Slashdot Mirror
HIV Vaccine
The Sexecutioner writes "WebMD is reporting on a new vaccine which has had an incredible effect in clinical trials. The vaccine, composed of human dendrites holding dead HIV viruses, has dropped test patients' viral load by up to 90% in one year. Could this be it?"
I'd imagine that this sort of therapy could be useful against a whole range of viruses since (as I understand) it operates by training the immune system rather than crippling something specific to the virus the way that other HIV treatments do. If that'd work for most viruses, maybe someday people will be able to just update their own virus definitions a few times a year -- of course, most of them probably wouldn't bother and then call me for support when they open some damn .exe file
they got in their friggin' email and... Sorry, started drifting there for a second.
Of course, it's awfully early to get too excited given this is just 18 people in Brazil so far, and "incredible effect" might be a bit strong since only 44% of the very small number of test patients are still showing the full benefit after one year, but I suppose any good news in this sort of scenario is, well, good news.
PS: Am I the only one who finds it darkly ironic that "The Sexecutioner" submitted this story?
Every year during my review, I just pray the words "slashdot.org" aren't mentioned.
You''ve got to have that word in there.
It's a vaccine because it "teaches" the immune system how to deal with HIV - at least to the extent of keeping it from getting worse, and in some percentage of cases, enough to drastically lower the viral load and rate of transmission.
But it's not a PREVENTIVE vaccine like most widespread vaccines, and it can't be mass-produced since it uses material from each patient and is custom-made for them.
It's still potentially a great leap in terms of treatment of HIV/AIDS, though.
Village idiot in some extremely smart villages.
I believe by dead, they mean that the virus can no longer replicate inside of the body.
They are talking about dendritic cells which are a component of the immune system - not neural tissue.
to catch the things that aren't in the summary.
This isn't a generic vaccine that's created in mass and given to everyone. The 'vaccine' is generated using viruses and dendrites from the specific patient. So it has to be done for each person. It reduces viral loads, but doesn't eliminate the infection.
Still it sounds really promising, but there's a LOT of work that would need to be done before this got anywhere close to general use. Also the article doesn't say how complex/expensive the process is per person. It doesn't sound like it's third world friendly, at least at the moment.
While this study (Nature Medicine Advance On-line publications Subscription required) shows promise, it is only a preliminary trial that included 18 participants. Sixteen of the participants were female and two were male. The figure stated in the /. article, of a 90% total drop in viral load, is not quite accurate. The article states that the patients plasma viral load levels were decreased by 80% (median) over the first 112 days following immunization. It then goes on to say that a prolonged suppression of viral load (up to 1 year after inoculation) of 90% was seen in only 8 individuals.
From my analysis of the HIV RNA expression data from this paper, after 1 year, eight of the patients had viral loads reduced by 90% or better, two patients had their viral loads reduced between 80% and 90% six patients had viral loads that were reduced somewhere between 10% and 50% and two of the patients actually had an increase in plasma HIV RNA levels.
"When Nature Calls We All Shall Drown" Johan Edlund
If it's effective, it will be affordable, one way or another. If the maker sets the price too high and governments or aid agencies don't step up, the demand will be met by the generics makers, and governments will turn a blind eye as necessary. No amount of flak about "respecting IP" outweighs a quarter of your population dropping dead.
I wouldn't be surprised to see the Bill & Melinda Gates Foundation get involved here, too. Say what you like about Bill, the Foundation has done some good work in this field, and he's not short of the shekels.
a dead virus is one that is no longer infective. your description of a virus is accurate, in that they are protein shells around genetic material (most of them, at least, some have enzymes in there and/or different shells)
From what I gather reading the actual article abstract, they're inactivating or killing them with a compound that breaks off small portions of the capsid (general idea abstracted here), but leaves the majority of the capsid intact. The slightly damaged capsid is unable to initiate infection, giving the host time to mount a defense against the real thing.
You are confused on this point. Dendrites are the tree like extensions that project out from a neuron (these are not cells, but are a part of a cell). Dendritic cells (which they are using in this study) are antigen-presenting cells (APCs) from your immune system and have nothing to do with the nervous system (They are also sometimes referred to as Helper T Cells).
"When Nature Calls We All Shall Drown" Johan Edlund
Actually drug prices in Canada are regulated by The Patented Medicines Price Review Board (PMPRB), which is a government agency that oversees the pharmaceutical industry. This agency negotiates the final price for prescription drugs with pharmaceutical companies.
