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Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

nytimes.com

51–60 of 64 posts

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#51
post #23

At least for HIV/AIDS & TB, a widely available and a sure cure would be great. Of course nothing beats the efficacy of vaccination.

TB is very curable in most cases. The problem is it takes a long time, the regimens can be difficult, and active cases become resistant if they're not monitored (why we use directly observed therapy), and latent cases with the typical treatment take just about as long.

What we really need for TB are shorter high-efficiency regimens. These would be done quicker, leave less opportunity for drug resistance, and make progress on today's latent cases which are tomorrow's active cases. The newer 3HP regimen reduces latent treatment to 3 months instead of six to nine, but we really need to get it down to weeks or less.

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#52
post #47

Earlier quoted context omitted.

There of course isn't one global homosexual community, but SF public health and other targeted information is what I see the most of. It may be biased just because it's pretty well funded and relatively well executed, but as someone without particular interest in STDs, it's what I see the most information about. e.g. https://josephsciambra.com/increasing-rates-of-all-stds-amon... https://www.sfdph.org/dph/files/repor…

Of course a decrease in condom use would most likely yield an increase in STD rates in any community. I'm having trouble discerning which source supports this: >are prevalent in certain communities at higher rates. You then seem to switch your perspective in the comment I'm replying to: > total number of infected persons is probably not as meaningful a metric in terms of transmission risk Which I would agree with, bu…

1) "About 10% of new Hepatitis A and 20% of all new Hepatitis B infections in the United States are among gay and bisexual men" (CDC, https://www.cdc.gov/msmhealth/viral-hepatitis.htm) -- that's a much higher number than the incidence of gay and bisexual men in the overall population of the US (2-5%?).

2) "Gay and bisexual men and other men who have sex with men have the highest prevalences of gonorrhea, chlamydia, and early syphilis." (SFDPH, https://www.sfdph.org/dph/files/reports/StudiesData/STD/SFST...)

3) "Men who have anal sex with men (MSM) are more likely to get anal HPV than men who only have sex with women. Researchers estimate that the prevalence of anal HPV among men who only have sex with women is around 15% while anal HPV prevalence for MSM is around 60%." (https://betablog.org/anal-cancer-hpv-gay-men-need-know/ which references http://jid.oxfordjournals.org/content/203/1/66.full.pdf+html)

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#54
post #53

Is also unlikely given if everyone gets vaccinated, drug companies lose hundreds of billions, they are likely to buy out and bury such endeavours. Someone tell me I’m wrong to think that way.

The recent Hep-C antivirals (Sovaldi & friends) should be a counterargument. With a course of medication you actually cure Hepatitis C. Previously you'd be looking at a liver transplant and taking immunosuppressants for the rest of your life.

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#55
post #19

Earlier quoted context omitted.

Can you point us to a source regarding this pill? Is it in clinical trials?

This is a medication that’s far beyond the clinical trial phase and is widely available in many countries, though still subject to some large-scale trials for this particular usage. There’s lots of information on sites like https://www.iwantprepnow.co.uk - it’s available through the healthcare system in some parts of the UK, purchasable privately in others, and from what I understand available on some insurances in t…

> and in both cases due to rare strains with resistance to both drugs.

So then it is only a matter of time before we have 'super' HIV strains that are resistant running around. Perhaps it's not such a great idea to have large numbers of people exposing these drugs to the virus regularly, else we'll end up with more resistant strains..

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#56

Earlier quoted context omitted.

This is a medication that’s far beyond the clinical trial phase and is widely available in many countries, though still subject to some large-scale trials for this particular usage. There’s lots of information on sites like https://www.iwantprepnow.co.uk - it’s available through the healthcare system in some parts of the UK, purchasable privately in others, and from what I understand available on some insurances in t…

> and in both cases due to rare strains with resistance to both drugs. So then it is only a matter of time before we have 'super' HIV strains that are resistant running around. Perhaps it's not such a great idea to have large numbers of people exposing these drugs to the virus regularly, else we'll end up with more resistant strains..

I'm not a virologist, but my understanding is that the lifecycle of HIV makes that unlikely. An individual must be infected with the virus in order for drug resistance to emerge; using PReP prevents infection from happening in the first place by stopping viral replication. HIV is quite hard to transmit – someone who is not infected or who is on a stable treatment regime can't transmit the virus to anybody, so resistance isn't much of a concern there.

The bigger risk of drug-resistant strains emerging is due to poor adherence to medication regimes. Missing doses of antiretroviral therapy can cause drug resistance to emerge rapidly, as viral replication is no longer suppressed and HIV mutates like crazy.

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#57

Earlier quoted context omitted.

This is a medication that’s far beyond the clinical trial phase and is widely available in many countries, though still subject to some large-scale trials for this particular usage. There’s lots of information on sites like https://www.iwantprepnow.co.uk - it’s available through the healthcare system in some parts of the UK, purchasable privately in others, and from what I understand available on some insurances in t…

> and in both cases due to rare strains with resistance to both drugs. So then it is only a matter of time before we have 'super' HIV strains that are resistant running around. Perhaps it's not such a great idea to have large numbers of people exposing these drugs to the virus regularly, else we'll end up with more resistant strains..

So what are you suggesting exactly, an end to vaccines? What makes HIV any different?

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#58

Earlier quoted context omitted.

> and in both cases due to rare strains with resistance to both drugs. So then it is only a matter of time before we have 'super' HIV strains that are resistant running around. Perhaps it's not such a great idea to have large numbers of people exposing these drugs to the virus regularly, else we'll end up with more resistant strains..

So what are you suggesting exactly, an end to vaccines? What makes HIV any different?

That is not a vaccine... No antibodies are created by the body to attack HIV. There's a big difference.

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#59
post #19

There is already prep, a once a day pill that if taken consistently, is over 95% effective at stopping HIV infection, I've heard some sources say it's 100% effective. While it's not medically considered to be a vaccine, most vaccines for other conditions have a lower effectiveness rate. There is work being done to turn prep into an injectable chip in the arm, like long term contraceptives, but for HIV prevention.

Can you point us to a source regarding this pill? Is it in clinical trials?

PrEP sold under the name Truvada in the U.S. I actually saw a TV commercial for it earlier today.

https://www.cdc.gov/hiv/basics/prep.html

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#60
post #11

Given what I learned in recent years about the scientific process I'm always a bit wary of making this a "spend XXX money to get YYY results". We have issues like that still a sizable amount of medical studies are unpublished because they don't produce the desired result the funder wants, that experts think a vast amount of studies are simply research waste due to poor methodology or that the majority of pre-clinical…

There needs to be a journal for negative results.

>We tried X it didn't work.

Would be invaluable in a lot of fields where knowing what's been tried is more important than knowing what hasn't.

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