Moderna Is About to Begin Trials for HIV Vaccine(them.us)
them.us
Moderna Is About to Begin Trials for HIV Vaccine
https://www.them.us/story/moderna-begins-hiv-vaccine-trials-covid-19-research
505 comments
Agreed this very exciting. Malaria is also being targeted using the same technology. BioNTech announced they were working on it last month and some results[1] in mice are already looking promising.
[1] Messenger RNA expressing PfCSP induces functional, protective immune responses against malaria in mice.
https://www.nature.com/articles/s41541-021-00345-0
[1] Messenger RNA expressing PfCSP induces functional, protective immune responses against malaria in mice.
https://www.nature.com/articles/s41541-021-00345-0
> But some cancers are caused by viruses.
Note that mRNA technology is not limited to viruses. The cancer vaccine is actually a misnomer as it is actually a personalized treatment for people who already have cancer [1]:
> The cells from the patient's tumor are analyzed, and genetic sequencing is used to identify twenty neoantigen epitopes that may elicit the strongest immune response in the patient. The sequences encoding the twenty patient-specific epitopes are transcribed and loaded onto a single mRNA molecule. [...] This leads to an induction of both cytotoxic T-lymphocyte (CTL)- and memory T-cell-dependent immune responses that specifically target and destroy the patient's cancer cells that express these neoantigens.
BioNTech has actually started Phase 2 trials for a mRNA-based cancer therapy [2].
[1] https://www.cancer.gov/publications/dictionaries/cancer-drug...
[2] https://www.clinicaltrialsarena.com/news/first-patient-dosed...
Note that mRNA technology is not limited to viruses. The cancer vaccine is actually a misnomer as it is actually a personalized treatment for people who already have cancer [1]:
> The cells from the patient's tumor are analyzed, and genetic sequencing is used to identify twenty neoantigen epitopes that may elicit the strongest immune response in the patient. The sequences encoding the twenty patient-specific epitopes are transcribed and loaded onto a single mRNA molecule. [...] This leads to an induction of both cytotoxic T-lymphocyte (CTL)- and memory T-cell-dependent immune responses that specifically target and destroy the patient's cancer cells that express these neoantigens.
BioNTech has actually started Phase 2 trials for a mRNA-based cancer therapy [2].
[1] https://www.cancer.gov/publications/dictionaries/cancer-drug...
[2] https://www.clinicaltrialsarena.com/news/first-patient-dosed...
Back when I was a freshman in medicine studying immune responses this kind of personalized medicine was my wet dream. This was less than 10 years ago. This is incredible how fast it's moving.
It's worth posting Moderna's research pipeline to understand the breadth and depth of where they plan to take mRNA vaccines: https://www.modernatx.com/pipeline
Wow flu & RSV elimination would be great, especially for infants/toddlers
> cervical cancer where it seems like most cases are caused by HPV strains
What's funny is the US initially only vaccinated women against HPV because "men can't get cervical cancer". Then it turned out lots of men were getting oral/throat cancers from oral HPV acquired from oral sex. Oops!
What's funny is the US initially only vaccinated women against HPV because "men can't get cervical cancer". Then it turned out lots of men were getting oral/throat cancers from oral HPV acquired from oral sex. Oops!
The bigger issue was anal cancer among men that have sex with men, if I remember correctly the risk was around 100x than in the general population, and also completely preventable by the HPV vaccine.
I am still wondering how many other cancers are caused by viruses that we have not isolated or maybe choose not to search for because "conventional wisdom"
The trail of bread crumbs seems to be there. - HPV - Hep C - Human T-cell leukemia/lymphoma virus (HTLV)
The trail of bread crumbs seems to be there. - HPV - Hep C - Human T-cell leukemia/lymphoma virus (HTLV)
Source for this, and the amount of time that we were only vaccinating women? If it was just a year or so, that's a very different story from decades.
I recall there being a sudden, loud push 10ish years ago, for everyone to get the HPV vaccine.
There were some anti-vax arguments against it for the same reason as there's resistance to sex ed; but no "men can't get cervical cancer" arguments, that I recall.