"When Nature Calls We All Shall Drown" Johan Edlund
Actually, the vaccine is being designed for use in countries where conventional therapy is simply much too expensive. It can be kept at temperatures up to 50 degrees (C) for up to 2 years - which, together with the fact that it seems to only work against the HIV-B strain (most common in Africa), seems to indicate that it is headed for sub-saharan Africa. One of the doctors following / contributing to this project gave a presentation on it at the Munich AIDS Days seminar last week. Although the stage one trials on people are showing some progress, the processing involved (own cells, own virus) still makes it kind of prohibitive - i heard that the time frame for wide-spread therapeutic use is 5-10 years.
The unfortunate fact is: it isn't a cure, but a management therapy which should allow infected people to live longer, more productive lives. Even worse - the pharma corps seem to be losing interest in designing new drugs - there hasn't been anything new for about 3 years now... No money in it, especially now that the UN and various charities are clamoring for reductions in trademark and other IP law restrictions. Good for HIV+ persons in poor countries, bad for the pharmacorps bottom line...
Steve -- If you have to call it a system, you don't know what it is.
Actually, the percentage of a drug company's annual budget that is spent on R&D is tiny compared to the amount that they spend on advertising for the big-name money-making drugs they release (like v!@gr@ and all it's offspring). In addition, Drug company profit margins average around 18%, an unheard-of profit level in any other industry.
Most R&D at the experimental level isn't even undertaken by drug companies. It's done in government-supported research institutes at Universities across the country. Only after a potentially useful drug has been dreamed up and researched by these folks will the drug companies step in to take it to the development and release stage.
The truth is that R&D is not a significant part of the reason drugs are so expensive in the US.
thats not entirely true either. i happen to work in the canadaian pharmaceutical industry and i would say that the no 1 reason that Canadian drugs are cheaper is that US patents run longer than Canadian ones. So a medication like fosamax can have a generic in canada a few years before the US industry can start producing one.
I dont work in the legal department, but i believe Canadian drug patents are good for ~5 years and US patents are ~8 years. after that time, companies like novopharm and other generic producing companies, can start churning out generics. even the big brand name companies (ie pfizer) have generic producing lines. this is primarily for overseas markets. in fact, alot of drug companies will manufacture the same drugs, with different names and pill shape/size, based on whatever region they are marketing in. a good example of this is reactine/zyrtec. those two medicines are the EXACT same. in canada however, you dont need a perscription for it an its called reactine. the length-of-patent experation numbers might be off but alot of the lower cost can be put squarely on the messed up US patent system.
Countries like New Zeland and the UK also have similar patent laws.
I have also heard, that the comapnies in fact do price medication higher in the states because they feel that thats what the market will bare. I dont think that the grandparent was that far off from the truth.
I'll just use my special getting high powers one more time...
I wish it were that simple. Unfortunately, drug companies only spend a small amount on R&D - in "The Truth About Drug Companies", Dr. Marcia Angell discusses how on average drug companies spend 2.5 times as much on advertising as they do on R&D. Furthermore, 1/3 of the drugs being marketted by the major manufacturers were discovered by universities or small biotech firms, but are being sold at greatly inflated prices.
For example, Taxol was discovered by NIH, but has been sold by Bristol-Meyers Squibb for 20 times what it cost to produce, and NIH only gets 0.5% royalties. Most drugs that the drug industry itself develops are what she calls "me-too" drugs - drugs that perform the same function as an already extant drug on the market with little difference, and often are based on the same chemical formula with minor modifications. They need not be more effective than current formulations in order to be able to be sold - just more effective than a placebo.
The top 10 pharmaceutical companies make more money than the rest of the Fortune 500 combined. And not only are they granted a limited monopoly, but they often cheat. For example, Astra-Zeneca, when their exclusive rights to Prilosec expired, patented a combination of Prilosec and an antibiotic, and then sued a manufacturer of generic Prilosec because a doctor might proscribe it along with an antibiotic and thus infringe on their new patent.
"99 dead duelists of Dios on the wall. 99 dead duelists of Dios! Take one's ring, pass it around..."
This is simply not true. R&D costs are huge, between $500M and $700M depending on who you believe. Clinical trials alone cost a fortune and take years to conduct. The vast majority of drugs do not make it to market. Thus pharmaceuticals must make huge profits on the ones that do to make up for all the many ones that don't.
