The COVID-19 pandemic has caused a significant loss of resources for HIV research, services, treatment, and more, as the focus went to pushing through a vaccine for the novel coronavirus. However, some of the technology developed in response to the pandemic may be the key to developing better treatments for HIV — and even a vaccine against it.
For over a decade, there have been a host of advances in HIV treatment and prevention. These include new drug combinations, once-a-day dosing, and long-acting injectables.
The next frontier, researchers hope, is finding a proper vaccine — though many caution that’s still years away. But some experimental vaccines have shown enough promise to be part of human trials, including those using messenger RNA, the key factor in the Moderna and Pfizer COVID-19 vaccines.
“Research on an HIV vaccine has been going on for years, with some advancements, and many disappointments. But I understand that through these disappointments, knowledge is gained, and together with the new knowledge gained by COVID-19 vaccines, perhaps we can finally find success with an HIV vaccine,” Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, tells Plus.
This fall, the International AIDS Vaccine Initiative, Scripps Research, Moderna, and some other partners announced a phase I clinical study for two vaccine candidates, both using mRNA. The candidates, mRNA 1644 and mRNA 1644v2 (a variant of mRNA 1644), provide an instruction book-like code that cells use to create fragments of proteins that then sit outside of a targeted virus, like HIV. An immune response is eventually triggered.
“The difficulties of vaccine candidates that have been tested in people so far is that none of them produced broadly neutralizing antibodies (bnAbs) against HIV, which are antibodies produced by the host immune system that have the ability to block HIV in target cells,” Dr. Mark Feinberg, president and CEO of IAVI, told WebMD.
The new trial involves 56 people who will be divided into four groups. Two groups will receive both variants and the other two will receive one of the variants. Researchers will see if the desired immune response is present.
“Moderna [is] testing a complicated concept which starts the immune response against HIV,” Robin Shattock, an immunologist at Imperial College London, told The Independent. “It gets you to first base, but it’s not a home run. Essentially we recognize that you need a series of vaccines to induce a response that gives you the breadth needed to neutralize HIV.”
He added, “It’s quite likely that their technology may allow them to start to look at that process, but we’re a very long way away from an effective vaccine.”
Aside from mRNA vaccines, new HIV treatments are going to human trials as well. For example, Excision BioTherapeutics was given the go-ahead by the U.S. Food and Drug Administration in September to conduct human trials for a new drug called EBT-101. The drug would use gene editing to prevent HIV from mutating in the body in hopes of achieving a so-called functional cure — meaning HIV would remain undetectable even if a person discontinued antiretroviral treatment. Researchers plan to give trial participants one dose of EBT-101, followed by three months of antiretroviral drugs, and then discontinue the antiretrovirals to see if the virus resurges. The functional cure distinction means that there would be no way to find out if the treatment removed every viral genome from a person.
Developing a cure or vaccine for HIV is difficult for several reasons. HIV can mutate quickly, faster than the body can react appropriately. It can also hide or camouflage itself. So researchers keep trying new approaches to meet the virus’s challenges.