I recall there being a sudden, loud push 10ish years ago, for everyone to get the HPV vaccine.
There were some anti-vax arguments against it for the same reason as there's resistance to sex ed; but no "men can't get cervical cancer" arguments, that I recall.
As of 2017 WHO was still recommending prioritizing girls under 15 for vaccination: https://www.who.int/immunization/policy/position_papers/pp_h...
> Vaccination of secondary target populations e.g. females aged ≥15 years or males, is only recommended if feasible, affordable, cost-effective and does not divert resources from vaccinating primary target population or from effective cervical cancer screening programmes.
> Vaccination of secondary target populations e.g. females aged ≥15 years or males, is only recommended if feasible, affordable, cost-effective and does not divert resources from vaccinating primary target population or from effective cervical cancer screening programmes.
I think the tone I read implied into your post was that it was something malicious or arrogant. "Don't protect the men because they don't need to care about giving it to women", followed by "oh noes, men can get sick too! Better protect them!" rather than a resource allocation problem, as the quote is arguing.
Source?
https://www.mdanderson.org/publications/focused-on-health/wh...
> HPV-related throat cancer is on the rise, and the typical patient is a male in his 50s or 60s.
> HPV-related throat cancer is on the rise, and the typical patient is a male in his 50s or 60s.
Building out the capacity to manufacture and distribute ten billion doses of new vaccines as quickly as we can validate their safety and efficacy would also be quite the feat.
It's nice for a first-world citizen that we were getting vaccinated against a new disease 12-18 months after it was first discovered, but with a big enough supply chain we could potentially be aiming to finish a world-wide vaccination campaign in 6-12 months, before we begin running up against the limits of our current methodologies for clinical trials.
It's nice for a first-world citizen that we were getting vaccinated against a new disease 12-18 months after it was first discovered, but with a big enough supply chain we could potentially be aiming to finish a world-wide vaccination campaign in 6-12 months, before we begin running up against the limits of our current methodologies for clinical trials.
>I am already beginning to wonder if the 2020s will be the story of the social transformation caused by mRNA vaccines. An effective and relatively cheap HIV vaccine will be huge.
In the 90s, sure. Between treatment so effective that you can't pass it on and PreP, the days of HIV is over anyway. Vactination might be a bigger deal in poor countries, but they are also the countries that can least afford it.
If they can cure HIV, that would be another thing.
In the 90s, sure. Between treatment so effective that you can't pass it on and PreP, the days of HIV is over anyway. Vactination might be a bigger deal in poor countries, but they are also the countries that can least afford it.
If they can cure HIV, that would be another thing.
If all mRNA have side effects like the current crop of COVID vaccines I’m honestly not sure they are worth it as a seasonal flu shot.
I’m not talking about the scare mongering of long term effects. Just the immediate.
The day after my second moderna shot was worse than any flu I can remember and many of my friends in their 20s and 30s had to take a day off after their shot. I know several people in their 60s who had to take several days to a week in bed from vaccine side effects.
That’s fine for ending a pandemic or curing HIV, but for seasonal flu?
In terms of lost labor days, my anec-data points to this vaccine seeming worse than a seasonal flu.
I’m not talking about the scare mongering of long term effects. Just the immediate.
The day after my second moderna shot was worse than any flu I can remember and many of my friends in their 20s and 30s had to take a day off after their shot. I know several people in their 60s who had to take several days to a week in bed from vaccine side effects.
That’s fine for ending a pandemic or curing HIV, but for seasonal flu?
In terms of lost labor days, my anec-data points to this vaccine seeming worse than a seasonal flu.
I don't know. The last time I had a seasonal flu, I was sick for a week. I cried because I needed to do laundry and simply didn't have the energy and I ate poorly - I lived alone at the time. All of my energy went to surviving work.
Compared to having a sore arm for a couple of days? Or even getting sick for a day or two - at a time I can choose - to just not deal with getting sick later on? Sure. And I'm awfully sure that the flu kills more than the vaccine for it. So many complications for so many people.