Well, out of my current three-drug regime for HIV, two of the three have "black-box" warnings (the strongest warnings the FDA has for drugs, short of pulling them from the market.) I think one of them (Viramune), causes severe liver problems in upwards of 10% of the population, and there is no push to take it off the formulary. (Admittedly, it's no longer considered a first-line drug, but I think that's more because a similar drug, Sustiva is available in once-a-day dosing) In the case of HIV, we're willing to take pretty bad side effects because the alternative is much, much worse.
Overall, it seems that the FDA, if anything, tends to let too many drugs through, and only after documented problems, move to take them off the market. For instance, both Phen-Fen and Vioxx were approved, then taken out (either by the FDA or the maker) when the side-effects (heart trouble and stroke) were far worse than the problem (weight loss and lower incidence of stomach problems in a pain killer, respectively).
AIDS does have low grade secondary transmission vectors.
No, it does not. HIV has never been shown to be transmitted by mosquitoes, and it isn't even clear how a mosquito could transmit HIV.
If over 99% of the population is AIDS free then the likelhood of a mosquitoe carrying AIDS and picking on a new victim is extremely low. However if 50% of the population has AIDS then the likelihood is quite significant.
50 times zero is still zero.
And even if you live with the misconception that HIV can be transmitted at a low rate, 50 times a very low rate is still a very low rate. If you regularly get bitten by mosquitoes, you are in serious trouble and should be taking more precautions.
If you don't have unprotected sex and don't share needles, you should be more worried about traffic accidents, falls, the flu, heart disease, cancer, and crossing the street, because one of those probably will get you.
There seems to be a lot of confusion as to what a vaccine is.
A vaccine boosts immune response to a disease agent. That's it.
The article refers to a vaccine used for therapy.
I always cringe when a medical piece is posted on slashdot. It's like watching english majors discuss computer science.
- biologist
Actually, the AIDS education groups have more money at their disposal now than they are able to spend. Most of them have not been able to scale their operations as fast as the US government, WHO, and other governments and private groups have been increasing funds. They are also having problems coordinating all the different aid groups and governments to get treatment/education where it is needed.
... well here is an article in the economist . It mainly talks about some peoples complaints with the money that is being given (mostly that it could go farther if the people giving it didn't require it to be spent in certain ways), but gets into some of the logistical issues towards the ends. Don't know if this article is available to nonsubscribers - googling for variations of the words 'ACHAP PEPFAR overload' might find other references.
trying to remember where I read about this
ERR... have you actually looked at any statistics latly? The fastest growing segment of new HIV patients is straight young Women. The largest segment are straight people. Gays numerically are a small group and they have a high infection rate, but fewer people with aids. A dozen people a year die from being stuck by lightning. A couple hundred striaght non-black people die each year of aids. I think your a few orders of magnitude off.
If you don't get laid, then you have the same chance of getting aids as beign struck by lightning. So I guess posting on slashdot is a cure?
"There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy."
The major impediment to the spread of antiretroviral (AZT etc) drugs, sex education, and general information about HIV in south africa, until recently, has been the national government.
Mbeki has stated publicly on multiple occasions that the cause of HIV has not been proven to be a virus (yea yea i know), and that the major cause of HIV infection in his country is poverty.
Things have turned around in the last year or two, with antiretrovirals finally being brought into the country due to mass demonstrations in his country.
That said, money has nothing to do with it if your government is lead by people who refuse to look at the facts.
And on a side note, dont knock college required classes without them I would have absolutely no detailed knowledge on the subject aside from HIV is bad in africa.
=P
Actually, I did some research here, and it turns out that both marketing and production dwarf R&D, at least for this company, the maker of Prozac.
It's been a long time.
Not to be a nazi, but HIV is Human immunodeficiency virus. Therefore "HIV viruses" is something like FAT table, or LED diode.
And that's without going into viruses/virii debate. (viruses is correct)
Like the parent said, it's a therapy, not a vaccine. It looks like it can help people who have been infected with HIV keep from developing AIDS, but it's not a cure and it won't prevent infection. Still, it's a welcome development.
