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Promising HIV vaccine passes phase one human trials with 90% success rate

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Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#41

Post by rdl »

joshklein wrote: post #38
scott_s wrote: post #27

Earlier quoted context omitted.

I'm confused by the statement that a vaccine would not be a game changer in terms of worldwide infection. Right now, the only way to reliably prevent HIV infection is through changing behavior , which is extremely difficult. But widespread use of a vaccine would just require a one-time injection, which is relatively easier. I'm further confused by your polio reference, because that sort of effort would only be possib…

EDIT: I actually meant smallpox when I was talking about polio. That's a big error; corrected it above. Thanks rdl. I should have been more specific - I meant that if we did develop a vaccine, then it makes following the [smallpox] example theoretically possible, but this is still extremely challenging due to the reasons given. Although you and I might have the vaccine, not everyone has it - not by a long shot - beca…

You may be thinking of smallpox, which exists in one or two declared labs (and probably a few more black labs).

Polio is unfortunately still "in the wild" in certain areas (Afghanistan/Pakistan/India, Sub-Saharan Africa), and had a bit of a resurgence lately. The Gates Foundation is putting a lot of effort into finishing up polio eradication.

Relevant TED talk: http://www.ted.com/talks/bruce_aylward_how_we_ll_stop_polio....

One of the main issues is that the polio vaccine requires a cold chain (presently; I think they have a new shelf-stable one); the smallpox vaccine, at least one of them, does not.

Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#42

Post by Symmetry »

davidmathers wrote: post #31
falcolas wrote: post #18

Earlier quoted context omitted.

[citation needed] First I've ever heard of anything like this.

It was a late 80's / early 90's thing: http://en.wikipedia.org/wiki/Duesberg_hypothesis http://en.wikipedia.org/wiki/AIDS_denialism#History

Well, it was a late 80s / early 90s thing among people who weren't crackpots. As evidenced by the OP, some people are reluctant to abandon the idea even though there is now overwhelming evidence against it.

Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#43

Post by rdl »

joshklein wrote: post #34
gst wrote: post #22

Earlier quoted context omitted.

Shouldn't this be more of a temporary problem? As soon as there is a vaccine its patents will expire at least 20 years afterwards. And then lots of much cheaper vaccines will flood the market.

The tough part about vaccines is that they only protect the recipient from the disease if they get the vaccine, and they only eradicate the virus if everyone on the planet is vaccinated. The Science (making the vaccine) and cost (creating enough vaccine) are only two barriers. Getting everyone (and it really must be EVERYONE) to take the vaccine is a very challenging project. That's what makes the story of [edit: sma…

You don't need to get 100% vaccination to eliminate the disease; somewhere around 90% works, unless it's incredibly contagious and in a high density environment.

"Herd immunity" protects the others -- basically, the disease itself can't spread if a sufficient number of people are vaccinated, so it dies out in a few generations (of the disease, not of humans).

Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#44

Post by axxl »

arethuza wrote: post #9
bhickey wrote: post #5

Earlier quoted context omitted.

While it won't probably kill you, it isn't exactly harmless. It can reemerge as shingles. There are cases of herpes causing death. For example, in an infant infected by his mohel, and a laboratory researcher killed after exposure to monkey feces. ( http://www.cdc.gov/mmwr/preview/mmwrhtml/00056008.htm )

Shingles can be very nasty - my mother had it after I had chickenpox. It was across her face and eyes - she was hospitalised and was on morphine for the pain.

I had it when I was younger, and I heard it only gets worse if you get it when you're older. It was pain unlike anything I've experienced since, I can't imagine what it felt like for her.

Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#45

Post by Alex3917 »

joshklein wrote: post #11

My father is an infectious disease specialist who has spent the last 30 or so years working on HIV in research, patient treatment, and education. The following thought comes from my casual conversations with him, and probably does not represent his professional opinion. It certainly does not reflect his specific thoughts in regards to this trial, as we haven't yet discussed it. The progress in treating HIV since it f…

"those infected with HIV - who get treatment and adhere to that treatment - can live long and relatively normal lives."