And to be fair: The folks you knew in their 60's had an unusual reaction. Older people with their aging immune systems are actually more likely to get little to know side effects to vaccines - younger folks tend to get more. The same goes for folks that are genetically female: You tend to get more side effects (they think this is because so many immune genes are on sex chromosomes, and women have more genes here.).
And to be fair: Taking a day off of work when you are sick isn't such a big deal if you live somewhere with labor protection laws that allow you sick days. It is a little less of a big deal if you live in the US and get paid sick time, but a lot of folks just don't have this so it makes being sick after a vaccine a bigger deal that it should be.
Compared to having a sore arm for a couple of days? Or even getting sick for a day or two - at a time I can choose - to just not deal with getting sick later on? Sure. And I'm awfully sure that the flu kills more than the vaccine for it. So many complications for so many people.
And to be fair: The folks you knew in their 60's had an unusual reaction. Older people with their aging immune systems are actually more likely to get little to know side effects to vaccines - younger folks tend to get more. The same goes for folks that are genetically female: You tend to get more side effects (they think this is because so many immune genes are on sex chromosomes, and women have more genes here.).
And to be fair: Taking a day off of work when you are sick isn't such a big deal if you live somewhere with labor protection laws that allow you sick days. It is a little less of a big deal if you live in the US and get paid sick time, but a lot of folks just don't have this so it makes being sick after a vaccine a bigger deal that it should be.
Like you said, it's anec-data. Among my friends, two were very sleepy the following day and otherwise fine. I had a sore arm for two days, and no other effects. My parents didn't have any noticeable effects.
But there is significant real data that the side effects from Moderna were significantly worse (but, again, not severe, and time-limited) than a flu shot.
I know this is just another anecdote, but I get a flu shot every year and have never experienced anything more than a sore arm. With 2nd Moderna dose I had a fever of 103 and was completely out of commission for 36 hours.
I know this is just another anecdote, but I get a flu shot every year and have never experienced anything more than a sore arm. With 2nd Moderna dose I had a fever of 103 and was completely out of commission for 36 hours.
>But there is significant real data that the side effects from Moderna were significantly worse (but, again, not severe, and time-limited) than a flu shot.
It's all relative. The side effects from a flu shot are mild compared to the flu. Ditto for the Moderna vaccine.
It's all relative. The side effects from a flu shot are mild compared to the flu. Ditto for the Moderna vaccine.
I think they just took the highest dose that had acceptable side effects because they had no time to figure out the perfect dose.
This is also my thinking, and doesn't seem too implausible given that the dosage is so much higher than Pfizer (100mcg vs 30mcg).
My relatives who got Moderna had similar reports to some of the posters above. I got Pfizer and barely noticed.
The worst case of flu I had lasted a month. It's usually several days of chills, aches, and coughing.
With the second phizer shot, I mild symptoms for a day.
With the second phizer shot, I mild symptoms for a day.
It's possible you never had a flu. It's pretty rough
I've had Moderna and the flu, and they were about equally bad ("I can move, but only because I'll wet the bed otherwise, please God let me sleep so it stops feeling like my bones are dissolving") but Moderna lasted only a day whereas the flu lasted several. I think you'll struggle to argue convincingly that Moderna doesn't commonly have awful side effects :P
You also didn't pass the Moderna side-effects to anyone else, unlike with the flu.
The question is simple, does the benefit of using said vaccine or medication outweigh the risk of not using it. In the case of covid being sick for a couple of days and a guarantee of preventing future death is better than a resulting death had the user not taken it.
I would say a couple of days of flu is vastly better than some of the other side effects I've seen with other medications. Take for instance:
- Suicidal thoughts - Abnormal heart rhythms - Internal bleeding - Cancer
At the end of the day, we rely on medical professionals to help us with these decisions and weigh the treatment of said ailments against the side effects we may incur if we do or don't take treatment. For what it's worth I've seen the opposite, most folks took the day off just in case there was a side effect, but ultimately everyone was fine. I know I scheduled my vaccine shots for a Thursday so I could have a 3 day weekend assuming I wasn't feeling ill, and I felt fine so I enjoyed my 3 day weekend.