The fact is, HIV is the most daunting disease we have ever faced. If it had hit even 50 years earlier we may very well have faced an epidemic on the order of the Black Death. It infects and kills stealthily, and evolves within our bodies faster than our immune systems can recognize it. If it hadn't hit the gay community so severely and specifically we might not have even been able to identify it, and it's only thanks to advanced sequencing and crystallography technology that we can study it in the necessary depth. But what is really sobering is this: HIV has infected tens of millions of people, living and mutating within their bodies for decades, and as far as we know no one has ever fought off an infection. The human immune system may very well be completely unable to handle HIV, and that means we may never see a traditional vaccine.
But we live in an age of rapid technological progress, and I do know of three promising possiblities that could actually prevent infection. None of them has yet been tested.
The first is another line of french vaccine work. Sequence comparison between various strains of the virus had identified a highly conserved protein region on the GP41 surface protein. The antibodies produced against the peptide seems to target the virus extremely well in the lab. So why don't we see antibodies against this epitope in the real world? It turns out we sometimes do - but those people can still get sick. It may yet be useful but based on that simple fact I'm not holding my breath.
The second hasn't even had an in vitro experiment yet and technically doens't prevent infection, but is a highly unusual and novel approach. Researchers at Berkeley have come up with the idea of a virus that is a parasite of HIV itself. The trick is that the antivirus cannot push the level of HIV too low, or the antivirus itself will die out and latent HIV will come back, which they were able to demonstrate thanks to computer simulations of the population dynamics. However, it can mute HIV activity and thus prevent infection from developing into full-blown AIDS. What's more, if the carrier happens to spread AIDS to someone else, the antivirus will go with it, and when HIV mutates the antivirus can still affect it. HIV would become a virus that people could live with without it killing them. But there is no way to know whether or not something unforseen can happen with what is essentially genetic engineering, and at the very least moving that research from the computer to the real world will be a real task. There is a lot of work to be done there.
The third technology could be the real deal. The fact is, some lucky people are resistant to HIV infection. Their CCR5 receptors are knocked out, and apparently HIV is unable to fuse with the cells as a result. Genetically altering your immune system to suppress this gene might thus offer protection against AIDS. However, that same mutation may be associated with multiple sclerosis. Again, nothing like this has ever been tried.
That's as far as I know, really. I regret that society and the government cynically ignored the epidemic when it was in far fewer people and might have been stopped with quarantine because it happened to affect a group that many people weren't fond of. I suspect now society may have to accept the inevitable and stop people from having multiple sexual partners. I fear the possiblity that HIV could mutate into something that can infect even without sexual contact in the meantime.
---If you can't trust a nerd, who can you trust?
Fenflurimine Hydrochloride doesn't sound very herbal to me. Do you mean derived from a plant? Would that make LSD, Cocaine, & Marijuana herbals too? A drug is anything you put into your body that is not nourishment or drink.
Jaysyn
There is a war going on for your mind.
HIV was discovered in the US
: _HIV_Discovery,_20_Years_Later.html, and you'll be able to find more informations.
Actually, no, it was discovered in France. While the complete research was done between a French (Montaigner) and an American scientist (Gallo), the actual discovery of the virus (not disease, virus) was done at l'Institut Pasteur by Montaigner and his team.
L'Institut Pasteur is a french public organization, owned and funded by the french governement.
In a quick google I found this link http://cbs5.com/news/local/2004/04/20/HealthWatch
And don't be lured, for pure science US doesn't lead the world in biomedical. The US leads the world in APPLIED biomedical. For fondamental research, many countries (such as France with Institut Pasteur) have roughly the same level and cooperate enough that none is leading.
As noted in the European Commission's recent Communication on an industrial policy for the pharmaceutical industry, the EUs share of "new chemical entities" (NCEs) developed worldwide has fallen from one half 20 years ago to only around one third today. Moreover, a McKinsey study has shown that Europe lags behind in major innovations. Of the NCEs developed in 1975-1989 categorized as "breakthroughs," as opposed to those representing merely "therapeutic progress," two-thirds originated in the laboratories of U.S. companies.
Why is the energy of the European industry more focused on the low risk/low reward end of R&D rather than achieving the therapeutic cutting edge?
The main obstacle is the lack of a free market. EU pricing policies in virtually every case involve some form of market distortion. Across Europe, health care tends to be public sector-dominated, creating a series of monopolies on the demand side. The state is either the insurer itself, or it controls the insurance. As health care demand rises, cost containment becomes the priority. Although drug costs are a relatively small percentage of overall health care budgets, drug companies are an easier political target than the state's own employees.
