminated or at very
             | least prevented from growing in count.
             | 
             | ---
             | 
             | Now this isn't anything terribly new. The real breakthrough
             | with this vaccine over other attempts in the past is that
             | it results in the production of a specific type of antibody
             | that can act on all known HIV strains with essentially the
             | same efficacy (where as prior vaccines couldn't result in
             | the production of antibodies that worked reliably on even
             | small portions of the thousands of different HIV strains).
        
         | sp332 wrote:
         | You can keep it from spreading quickly within a person's body,
         | and reduce the chances of transmission, if you can reduce the
         | amount of viral particles that exist outside of host cells.
        
           | nickthemagicman wrote:
           | Seems like even vaccine mediated immune response takes time
           | to ramp up and generate antibodies.
           | 
           | Especially from memory cells.
           | 
           | I don't know if that window of opportunity is sufficient for
           | HIV to integrate into the host genome.
        
             | sp332 wrote:
             | I meant vaccinating the person who already has the
             | infection. Their own immune system will remove the virus
             | particles before they can travel.
        
             | _Microft wrote:
             | As I understand, this integration might happen but would be
             | meaningless because viruses ejected from infected cells
             | will subsequently be intercepted.
        
               | sudosysgen wrote:
               | Depending on the immune response, infected cells can also
               | be destroyed.
        
         | olliej wrote:
         | What the hell are you talking about? It does not "integrate
         | with the human genome".
        
           | nickthemagicman wrote:
           | What the hell are you talking about?
           | 
           | Does every Dunning Kruger moron on the planet just talk with
           | authority about science now because they posted the hashtag
           | #believeInScience during Coronavirus?
           | 
           | The numb skulls in this thread need to gooogle retrovirus,
           | integrase, and reverse transcriptase before even typing or
           | better yet even thinking they know anything about biology
           | just because they know how to write a JavaScript component.
        
           | programmarchy wrote:
           | The mechanism is called reverse transcription. It's a well
           | known exception to the "central dogma of molecular biology".
        
             | nickthemagicman wrote:
             | Thank you. And it uses the enzyme integrase to integrate
             | into the host cells genome and reverse transcriptase to
             | create DNA from RNA.
             | 
             | Anyone who has looked into any science beyond what the
             | media talks about knows this about HIV.
             | 
             | What's even more interesting is that there's latent
             | reservoirs in a person's body that we don't know where they
             | are so that even after we get someone's viral count
             | undetectable with meds, if they stop the medicine hov can
             | come back
        
           | nlitened wrote:
           | I 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
           | 
           | I'd really appreciate some input from someone who knows more
           | on this topic.
        
             | Gibbon1 wrote:
             | That HIV can and does do that is consistent with what I've
             | read. Some percentage of cells HIV can lay dormant for an
             | indefinint amount of time.
        
             | tjohns wrote:
             | Yes, 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
        
             | david38 wrote:
             | Ah... no. It's special because it attacks white blood cells
             | and white blood cells are what are supposed to attack it.
        
           | retrac wrote:
           | HIV does not generally infect the germ cells that produce
           | sperm or eggs, so it is not heritable, which is maybe the
           | sense you interpreted OP's comment.
           | 
           | Still, HIV is a provirus. Retroviruses write themselves into
           | the genome of the host cell. Cells which are infected and
           | survive to reproduce carry the HIV provirus. As will their
           | descendants, and so on. They will produce HIV when mature
           | even without any HIV particles in the cell. This is
           | integration with the host genome.
           | 
           | This is why HIV cannot be cured with antivirals which fully
           | inhibit its replication. It's also why complete destruction
           | of the immune system (in the process destroying all the cells
           | which are the specific hosts) while flooding the body with
           | high dose antivirals, and then grafting innately immune
           | T-cells, is an effective, if rather drastic, cure.
        
       | stunt wrote:
       | So many vaccine news on HN now. Why are we discussing them here?
       | I visit other websites for vaccine news.
        
         | arbitrage wrote:
         | Why 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.
        
           | imwillofficial wrote:
           | Because 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 wrote:
             | Be 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 wrote:
             | From 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.
        
               | [deleted]
        
           | [deleted]
        
         | purerandomness wrote:
         | Quoting the "Hacker News Guidelines":
         | 
         | "What to Submit
         | 
         | On-Topic: Anything that good hackers would find interesting.
         | That includes more than hacking and startups. If you had to
         | reduce it to a sentence, the answer might be: anything that
         | gratifies one's intellectual curiosity."
        
           | sho_hn wrote:
           | From the OP:
           | 
           | > I visit other websites for vaccine news
           | 
           | Now I'm curious what a good website for vaccine news is ...
        
             | dcminter wrote:
             | I've found Derek Lowe's commentary to be very enlightening:
             | https://blogs.sciencemag.org/pipeline/
        
             | stunt wrote:
             | > Now I'm curious what a good website for vaccine news is
             | ...
             | 
             | Health science journals or communities perhaps.
             | 
             | I was triggered by seeing multiple posts about AstraZeneca
             | blood clot all from major news websites. But somehow I
             | ended up leaving comment on this post unintentionally.
             | 
             | For that (COVID-19 vaccine updates) I like NYT vaccine
             | tracker[1] and Our World in Data[2] but I don't really
             | check them regularly since it's impossible to miss any
             | COVID-19 related update these days anyway.
             | 
             | [1] https://www.nytimes.com/interactive/2020/science/corona
             | virus...
             | 
             | [2] https://ourworldindata.org/covid-vaccinations
        
       ___________________________________________________________________
       (page generated 2021-04-04 23:00 UTC)