I would say a couple of days of flu is vastly better than some of the other side effects I've seen with other medications. Take for instance:
- Suicidal thoughts - Abnormal heart rhythms - Internal bleeding - Cancer
At the end of the day, we rely on medical professionals to help us with these decisions and weigh the treatment of said ailments against the side effects we may incur if we do or don't take treatment. For what it's worth I've seen the opposite, most folks took the day off just in case there was a side effect, but ultimately everyone was fine. I know I scheduled my vaccine shots for a Thursday so I could have a 3 day weekend assuming I wasn't feeling ill, and I felt fine so I enjoyed my 3 day weekend.
do all mRNA vaccines have to be multi-dose?
I'm sure a second shot of the traditional flu vaccine wouldn't feel great.
I'm sure a second shot of the traditional flu vaccine wouldn't feel great.
This is fair since existing flu vaccines are seems to fine and flu medication is available, but good to have mRNA option.
It may be that the vaccine side effect severity is proportional to the severity of the disease it prevents.
Also, these vaccines were very rapidly developed so perhaps the next generation of them will be a bit easier on the body.
Also, these vaccines were very rapidly developed so perhaps the next generation of them will be a bit easier on the body.
It is more likely the opposite - a strong immune system causes a strong vaccine reaction.
I have a similar feeling regarding cancer. It's a seemingly uncontrolled chaos that manages to paint itself into the sweetest spot to keep growing .. so many positive reinforcement failures it's eery
I've been having difficulty trying to think about how much Moderna will charge for their other products
like the covid one is sold at super low prices compared to what would normally be possible
but the other products won't have nearly as many customers either
what do you guys think?
like the covid one is sold at super low prices compared to what would normally be possible
but the other products won't have nearly as many customers either
what do you guys think?
If the argument is that you can make mRNA vaccines faster, that would also tend to imply cheaper. Which could mean they can make it up on volume.
How is HIV sophisticated? What makes it effective?
To me the "coolest" feature is that it saves dormant copies in cells, so that even if there is no detectable virus in the blood, a few months after stopping taking anti-HIV drugs the virus will reappear. If you sample the virus right when the first spike reappears, you will see a bunch of different HIV virus types, essentially the history of each mutation on that person, as each virus strain saves its own copies... (soon after the strongest strain dominates)
If you want a more-than-surface-deep (but not academic deep) article on what makes HIV fascinating - https://www.avert.org/professionals/hiv-science/overview is a good quick read
A person with HIV will actually be infected by multiple variants simultaneously, since the virus mutates rapidly within a single host (tons of variants will be produced in a single day). So, even though the immune system will fight the virus and produce antibodies, the virus stays one step ahead. That also means that a person will not develop long-term immunity after being exposed to the live virus (and can even be infected multiple times with different variants and strains), and is the main challenge with developing an HIV vaccine.
I am no expert but my understanding is that AIDS occurs when a variant targeting receptors more specific to CD4 T-cells begins replicating (or begins replicating at too high a rate), which results in T-cell counts falling below some threshold. So a person will go through an extended period without feeling any symptoms, possibly transmitting the virus to others (hence the importance of widespread, easy access to testing), only to be incapacitated by AIDS later when the "balance" of the variants changes (assuming they do not receive HIV-suppressing medications).
I am no expert but my understanding is that AIDS occurs when a variant targeting receptors more specific to CD4 T-cells begins replicating (or begins replicating at too high a rate), which results in T-cell counts falling below some threshold. So a person will go through an extended period without feeling any symptoms, possibly transmitting the virus to others (hence the importance of widespread, easy access to testing), only to be incapacitated by AIDS later when the "balance" of the variants changes (assuming they do not receive HIV-suppressing medications).
What a wonderful time to be alive!
Video of the lifecycle of HIV. To me it's absolutely mind-blowing to think that this entire process developed on its own, in dark, and is mindlessly progressing along so effectively that despite all of our technological capability we can barely contain it.
https://vimeo.com/260291607
(also how awesome is the music?)
https://vimeo.com/260291607
(also how awesome is the music?)
Sometimes I find it a little depressing that (at least through my laymen eyes) we are nearing a technological plateau and that more research into physics is unlikely to get us to a world describe in traditional science fiction with FTL drives and large metal spaceships that can take you from planet to planet.