Where price control is used for cost containment, the tendency is to drive out innovation. This happened in Canada and Australia, which have both seen a steep decline in the introduction of new products.
The same will probably happen to countries which engage in "reference" pricing. The trend will be to encourage the use of older, cheaper and less effective drugs rather than newer, better formulations.
A few other misconceptions in the parent post:
1) To my knowledge dendritic cells are not viable for 2 years at 50C. In the paper, the DCs were stored at -140C for no more than 4 weeks.
2) Even though virus in the blood decreased by 90% in some patients, CD4 counts still declined during the study. Unclear whether the reduction in virus burden really has a clinical benefit.
3) Fuzeon, the first drug in a new class of therapies termed entry inhibitors, was approved by the FDA in March 2003. Earlier this year, Merck published the results of a promising monkey trial of an HIV integrase inhibitor. Saying that there hasn't been anything new for 3 years in simply incorrect.
What the bloody hell is it with you yanks(Only yanks would argue because they have the highest prices in the world!) and your disdain for collective bargining agreements?
Seriously. These aren't sports cars, they're drugs many people need to continue living. Drugs which don't fall under this category, such as Prozac and Viagra, cost more in Canada than they do in the US.
Look at this page. When allergy medication and breast cancer treatments are being sold for 1/3 the price here than in the states, and the drug companies are still making a profit(they wouldn't sell here otherwise), you're being ripped off in the worst way -- with a gun to your head. Pay or die.
This page is very interesting as well, because it outlines the criteria the PMPRB uses to set the price of patented prescripted drugs. Breakthrough drug prices are limited to the median of the prices for the same drugs charged in other specified industrialized countries that are set out in the Patented Medicines Regulations (France, Germany, Italy, Sweden, Switzerland, U.K. and the U.S.). This is hardly the Wal-mart model of bleeding everyone else dry.
Frankly, this is a stupid discussion. You guys seem to have forgotten that capitalism is a two way street -- Just like labour unions formed because companies abused individually powerless workers during the industrial revolution, collective bargining of some sort has to be utilized (ESPECIALLY since these companies are the only supplier because of patents and our government generally keeps it's fingers out of that pie, sending aids medicine to africa excepted) to keep drug companies from charging whatever they want for things people need to stay alive. You guys can keep getting extorted if you want, but don't argue that we're wrong for wanting affordable drugs and are willing to use force to achieve those ends.
It's been a long time.
While I've no argument with the above posts, that's not a complete picture of Merck's behaviour:
Ivermectin is also used to prevent heartworm infections in dogs. When I did the math, here's what I found: sold in pill form, the only form available for dogs, the cost at wholesale to treat 30 medium-sized dogs for one year was $1500. The exact same quantity of drug, sold as an injectable/drench for sheep, cost $2.50 at retail (and that's about 4 times the price for the same drug as formulated for cattle). Despite numerous requests, Merck refused to make an injectable/drench formulated for dogs, even tho there is no reason not to (other than "got 'em by the balls, so squeeze hard"). The price is not so bad if you've only got one pet, but it's quite expensive if you've got a kennel.
Judging by the price for the most concentrated formulalation (for cattle), ivermectin is so cheap to produce that it might as well be free; most of the cost is evidently unavoidable overhead, like bottling and shipping. So don't get too excited about Merck giving it away to treat river blindness. It makes them look good (and it was the right thing to do) but it cost them damnear nothing.
~REZ~ #43301. Who'd fake being me anyway?
I live in South Africa where preventative measures, i.e. condoms, are handed out at traffic lights for free (at least in Johannesburg). Sex education is also big here. Children are told about sex as soon as possible (I don't really know at what age) in primary school already. Local television does a LOT to try to make people aware of the HIV/AIDS. A local radio station had an AIDS day just yesterday, where they were collecting money to help people with AIDS (They made over 2 million Rands by the way.) All these measures, and still something like one in 10 people have AIDS.
:(
Then again, until recently our president refused to beleive that HIV causes AIDS.
My point is that I agree with you that some people are just irresponsible, no matter what. Some days, it seems like responsible behaviour really is a lost cause, at least for some.
Ehm no... that was the world. 1 december was World Aids Day :-)
"WordNet (r) 2.0"
vaccine
n : immunogen consisting of a suspension of weakened or dead
pathogenic cells injected in order to stimulate the
production of antibodies