Moderna, the biotech company that developed one of the first COVID-19 vaccines last year, is aiming to tackle another pandemic that’s been around for forty years already: HIV/AIDS. Two of its mRNA-based HIV vaccines could start human trials this week, according to a posting shared in the National Institutes of Health’s (NIH) clinical trial registry last week.
Moderna is seeking 56 individuals, aged 18 to 50 and who are HIV-negative, for the trial, which is estimated to begin on 19 August and conclude in spring 2023. The biotech company is also reportedly developing an influenza vaccine based on the same technology.
The ‘Phase I study’ would test the vaccines’ safety, as well as collect basic data on whether they’re inducing any kind of immunity, but would still need to go through ‘Phases II’ and ‘III’ in order to see how effective they might be.
So far, Moderna’s vaccines passed Phase I testing earlier this year, with 97 per cent of participants developing some kind of immune response (though not the full response that would be required to fend off HIV infection). Phase II tests for a vaccine’s overall effectiveness, and with the move into Phase III, Moderna will be looking at its efficacy versus other prevention treatments currently on the market, such as pre-exposure prophylaxis, also known as PreP.
These shots would be based on the same technology as Moderna’s COVID-19 vaccine: mRNA strands in the vaccine enter human cells, providing them with the code to make little bits of the same proteins that sit on the virus’ exterior. “Those proteins then act like test dummies for our immune systems to recognise, so immune cells in the future can identify and neutralise the actual virus. The process works incredibly well against SARS-CoV-2, and there’s hope that it may work with HIV as well,” reports Popular Science.
Until now, the history of HIV vaccine development has been marked by numerous setbacks and disappointments, with each apparent ‘breakthrough’ presenting even more challenges and hurdles to overcome. This is due, in part, because the virus integrates itself into the human genome rapidly—within 72 hours of transmission—thus producing an irreversible infection.
Since the late 1700s, researchers have developed several different types of vaccines, but most vaccines for other viruses have proven ineffective against HIV. “Also known as the human immunodeficiency virus, it attacks the immune system itself and breaks down the body’s ability to fight other diseases and infections,” adds them. when reporting on the same topic.
In that sense, mRNA vaccines could be the breakthrough we’ve been waiting for as, unlike inactive or live vaccines, they don’t contain parts of a virus—but create proteins that themselves trigger an immune response in the body. There are currently 16 known HIV mutations. Moderna’s vaccine could potentially allow a patient’s body to recognise new variants of the virus on top of being easier to mass-produce and distribute.
Sceptics might point out that mRNA vaccine technology has been around for decades—which is true—but the extensive approval time required by the Food and Drug Administration (FDA) has previously limited the number of mRNA vaccines that eventually make it to widespread use in the US. The COVID-19 pandemic changed that, however, as last year’s private-public partnership programme Operation Warp Speed (OWS) accelerated the timetable for clinical vaccine trials and FDA approval.
And Moderna scientists aren’t alone in their efforts: Phase I testing for a ‘mosaic vaccine’ began at Oxford University back in July 2021. Between the two, we may hopefully see the spread of one of the world’s most devastating viruses halted in the coming decade.
“The only real hope we have of ending the HIV/AIDS pandemic is through the deployment of an effective HIV vaccine, one that is achieved through the work of partners, advocates, and community members joining hands to do together what no one individual or group can do on its own,” wrote International AIDS Vaccine Initiative (IAVI) President, Doctor Mark Feinberg, in a June statement marking the 40th anniversary of the HIV epidemic.
There seems to be less of an urgency associated with our current discussions around HIV/AIDS. Though still a source of stigma and lingering fear, HIV often appears to us as a tragedy of the previous generation. Alas, the pandemic is far from being over, and in 2017 an estimated 36.9 million people lived with HIV globally, including 1.8 million children.
Vulnerable populations and people living in low and middle-income countries are disproportionately affected by the virus, with over 65 percent of individuals living with HIV located in sub-Saharan Africa. In Russia and Eastern Europe, HIV diagnoses are at an all-time high, and in the United States infection rates among certain ethnic and racial minorities has increased in the past few years. What all of these populations share in common is a deadly concoction of meagre resources and prevalent conservatism, which prevents them from finding out their status and seeking help.
UNAIDS, the United Nations Program on HIV and AIDS, has set a goal of eliminating the epidemic worldwide by 2030. In order to achieve this ambitious target, the organisation has set an additional ‘90-90-90’ goal, according to which by 2020 90 percent of all people living with HIV will know their HIV status, 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy, and 90 percent of all people receiving antiretroviral therapy will have viral suppression. However, lack of awareness and crippling stigmas surrounding the disease make reaching these goals unlikely.
AIDSVu, an interactive online map that visualises the impact of HIV on communities across the U.S., offers a highly useful solution to this problem. Led by Patrick Sullivan, PhD, Professor of Epidemiology and co-director of the CFAR Prevention Science Core, the project uses data from the Centers for Disease Control and Prevention, local health departments, and prescription analytics in order to map out and track HIV statistics across 36 U.S. cities, 49 states, DC, and Puerto Rico.
Using AIDSVu’s interactive map, people can learn about the HIV epidemic reality in their state, county, or even zip code. In addition to providing statistics about diagnoses according to location, sex, race, and method of transmission, AIDSVu also help users locate services such as HIV prevention, testing, treatment, and clinical trials available in their communities. The website also offers focused information tool kits and experts’ views to particular groups that are vulnerable to HIV, such as trans people and youths.
One of the great advantages of AIDSVu is that it paints an incredibly vivid map of the HIV reality in the United States. Glancing at the statistics city by city, county by county, and state by state, one could immediately discern the troubling disparities that exist between communities in terms of access to information, care, and services, largely along lines of race and socio-economic background. In Pennsylvania, for instance, out of 34,233 individuals living with HIV 48.3 percent of them are African American and 16.4 percent are Hispanic/ Latinx. In Atlanta, black males are 5 times more likely to be living with HIV than white males and black females are 15 times more likely to contract the virus than their white counterparts. And the list goes on.
Furthermore, by making HIV statistics and services information so easily accessible online, AIDSVu significantly contributes to spreading awareness of the issue. As stigma, misconceptions, and fear still shroud the HIV/AIDS epidemic, many people prefer to remain in the dark and do not get tested, learn about prevention methods, or seek care. Disseminating such information online may grant a certain degree of anonymity and privacy to individuals who are afraid to openly consult their peers or community members about the issue.
While an increased number of government funded programs and formal education campaigns are needed in order to effectively tackle the HIV pandemic and meet the 2030 UNAIDS goal, an initiative such as AIDSVu could nonetheless provide an immense contribution to the fight against the virus. Imagine what an effect could such a platform have in a place like Tanzania or Nigeria—where openly seeking out HIV-related care could mean a death sentence.