Then something like this reminds me that if we as a species were able to unlock the secrets of bio-chemistry (not sure if that's the right term) it would be a game changer unlike any seen so far. And the fact that there is a huge corpus of evidence out there in the world called "life" proving some of the possibilities already gives me hope that while we may never have FTL, the future could still be pretty wild.
Then something like this reminds me that if we as a species were able to unlock the secrets of bio-chemistry (not sure if that's the right term) it would be a game changer unlike any seen so far. And the fact that there is a huge corpus of evidence out there in the world called "life" proving some of the possibilities already gives me hope that while we may never have FTL, the future could still be pretty wild.
> we are nearing a technological plateau
Max Planck was famously discouraged from studying physics by one of his professors because "in this field, almost everything is already discovered, and all that remains is to fill a few holes." [1]
Having studied physics myself, my opinion is that we may very well be at a similar point right now. The big advancements of the last century in physics (quantum theory, relativity, chaos theory, etc.) brought us an era of swift and sweeping technological progress, and now the easy fruit seems to have been plucked. But there are still plenty of known unknowns, dark matter and dark energy being perhaps the most prominent one. Who knows what unknown unknowns are hiding behind those known unknowns?
[1] https://en.wikipedia.org/wiki/Philipp_von_Jolly
Max Planck was famously discouraged from studying physics by one of his professors because "in this field, almost everything is already discovered, and all that remains is to fill a few holes." [1]
Having studied physics myself, my opinion is that we may very well be at a similar point right now. The big advancements of the last century in physics (quantum theory, relativity, chaos theory, etc.) brought us an era of swift and sweeping technological progress, and now the easy fruit seems to have been plucked. But there are still plenty of known unknowns, dark matter and dark energy being perhaps the most prominent one. Who knows what unknown unknowns are hiding behind those known unknowns?
[1] https://en.wikipedia.org/wiki/Philipp_von_Jolly
> Having studied physics myself, my opinion is that we may very well be at a similar point right now.
We're not anywhere near a technological plateau, we just lost track on funding. Until the fall of the Soviet Union, the US invested a lot of money in foundational research, often not even caring if it would prove useful or possible, and with big enough money behind it that people could plan careers.
These days, researchers have to waste half their working time to chasing the few grants that are still available, and forget about a stable career, job security or enough work-life balance to found a family.
We're not anywhere near a technological plateau, we just lost track on funding. Until the fall of the Soviet Union, the US invested a lot of money in foundational research, often not even caring if it would prove useful or possible, and with big enough money behind it that people could plan careers.
These days, researchers have to waste half their working time to chasing the few grants that are still available, and forget about a stable career, job security or enough work-life balance to found a family.
It's really too sad ... I (PhD on CompSci) could helping on the research of something groundbreaking for humanity instead of "maximizing shareholder profits". But Academia basically sucks in its current state, and in my country there is less than 0 capabilities to do real research.
I do want us to pour money into foundational research, but form an outsider's perspective, it does seem like a lot of it does require increasingly large capital costs with things like the LHC, and feels all so theoretical.
I think it's worth every penny, but at first glance it feels incredibly abstract and disconnected from practical application, as well as expensive. (Though, to be honest, I just looked up the LHC cost and $9Bn USD doesn't feel expensive. I was expected it to come up in the hundreds of billions.)
I think it's worth every penny, but at first glance it feels incredibly abstract and disconnected from practical application, as well as expensive. (Though, to be honest, I just looked up the LHC cost and $9Bn USD doesn't feel expensive. I was expected it to come up in the hundreds of billions.)
Lord Kelvin famously said there were just two "clouds" in left to physics—two mysteries remaining to explain. Those two mysteries let to relativity and quantum mechanics.
There's also this famous quote that is frequently mis-attributed to Kelvin: "There is nothing new to be discovered in physics now. All that remains is more and more precise measurement".[0] (I'm not sure who actually said it.)
[0] https://www.quora.com/Which-19th-century-physicist-famously-...
There's also this famous quote that is frequently mis-attributed to Kelvin: "There is nothing new to be discovered in physics now. All that remains is more and more precise measurement".[0] (I'm not sure who actually said it.)
