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Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

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Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#91

Post by droningparrot »

quitit wrote: post #73
t-writescode wrote: post #2

This is incredibly exciting! The main method available for PrEP, in the United States, at least, is a daily pill. I think (I don't know) there is a monthly shot, too. Daily pills take a lot of time investment; monthly shots are better; but once every 6 months is awesome! Especially in circumstances where it might be difficult to guarantee a daily pill or even a monthly shot.

The problem is the cost, in Europe and the USA the treatment is over $40,000 USD per year, which isn't realistic for regular people.

Drug plans often bring this down to $0-600/year out of pocket

Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#92

Post by JeremyNT »

t-writescode wrote: post #2

This is incredibly exciting! The main method available for PrEP, in the United States, at least, is a daily pill. I think (I don't know) there is a monthly shot, too. Daily pills take a lot of time investment; monthly shots are better; but once every 6 months is awesome! Especially in circumstances where it might be difficult to guarantee a daily pill or even a monthly shot.

Am I wrong in thinking this is a huge development? Maybe one of the most important stories for public health this decade?

AIDS kills more people than malaria, and preventing malaria has long been viewed as one of the lowest hanging fruits in public health.

Hoping for eradication is too much with the limited immunity duration, but if we can mass produce a vaccine - even if it has to be administered twice a year - this could save millions of lives over the course of a decade.

Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#93

Post by AlotOfReading »

normalaccess wrote: post #87

[flagged]

Because "abstinence education" approaches have repeatedly failed to effectively address these kinds of problems while also causing immense issues with stigmatization. People are going to have sex. Public health programs have to be focused on policies that work instead of moral grandstanding.

Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#95

Post by JumpCrisscross »

raylad wrote: post #48

This treatment does not in fact prevent HIV infection. It prevents infected cells from producing viable virus particles. Because of this, it seems very likely that if any patient being treated with this drug ever discontinued it, they could develop HIV quickly from cells that were already infected in their body that had been suppressed from producing virus particles but were no longer suppressed. I was not able to fi…

> This treatment does not in fact prevent HIV infection. It prevents infected cells from producing viable virus particles

Lenacapavir interferes "with multiple essential steps of the viral lifecycle, including capsid-mediated nuclear uptake of HIV-1 proviral DNA (by blocking nuclear import proteins binding to capsid), virus assembly and release (by interfering with Gag/Gag-Pol functioning, reducing production of capsid protein subunits), and capsid core formation (by disrupting the rate of capsid subunit association, leading to malformed capsids)" [1].

For comparison, tenofovir diphosphate (from Descovy) "inhibits the activity of HIV reverse transcriptase and causes DNA chain termination after getting incorporated into the viral DNA" [2].

Descovy thus works at stage 3 (reverse transcription); Lenacapavir works at stages 3 (integration), 6 (assembly) and 7 (budding) [3].

> it seems very likely that if any patient being treated with this drug ever discontinued it, they could develop HIV quickly from cells that were already infected in their body

HIV-uninhibted T cells should be fine clearing these out. IT would be more surprising to see the cells stick around after having been infected.

[1] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e56...

[2] https://www.clinicaltrialsarena.com/projects/descovy-emtrici...

[3] https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-li...

Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#96

Post by n4r9 »

thaumasiotes wrote: post #79
viraptor wrote: post #59

Earlier quoted context omitted.

> because there's nothing the kids can be doing that won't wait for that. I feel you don't have young kids then. Jumping on you, bleeding, having a nightmare, making possibly-chocking-sounds, running away with your pills, vomiting on the floor, etc. will definitely take priority over whatever you thought you were going to do after waking up. And that doesn't even touch on people with executive functions issues. Or th…

> Jumping on you, bleeding, having a nightmare, making possibly-chocking-sounds, running away with your pills, vomiting on the floor, etc. will definitely take priority over whatever you thought you were going to do after waking up. No, you're just desperately hoping to imagine a scenario that might make it difficult to take a pill with a one-minute take-it-now-or-die window. You're crazy, and you should try to refra…

This comment is dismissive and needlessly insulting. Calling people crazy is a surefire way to stop them from listening. But I get some amusement from imagining the look on my wife's face if she saw me leaving a vomit-covered rug to go and take some vitamin pills.

Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#97

Post by JumpCrisscross »

droningparrot wrote: post #91
quitit wrote: post #73

Earlier quoted context omitted.

The problem is the cost, in Europe and the USA the treatment is over $40,000 USD per year, which isn't realistic for regular people.

Drug plans often bring this down to $0-600/year out of pocket

It's frankly nuts that we don't make preventative medicine for transmissable diseases free in the rich world. It's so obviously in the collective interest to reduce prevalence.

Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#98

Post by mschuster91 »

JumpCrisscross wrote: post #97
droningparrot wrote: post #91

Earlier quoted context omitted.

Drug plans often bring this down to $0-600/year out of pocket

It's frankly nuts that we don't make preventative medicine for transmissable diseases free in the rich world. It's so obviously in the collective interest to reduce prevalence.

The problem is, as usual, payment.

There have been many failed attempts at developing suppressive, curative and preventative medicine against HIV over the decades, and not all of that was funded by charities or government grants that don't expect repayment - especially not the later stage trials.

Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#99

Post by raylad »

roywiggins wrote: post #74
raylad wrote: post #48

This treatment does not in fact prevent HIV infection. It prevents infected cells from producing viable virus particles. Because of this, it seems very likely that if any patient being treated with this drug ever discontinued it, they could develop HIV quickly from cells that were already infected in their body that had been suppressed from producing virus particles but were no longer suppressed. I was not able to fi…

PrEP is not new, surely if this was common there would be studies showing everyone going off PrEP suddenly testing positive at enormous rates?

The existing PrEP drugs work differently.

Cabotegravir is an integrase strand transfer inhibitor. This means it blocks the HIV's enzyme integrase, thereby preventing its genome from being integrated into the human cells' DNA.

Emtricitabine is an analogue of cytidine. The drug works by inhibiting reverse transcriptase, the enzyme that copies HIV RNA into new viral DNA.

Both of these drugs actually prevent infection.

Re: Twice-Yearly HIV Shot Shows 100% Effectiveness in Women

#100

Post by JumpCrisscross »

mschuster91 wrote: post #98
JumpCrisscross wrote: post #97

Earlier quoted context omitted.

It's frankly nuts that we don't make preventative medicine for transmissable diseases free in the rich world. It's so obviously in the collective interest to reduce prevalence.

The problem is, as usual, payment. There have been many failed attempts at developing suppressive, curative and preventative medicine against HIV over the decades, and not all of that was funded by charities or government grants that don't expect repayment - especially not the later stage trials.

> problem is, as usual, payment

If only we had an institution with the aim of pursuing the long-term interests of the collective.

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