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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?"
While I am glad that we may have found the cure to HIV that kills millions every year, I wonder if the vaccine will be affordable to those unfortunate ones?
I got a feeling that only those wealthy people can afford to get fixed up, but most of them caught HIV due to their irresponsible action. Yet innocent victims who caught the disease, for instance by birth, may never see the light.
It seems like most medical findings are "open-source", that you can read about them in journals, but the actual cost to produce a medicine is usually very prohibitive.
Rock that crushes, Paper & Scissors that don't matter.
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.
Well, it's a trade-off: we want private companies to invest billions of dollars to develop medicines we need, but they'll only do so if there's the potential for profit. If there isn't, capital will flow out of drug companies's R&D budgets and into car manufacturers or something.
Governments that want to make a new life-saving drug available to all, not just those who can afford it, are free to subsidize it. Citizens and governments in wealthy countries who want to make the drugs available to citizens of poor countries can likewise fund it.
It's easy to paint a company as horrible because it wants to charge a lot of money for a life-saving new treatment. But in many cases that treatment wouldn't exist if the company couldn't make money from it.
I should buy some cement.
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
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.
Let's apply Occam's Razor here.
On one hand, we can claim that the West created a virus designed to kill Africans, but yet still somehow manages to kill millions in North America/Europe; not particularly effective from a genocide point of view.
Another, perhaps more practical point of view, is that sex education and safe-sex practices are far less common in Africa. The lack of knowledge about STD's and the absence of the rule of law in many parts of Africa would make a far more effective explanation.
If we take Ms. Maathai's explanation, then food must obviously also be a genetically engineered weapon, since millions more in Africa die from starvation than those in the West.
Great idea : it may be of use for patient with resistance to all known anti-retrovirals. But...
It is NOT a vaccine. It is NOT a cure. It's a temporary (at best) treatment. The title is highly misleading. And its far from practical. You need to isolate dendritic cells from an (infected) patient, which is costly, require specific equipment and isn't trivial (forget developing countries, which can't even afford AZT). Then you pulse these cells with killed HIV, which I assume should come from the patient (else soon the treatment will go ineffective due to mutations acquired by the virus) and you reinject the cells, which will go 'alert' the immune system that something is wrong. So mass scale treatment is out of question. Basically, you're only boosting the (ineffective) immune system against HIV-1. After a year, their treatment reduced viral load by 90% in 8 of 18 patients. 90% isn't a lot (anti-retroviral do a lot better than that), and they aren't even achieving 50% success after a year. I would imagine that after 2 or 3 years, the success rate is even lower. And the CD4 count is stable, not increasing to normal levels.
So no, its not 'it'. Don't hold your breath either.
Eureka Science News - automatically updated
Think of it as a Windows install disk that's been badly scratched.
help me i've cloned myself and can't remember which one I am
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...
Erm. The same company that devloped Vioxx also devloped Ivermectin (Mectizan), a highly effective treatment plan (once every 12 months) for River blindness, a dehabilitating disease that affects people who can't afford modern medicine. Despite Merck dumping about $290 million into developing the treatment, they give it away for free.
Before you attack Merck with pitchforks and torches in hand, you ought to realise that this company has an unprecedented history of philanthropy, and it saddens me to know that somebody at that company with their eyes in profit instead of the Right Thing screwed up so royally with the debacle we know today as Vioxx.
Whatever happens with that company, I hope that at least some of their positive ideological foundations are continuted.
--sean
"[T]he single essential element on which all discoveries will be dependent is human freedom." -- Barry Goldwater
The development of an AIDS vaccine is wonderful news for sure, but it is still not a cure at this point (it is only a treatment that keeps the disease at bay at this point). What's at least as important (if not more) is education as you have pointed out.
The problem is getting the third world (where the epidemic is most serious) to accept western medicine. Westerners think African-witch-doctor medicine is a bunch of bunk--well Africans have the same opinion of much of western medicine. Even if this vaccine WAS a cure, getting poor, illiterate Africans to accept treatment would require a lot of education and convincing (not to mention money that most of these victims do not have).
The most perverse myth in some African cultures is that STDs (including AIDS) can be cured in men by having unprotected sex with a virgin girl. I shudder when I think about how many HIV+ men there are in Africa who think they are cured because they have done this, but in fact may have infected some young woman and the child she might have conceived as a result--then in the mistaken belief that they are cure go on to infect other sexual partners. Somehow putting that myth to rest would do more to combat AIDS than the most expensive drugs currently available.