[0] https://www.quora.com/Which-19th-century-physicist-famously-...
Time. We still don't think about time properly - there are likely some huge technological gains if we can unlock time in relation to physics (not in terms of sci fi time traveling).
Along the same lines, FTL won't be needed if we merge with technology and live indefinitely long.
One human lifespan will be seen as a trivial amount of time to the next step of humanity.
One human lifespan will be seen as a trivial amount of time to the next step of humanity.
This isn't entirely accurate. We will not be able to visit the vast majority of the universe even given infinite time if we are not able to travel faster than light. Like 94% of the universe is unreachable without FTL, even without time constraints.
https://www.forbes.com/sites/startswithabang/2016/05/12/the-...
And at some point we also don't have infinite time - we will have heat death of the universe at some point too.
https://www.forbes.com/sites/startswithabang/2016/05/12/the-...
And at some point we also don't have infinite time - we will have heat death of the universe at some point too.
The remaining 6% is still orders of magnitude larger than would be involved in a typical space opera.
I've never actually looked up what the "quadrants" are in Star Trek. Apparently just our one galaxy divided into four. 6% of the universe is indeed an unfathomably large amount of space.
There's also the minor issue that probably our two best physical theories, quantum dynamics and general relativity, are incompatible.
So they can't both be right.
https://www.theguardian.com/news/2015/nov/04/relativity-quan...
So they can't both be right.
https://www.theguardian.com/news/2015/nov/04/relativity-quan...
Gravity. Still the biggest unknown.
Do we even have a total understanding of light, or electricity? (I may be wrong, but I thought there were still some pretty fundamental unknowns)
It depends on what you mean by "understanding". We can explain using a specific set of rules how something works. It doesn't mean that those rules are the best way to explain it or that they are even correct.
For example, we could explain that electricity works because of how electrons move, which would be correct from our point of view, but if we find out that we were living in a simulation, then the explanation would be that this is how "electricity" was coded to behave.
Also, usually in physics a formula is thought to be correct until some new laws/rules are found, then the formula is updated by adding some extra terms and then again thought to be correct.
For example, we could explain that electricity works because of how electrons move, which would be correct from our point of view, but if we find out that we were living in a simulation, then the explanation would be that this is how "electricity" was coded to behave.
Also, usually in physics a formula is thought to be correct until some new laws/rules are found, then the formula is updated by adding some extra terms and then again thought to be correct.
To summarize: we know how to smash two particles together, but not much about what they are made of. Replace particles with stones and bones. 10000 years of science progress and we are still smashing things. With the occasional lab accident like discovering that mold kills bacteria.
Maybe at a certain point "what they are made of" ceases to be a meaningful question.
Quantum electrodynamics is the most precise and accurate theory ever created. So not sure what you mean exactly by understand.
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One big difference—the discoveries waiting to be made in the early 20th century all concerned regular matter. As a result, once they were made, they enabled huge technological advancements.
>we are nearing a technological plateau and that more research into physics is unlikely to get us to a world describe in traditional science fiction with FTL drives and large metal spaceships that can take you from planet to planet.
strange to me how nobody questions why beavers only make damns a certain size, birds only make nests and don't go beyond that in complexity.
So many people seem blind to the idea that humans might be near their intellectual limit as a species and assume we will just keep progressing technologically. For all we know it's possible we hit a brick wall in terms of progress. Average human struggles with calculus, what if there was a species that could do advanced math as easily as we do 2 + 2?
Seems the limit for human advancement is tied to rate of learning, life span, and general cognitive ability. If you want more advanced tech you need to focus on those problems
strange to me how nobody questions why beavers only make damns a certain size, birds only make nests and don't go beyond that in complexity.
So many people seem blind to the idea that humans might be near their intellectual limit as a species and assume we will just keep progressing technologically. For all we know it's possible we hit a brick wall in terms of progress. Average human struggles with calculus, what if there was a species that could do advanced math as easily as we do 2 + 2?