The adherence part is the most interest bit of the story. The adherence to HIV medications is ~93%, much greater than the adherence to almost every other drug or behavioral treatment. If diabetes patients or cardiac patients had adherence rates anywhere near that high then the life expectancy of the average American would be dramatically higher.

Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#46

Post by joshklein »

burgerbrain wrote: post #29
gst wrote: post #22

Earlier quoted context omitted.

Shouldn't this be more of a temporary problem? As soon as there is a vaccine its patents will expire at least 20 years afterwards. And then lots of much cheaper vaccines will flood the market.

And with any luck by that time everyone who has it but refuses to seek treatment will be dead, and everyone else will have been exposed to years of news about the vaccine.. and years of people refusing to take it dying. I think things should work out well in the end, but it might take a while.

"Refuses to seek treatment" is not necessarily a fair description of these people's actions. They can get HIV at birth through their mother without engaging in any "at risk" behavior. They can have it and not know it. They can lack education. They can lack resources. They can have received misinformation.

There are places where the official government-endorsed treatment for HIV was sex with a virgin. There are religious notions that declare use of birth control sinful. There are moral police that call education about safe sex (instead of abstinence) wrong, despite its proven efficacy.

Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#47

Post by vibragiel »

burgerbrain wrote: post #20
palish wrote: post #10

Earlier quoted context omitted.

Isn't the point of a vaccine to prevent, not cure? EDIT: thanks guys, but I have enough upvotes. My comment didn't add much to HN. Wasn't actually trying to prove him wrong -- I thought I'd missed something and was asking for clarification.

That certainly is the common point, however (provided the patient is strong enough to survive the additional initial strain) shouldn't it also kickstart an immune response in patients who are already infected? And once that starts, shouldn't that likely help fight the infection? I don't know myself, I know next to nothing about medicine.

It might. While this trial was meant to check if this vaccine could help prevent or restrain the infection (a prophylactic), in the same press conference¹ where these results were presented, the authors announced they were about to conduct a second phase I trial, this time to check for therapeutic effects on infected individuals.

1. http://www.cienciatk.csic.es/Videos/PRESENTACION+DE+LOS+RESU... (Spanish)

Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#49

Post by rdl »

gst wrote: post #22
joshklein wrote: post #11

My father is an infectious disease specialist who has spent the last 30 or so years working on HIV in research, patient treatment, and education. The following thought comes from my casual conversations with him, and probably does not represent his professional opinion. It certainly does not reflect his specific thoughts in regards to this trial, as we haven't yet discussed it. The progress in treating HIV since it f…

Shouldn't this be more of a temporary problem? As soon as there is a vaccine its patents will expire at least 20 years afterwards. And then lots of much cheaper vaccines will flood the market.

Patents aren't the problem here, but it's an interesting thought experiment to think about what commercial terms a vaccine for AIDS or other diseases which at this point mainly affect poor, third-world people would be distributed under.

India would probably just violate the patent, claiming national security reasons, and sell it for ~production cost throughout the world. The USA might enforce a patent domestically, and it would be a rational economic choice for insurers to pay for it for many patients instead of long-term treatment if someone contracts AIDS otherwise -- if you have a 0.1% risk of contracting AIDS in a lifetime, and lifetime treatment costs $1mm, it's worthwhile to pay $100-$1000 for it.

A charity (or government) might pay for full rights to the vaccine globally, and then distribute it for the good of humanity (and to burnish their reputation), but the really out of the box thing would be for a consumer product company to distribute the vaccine cheaply, purely as a form of PR. Imagine: "Coca-Cola, the drink that is good for you. Remember, we cured AIDS."

Re: Promising HIV vaccine passes phase one human trials with 90% success rate

#50

Post by eli »

appendix_a wrote: post #48

how do you sign up people to be infected with HIV?

You don't. But given a large enough group of people, some will contract the infection "organically." So some people get a vaccine and some get a placebo and then you check back in years later and see if the vaccine group has a lower infection rate.
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