New research findings have been presented into new kinds of biomedical HIV prevention, improvements in monoclonal antibodies for preventing both COVID-19 and HIV, and findings on HIV therapy regimens for pregnant women.
HIV Prevention Advances
Safe and effective kinds of long-acting HIV prevention could provide options to currently available daily oral pre-exposure prophylaxis (PrEP), which many people find hard to adhere to.
There are quite a few alternatives that would require less regular and alternative types of dosing, including a monthly injectable vaginal ring; injections that could offer HIV prevention lasting one, two, or six months; implants which gradually release an HIV prevention medication for up to a year; or an oral pill which could offer protection for 30 days. This expanded variety of options would better meet the HIV prevention needs of more people.
There are also new findings on research into a long-acting type of HIV medication cabotegravir injected once every eight months. This past year, researchers reported that this long-acting injectable is safe and more effective than regular oral Truvada at preventing HIV infection among cisgender men who have sex with transgender women and other men who have sex with men.
At CROI, Dr. Raphael Landovitz from UCLA shared studies conducted to understand better the HIV properties that appeared among the 4,566 research participants throughout the trial. They revealed that 37 of 39 participants at the Truvada group who got HIV through the study had levels of this drug in their blood that weren’t consistent with daily usage.
Of the 12 HIV acquisitions in the Cabotegravir group, just four occurred among participants who obtained on-time cabotegravir shots to got achieve targeted drug concentrations. These outcomes further underscore both Truvada and long-acting cabotegravir are very effective for HIV inhibition. It was also noted that in a companion study, HPTN 084, long-acting cabotegravir was confirmed to be safe and more effective among cisgender ladies.
Using Antibodies for Prevention of HIV and COVID-19
New studies of monoclonal antibodies for prevention of both HIV and COVID-19. There are findings that monoclonal antibodies are capable of preventing acute COVID-19 and death. NIH also encourages studies of monoclonal antibodies for HIV prevention, noting that resources honed over several years to create monoclonal antibodies for HIV allowed rapid studies of these antibodies for COVID-19. As researchers continue the HIV antibody research, they investigate how combinations of many antibodies might function as a long-acting HIV prevention or therapy instrument.
New Medication Discoveries For HIV Treatment
In the Conference on Retroviruses and Opportunistic Infections (CROI), there was a study presented regarding lenacapavir, a possible long-acting medication for the treatment and prevention of HIV. Research given by Dr. Sorana Segal-Maurer from New York-Presbyterian Queens discovered that one of the heavily treatment-experienced individuals with HIV whose current treatment regimen was failing, subcutaneous injection of lenacapavir given every six months as part of an entire HIV treatment regimen was well-tolerated, safe, and led to viral suppression.
Data from animal research also provided a proof of concept for additional exploration of the use of lencapavir for HIV prevention. These improvements are examples of how drug discovery for both HIV prevention and treatment persists.
Moreover, investigators from the NIH-supported IMPAACT 2010 studies reported added evaluation of three HIV therapy regimens initiated in pregnancy. Two of the three regimens included dolutegravir, and the third included efavirenz. Formerly, at CROI 2020, the investigators had informed that dolutegravir-containing regimens were more useful for maternal viral suppression through a time of delivery.
The new data shown by Dr. Lameck Chinula of the University of North Carolina Project-Malawi provides insights into the three regimens’ efficacy and safety for both mother and infant during the first postpartum year. Infant death was higher among moms using the efavirenz dose. One-year postpartum matrilineal viral suppression rates were high for all three procedures, yet more ladies on the efavirenz regimen underwent virologic failure and needed to change regimens.
Could There Be A HIV Vaccine Similar To the Covid-19 Vaccine?
Studies have taken the first step Toward developing a novel sort of vaccine regimen which could protect people against HIV. The virus, which weakens the immune system, affects roughly 38 million people.
Highly effective antiviral treatments for HIV can be found, but those living with the virus must get them for the rest of their life, and the long-term health effects of the disease stay challenging.
Additionally, access to prevention and treatment services is restricted in some areas of the world. The World Health Organization (WHO) estimates that, because of this, there were 1.7 million new infections with HIV in 2019, and 690,000 people passed away from HIV-related causes. Despite decades of hard work, scientists have failed to create an effective vaccine against the virus.
This is because most of the surface of the virus is densely covered with sugar molecules that don’t trigger an immune reaction, and the vulnerable components are highly variable. As with SARS-CoV-2, which’s the virus that induces COVID-19, HIV utilizes spike proteins on its external surface to obtain entry to its host cells.
“The spike protein on HIV viruses is a lot more devious,” says William Schief, an immunologist and professor at the Scripps Research Institute in La Jolla, CA, and executive director of the International AIDS Vaccine Initiative (IAVI).
Because of the rapid mutation of the genes which produce the spike, HIV has countless different strains. For this reason, antibodies against one breed are not likely to neutralize others.
Broadly Neutralizing Antibodies
Although, researchers have known that there are hard-to-access regions of the spike that don’t change very much. Antibodies that adhere to these areas are called broadly neutralizing antibodies (bnAbs) as, in theory, they could target a vast array of HIV strains.
On rare events, people with HIV create these antibodies naturally. This organic generation allows scientists to know where the antibodies adhere to the virus. Using this information, they could produce “immunogens” to use in vaccines.
The catch is that only a unique kind of immature immune cell, called a naive B cell, can grow into moving B cells capable of creating bnAbs against HIV. Only about one in a million naive B cells possess this capacity, says Prof. Schief.
To overcome this dilemma, he and his colleagues at Scripps Research and IAVI employed germline targeting to make a vaccine that triggers these rare cells. In the phase one clinical trial, the vaccine appeared to be secure, and it had the desired effect in almost all the volunteers that received it.
Experts at George Washington University in Washington, D.C., and the Fred Hutchinson Cancer Research Center in Seattle, WA, employed 48 healthy adult volunteers for the trial.
They gave the participants doses of the vaccine or a placebo. The experts report that the vaccine stimulated naive B cells in 97 percent of participants who obtained it.
“A holy grail of the HIV vaccine field is to obtain broadly neutralizing antibodies by vaccination. And here, we have shown in humans that we can begin that process,” states Prof. Schief.
He also presented the results at a virtual convention of the International AIDS Society HIV Research for Prevention on February 3, 2021. It’s worth noting that the trial was small, and the results have yet to be published in a scientific journal.
Additionally, it is essential to notice that additional studies and many more clinical trials will be required to develop and test later phases in the vaccine regimen.
Collection Of Injections
The vaccine would be just the first in a series of shots to build immunity against the virus. The first jab would”wake up” the naive B cells, and following jabs would instruct their descendants to create bnAbs against HIV.
“We think this method will be crucial to creating an HIV vaccine and perhaps vital for producing vaccines against other infections,” says Prof. Schief in a media release from Scripps. He thinks that researchers could use the same procedure to formulate vaccines against other deadly pathogens, such as flu, dengue, Zika, hepatitis C, and malaria.
The group has joined forces with the biotech firm Moderna to create an mRNA-based vaccine that targets the same cells. As it has with the growth of COVID-19 vaccines, mRNA technology must accelerate developing the vaccines.