Seems the limit for human advancement is tied to rate of learning, life span, and general cognitive ability. If you want more advanced tech you need to focus on those problems
I've often wondered about this. My suspicion is that there is a limit to the complexity of mental models that humans can fluently manipulate and I think we're starting to bump into it in some cases.
I think we will eventually need a paradigm shift from science being built around human grokable models (e=mc^2) to external human manipulatable models (ie, large scale machine derived models that we can't actually grok but can use for analysis and engineering). I think we're already starting to see this - there are already mathematical proofs that are so large and complex (in the GB range) that they had to be found by automation and only other automation can verify them.
I think we will eventually need a paradigm shift from science being built around human grokable models (e=mc^2) to external human manipulatable models (ie, large scale machine derived models that we can't actually grok but can use for analysis and engineering). I think we're already starting to see this - there are already mathematical proofs that are so large and complex (in the GB range) that they had to be found by automation and only other automation can verify them.
We have tons of numerical simulations in engineering. Light modulation alone, just 3-5 lenses with different qualities can occupy a modern processor for a few hours.
> ...strange to me how nobody questions why beavers only make damns a certain size, birds only make nests and don't go beyond that in complexity.
Isn't most of this kind of just a matter of fitness, same as why birds become flightless on islands where there are no predators which demand flight to escape from? Basically, building anything more than a minimally-viable nest or a dam requires using energy that could be invested elsewhere to greater evolutionary advantage.
Humans have gone beyond because for as long as we can remember, we've always had vast, vast surpluses of energy, initially through the cooking of meat and agriculture, then via animal labour, and then finally via fossil fuels.
Isn't most of this kind of just a matter of fitness, same as why birds become flightless on islands where there are no predators which demand flight to escape from? Basically, building anything more than a minimally-viable nest or a dam requires using energy that could be invested elsewhere to greater evolutionary advantage.
Humans have gone beyond because for as long as we can remember, we've always had vast, vast surpluses of energy, initially through the cooking of meat and agriculture, then via animal labour, and then finally via fossil fuels.
I love the analogy, but I think it flawed: the limits are practical and excess just adds risk.
On the flip side, nothing seems more exemplified by humanity than a zeal for doing a thing as big and grandiose as possible: for curiosity, for business, for art, or just for sheer vanity.
I don't think we've seen how far those will take us yet, even w/o improvements to the bottlenecks you suggest. I do agree that those "meta" fields matter and will make a huge difference.
On the flip side, nothing seems more exemplified by humanity than a zeal for doing a thing as big and grandiose as possible: for curiosity, for business, for art, or just for sheer vanity.
I don't think we've seen how far those will take us yet, even w/o improvements to the bottlenecks you suggest. I do agree that those "meta" fields matter and will make a huge difference.
> strange to me how nobody questions why beavers only make damns a certain size, birds only make nests and don't go beyond that in complexity.
Probably because beavers and birds have made dams and nests the same way for the past 100 years, whereas humans in the same time have developed a bunch of tools and can specialize and distribute the fruits of their expertise without requiring others to be experts themselves.
Perhaps it's not true that on average we know more e.g. math now than we did 100 years ago, because there are so many more people. I believe we are nonetheless much better at teaching and learning now.
It's more than possible that all of this growth will be our downfall, and that that will regulate our growth, however.
Probably because beavers and birds have made dams and nests the same way for the past 100 years, whereas humans in the same time have developed a bunch of tools and can specialize and distribute the fruits of their expertise without requiring others to be experts themselves.
Perhaps it's not true that on average we know more e.g. math now than we did 100 years ago, because there are so many more people. I believe we are nonetheless much better at teaching and learning now.
It's more than possible that all of this growth will be our downfall, and that that will regulate our growth, however.
Life span is hardly a limiting factor. It is known that most scientific breakthroughs were made by people in their twenties-early thirties.
what if you could extend that academic "prime" by 30 years or longer?
It would do little, I think. Not because people get less smart with age, but because with years they establish themselves in their field, and become more conservative and less willing to shake the status quo.
