Bad news for fight against HIV/AIDS
On the 18th of January 2023, the medical world woke up to more devastating news in the fight against HIV/AIDS. This came after the only HIV vaccine candidate in advanced clinical trials was declared a failure due to it not being effective against the virus.
The clinical trial – named Mosaico – led by Janssen Pharmaceuticals, has been running since October 2019 at 50 different trial sites in nine (9) countries (Argentina, Brazil, Italy, Mexico, Peru, Poland, Puerto Rico, Spain and the U.S). It was intended to complete in March 2024, but had to be halted prematurely due to the candidate not showing enough effectiveness against the deadly virus.
An approximate total of 3,900 participants (from all the 50 sites) were involved in the trial, all of them being classified as cisgender men (those who have always identified as male) and transgender individuals who have sex with cisgender men and transgender individuals.
The trial had to be ended after an independent panel of experts, the Data and Safety Monitoring Board (DSMB), determined that the candidate was not effective in preventing infection compared to the placebo that was given to the other set of participants. Guidelines set before the trial dictated that the trial be halted.
This is catastrophic news especially for a disease that has been rampant for over four (4) decades now and continues to infect at least 1.5 million people a year world-wide with a global mortality of at least 650,000 a year.
It is worth noting that every individual in the medical sphere had pinned their hopes on this vaccine candidate becoming a success after a similar trial – the Imbokodo trial – also got prematurely ended in August 2021 for the same reason.
The Imbokodo was carried out in Sub-Saharan Africa (Malawi, Mozambique, South Africa, Zambia and Zimbabwe) enrolling an approximate total of 2,600 women aged 18-35 years using a similar vaccine candidate as the one used in the Mosaico trial.
In the Imbokodo, the regimen displayed only 25 percent protection against HIV infection which was too little for Public Health experts to proceed with as they say it should have reached at least 50 percent efficacy in order for it to be able to curb the pandemic. One of the main reasons it had to be halted was that it ran the risk of giving women a “false sense of security”.
The only positive aspect about both trials was that the vaccine candidate proved to have a favourable safety profile, meaning that there were no safety issues identified during the entirety of both trials. No side effects directly linked to the vaccine were picked from either trial.
However, not all is lost as data analysis is still ongoing for the Mosaico. One can only hope that bits and pieces of positive details will be picked from the analysis which can then be used to enhance future HIV vaccine trials to improve them even further. The ultimate aim is to come up with one that will prevent HIV infection totally because that is the only way we will be able to beat this pandemic.
What does all this mean?
This means that we have suffered a setback of at least four (4) to five (5) years of HIV research, which basically denotes that the vaccine we were hoping to have soon will not be around for the next 4 to 5 years as more research will continue to be done.
The only comforting part is that the current existing treatments are continuing to improve even further with the introduction of the shots that will be given every two months. This new advancement practically eliminates a lot of hindrances that have been causing many people to derail from their treatment; stigmatisation, forgetting to take their medication at the right times every day etc.
With the shots, one will only have to take it just six (6) times in a year discreetly. There are also promising studies being done to improve the shot to be taken once every six (6) months, thus only twice a year. Talk about massive improvement.
I wish everybody a healthy and safe weekend.
Kenneth T. Photlokwe MSc Medicine (Vaccinology) – Wits SANBio Youth Ambassador Email: photlokwekenneth@gmail.com Facebook: Kenneth T. Photlokwe Twitter: @Kenny_TP