There is even a problem in the "educated" west too--it is that we are perhaps TOO educated (but in the wrong way). All this emphasis on advanced treatments for AIDS is making some people perceive the disease as no longer a death sentance but rather a chronic disease. The attitude when engaging in risky behaviour is becoming "Uh oh...I might have exposed myself to HIV...oh well, nowadays HIV is treatable like hepatitis and herpes--it would be a pain in the ass to have to treat it but I'll live alright anyways".
The homosexual communities of large metropolitan areas are already having to combat this attitude (having previosuly become the most educated/aware segment of society concerning AIDS) and if we aren't careful the rest of the public will start believing this too. In actual fact, even if a person could live a normal lifespan with HIV, delivering a vaccine cusomised for each recipient and treating symptoms with an expensive regimen of drugs would be another big burden on the healthcare system, not to mention that the quality of life would be permanently reduced even with todays treatments.
Yes, this is an important development, but without education and empasis on personal responsibility AIDS won't go the way of smallpox any time soon.
Well the real cause for concern with the latest scandal with drugs and the FDA is a fundamental problem of pharmaceutical companies continually trying to reinvent the wheel by making new drugs to treat highly common cronic diseases with treatments that are just as effective already ( eg long term prevention of heart disease, athritis, obesity, depression, sleeping disorders), with often a "me to" approach of producing new drugs that work similary to drugs from another company (notice the explosion in erectile disfunction drugs after the introduction of viagra.
In the case of vioxx, the treatment was designed for anti-inflammatory pain relief in arthritis, by inhibiting an enzyme COX2. It is about as effective as another drug many of us have taken ibuprofen (Advil) for this purpose but instead of being 3-5 bucks for a bottle of 50 to 100 pills, it was sold at ~$2 a pill (it is also how aspirin works to relieve pain as, thus the running joke that the pharmaceutical companies had invented the $2 apirin).
So what was so much better about vioxx that it was developed, FDA approved and prescribed by doctors.
Well it doesn't inhibit another enzyme COX1, like aspirin and ibuprofen do. Inhibiting Cox1 has several effects, the two most important are: the negative effect, gastrointestinal problems like stomach bleeding and ulcers; but it also has a positive effect which is prevention of blood platelet aggregation which prevents blood clots, heart attacks and strokes. This is why aspirin is taken to prevent heart attack, if you take aspirin to prevent heart disease and a specific COX2 inhibitor for arthritis like vioxx together you are really losing the benefit vioxx had over ibuprofen.
Anyway not everyone has a sensitivity to asprin and Ibuprofen, there are estimate that only 8% of those prescribed Vioxx actually got a benefit over cheaper alternatives, but vioxx had a great ad campaign that convinced everybody that they should "ask" (read demand) their doctor to prescribe it, even though it is vastly more expensive. Also the FDA approval could be pushed through because of the "benefit" to those 8% of patients that had gastrointestinal sensitivity to aspirin and ibuprofen.
So what have they found out now- well just inhibiting COX2 by itself actually causes increased blood platelet aggregation and increased risk of heart disease and stroke, this effect is balanced out by the inhibition of COX1 in aspirin and ibuprofen etc. that prevents platelet aggregation.
Now the real issue, Vioxx was pushed out to compete with very cheap, safe and well charactised drugs (so we know all the side effects etc., why do you think you can buy them at the supermarket) due to a very long history of use. Patent it and get it approved for use by the FDA targeting it to one small specific group that have a problem with current treatments to help push the approval through. Once it is approved marketing it to a much wider group of people that are not the specific target group, and will not gain any benefit over a cheaper, better characterised and now known to be safer alternative. To compound the problem the TV advertising of prescription drugs now almost approaching saturation increases this problem by getting the public to demand drugs they don't need.
The reason this work is coming out of Brazil is the same reason the spinal cord story earlier this week came out of Korea. Namely, ethics. The single greatest hindrance to scientific advancement in the US. In the US, it would be unethical to conduct this study, because you couldn't let a group of people go without HIV meds for a year. That would be unethical. It's the same way it's unethical to test experimental therapies on patients with terminal cancer. Since their disease is terminal, it can be argued that they are consenting out of desperation, and the researcher is therefore taking advantage of them.
In any case, dendritic cells were discovered in the US, HIV was discovered in the US, etc., so it can't be argued that the giant money machine of US science didn't contribute. It also can't be argued that the US does not lead the world in biomedical science. This is because we spend so much money on it that the best scientists from all over the world are concentrated here. However, I agree with you that this is not the same as the idiotic statement that we are subsidizing other nations' healthcare.
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?