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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.
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.
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.
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..."
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?