A stage one clinical trial for a promising HIV vaccine is underway. The vaccine uses Moderna’s mRNA technology, first deployed in Moderna’s COVID-19 vaccine.
In the clinical trial, 56 patients without HIV will undergo a series of vaccinations to test the safety and immune response of the vaccine, with vaccinations having already been administered at George Washington University in Washington, D.C. The goal is to help the immune system recognize and neutralize the virus before it can attack the white blood cells.
“The search for an HIV vaccine has been long and challenging, and having new tools in terms of immunogens and platforms could be the key to making rapid progress toward an urgently needed, effective HIV vaccine,” Mark Feinberg, M.D., Ph.D., president and CEO of IAVI, said in a statement.
Currently, medications can achieve a state of viral suppression, which will stop the virus from being passed from a patient with HIV to someone without.
There were approximately 2,242 new cases of HIV were reported in Canada in 2018, according to the Public Health Agency of Canada, making it the fourth consecutive year that HIV transmission rates had increased. It is estimated that approximately 62,050 people in Canada live with HIV today.
*Editors note: to learn more about living with HIV, read What it feels like: Living with HIV
A skeleton key to unlock millions of doors
Developing a vaccine that can adequately protect the body from contracting HIV has proved elusive because the antigens that cause HIV mutate rapidly (to the tune of millions of different HIV strains), making it difficult to find a precise target that a single vaccine can use.
HIV variant seen in Netherlands
Researchers are also constantly discovering new forms of HIV, like the highly virulent version found in the Netherlands in January. While this variant of HIV thankfully still responds to medication and isn’t considered a public health crisis, it highlights the need for preventative strategies if countries want to reach the UNAIDS goal to eliminate HIV by 2030.
The aim of this vaccine is to prompt the body to develop a specific type of B-cell, a type of white blood cell, to make a complicated antibody capable of neutralizing the multitude of different types of strains that cause HIV.
This new vaccine strategy is, in a way, reverse-engineering a type of antibody that has been discovered in some patients who seem to have developed at least partial immunity to HIV. These individuals have produced an antibody dubbed ‘broadly neutralizing antibodies’ (bnAbs), which target difficult-to-access markers on the virus that are similar across HIV strains. Research into bnAbs has been going on for more than 12 years.
The task is to train B cells in the body to produce this very complex bnAb, something that only one in every 300,000 naïve B cells are thought to be capable of. This is not going to be a one-shot process, as shepherding these B cells into mature, bnAb production factories will require cutting edge precision. However, the results of a trial released in 2021 showed that at least the first step, prompting those B cells capable of producing bnAbs to begin to develop into antibody machines, is possible.
The researchers turned to Moderna’s mRNA vaccine technology, according to a news release, because it allows them to quickly produce improvements to the vaccine that could “potentially shav[e] off years from typical vaccine development timelines.” This will allow researchers to spend more time on evaluating the clinical trials, to determine if each step is safe and developing the immune cells needed.
If successful, larger subsequent trials of the vaccine will be necessary, a process that takes years.
The immunogens being tested in the development of the mRNA were developed by researchers at Scripps Research and the International AIDS Vaccine Initiative (IAVI), “a nonprofit scientific research organization that develops vaccines and antibodies for HIV, tuberculosis, emerging infectious diseases (including COVID-19), and neglected diseases such as snakebite.” Research is funded in part by the Bill and Melinda Gates Foundation.
Previously, Moderna has pledged to use the mRNA technology to target illnesses that have evaded the defence of vaccines.
“The uniquely challenging year of 2020 for all of society proved to be an extraordinary proof-of-concept period for Moderna,” Stéphane Bancel, Moderna’s chief executive officer, in a 2021 press release announcing new vaccine programs addressing seasonal flu, HIV and the Nipah virus. “Even as we have shown that our mRNA-based vaccine can prevent COVID-19, this has encouraged us to pursue more-ambitious development programs.”
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