I normally buy into this sort of logic, but there's a fundamental difference. We experience the world in a way that recognizes beavers' and birds' limits, whereas they do not. We can modify ourselves and our environment in a way and changes our limits. Perhaps if the world is a simulation, then there are hard limits, as we are but bits in a computer so to speak, but even then it's not certain - we could become aware of the world outside the simulation and learn to manipulate it thought I/O mechanisms.
Average humans struggle with calculus because we have instructed average humans that calculus is hard. If we taught it to 12 year olds as a routine matter, average 12 year olds would know calculus.
You can teach smart (not average) 12 year olds the basic rules how to compute derivation or primitive function, but I doubt they are capable of distinguishing between, say, continuous and uniformly continuous function. Which is actually pretty important when trying to reason your way around calculus.
> strange to me how nobody questions why beavers only make damns a certain size, birds only make nests and don't go beyond that in complexity.
Unlike humans, beavers and most species of birds don't work cooperatively, which means they can't separate the workload needed for survival (e.g. one group hunts, one group builds dams, one group does childcare).
Unlike humans, beavers and most species of birds don't work cooperatively, which means they can't separate the workload needed for survival (e.g. one group hunts, one group builds dams, one group does childcare).
We'll reach the stars thru life sciences. Future humans will become space and time adapted. Hardened against radiation. Metabolism so slow that years will feel like minutes.
The future will be pretty wild.
The future will be pretty wild.
I'm not so sure that is the case, simply for economic and social reasons. Climate change is a much more tractable and immediate problem, yet technological developments and their implementations still seem to be moving too slowly to matter at the moment.
Solar has dropped 50-75% in cost in the last decade, and accounts for 10x more wattage. Battery capacity has doubled in that time. Wind energy capacity has doubled. Geothermal capacity is 1.5x. Electric cars are 4x more common than they were 5 years ago. Carbon sequestration has advanced at a technological level, although production hasn't seen serious advances (probably because renewable energy produces a profitable resource, while sequestering just exchanges money for fighting climate change).
If that's not enough to make a difference, it's because we started too late and the problem is too large, not because technological development is too slow. Admittedly, nuclear could have done the job already, and the issue there is social.
If human lifespan technology moved at half the climate change technology speed, we'd have 25 extra years per decade and be effectively immortal today.
If that's not enough to make a difference, it's because we started too late and the problem is too large, not because technological development is too slow. Admittedly, nuclear could have done the job already, and the issue there is social.
If human lifespan technology moved at half the climate change technology speed, we'd have 25 extra years per decade and be effectively immortal today.
It seems to older me that punctuated equilibrium is some kind of natural law.
Incremental progress may be ideal. Alas, whatever forces that may be, trying to preserve the current equilibrium, fight off change. Until the compulsion to change overwhelms the system.
Lather, rinse, repeat.
So when humanity finally goes carbon negative, it'll be despite the opposition, because they couldn't defend the status quo any longer. Then all that bottled up change will be like a dam bursting.
Hopefully it'll happen sooner than later.
Incremental progress may be ideal. Alas, whatever forces that may be, trying to preserve the current equilibrium, fight off change. Until the compulsion to change overwhelms the system.
Lather, rinse, repeat.
So when humanity finally goes carbon negative, it'll be despite the opposition, because they couldn't defend the status quo any longer. Then all that bottled up change will be like a dam bursting.
Hopefully it'll happen sooner than later.
Instantly made me think of Cordwainer Smith. In particular "Scanners live in vain", but many of his stories deal with adaptations to space.
What if this is just not possible?
We can send persons without sending humans. With a good enough brain-computer interface we should be able to duplicate our brain contents to a digital medium, which we know can travel to interstellar space and beyond
Complex computers break down too. It might well be true that any computer capable of approximated human intelligence is even more fragile than normal human.
I don't think we are capable building computer system (and that includes power system for running it) right now that would last few hundred years without any maintenance, even here on planet.
Or it would at least be very non trivial to build it
I don't think we are capable building computer system (and that includes power system for running it) right now that would last few hundred years without any maintenance, even here on planet.
Or it would at least be very non trivial to build it
we currently have at least 2 functioning computers in interstellar space that are 44 years old. I think we are already at a point that we can make centuries-lasting computers
We are far away from such an interface and space travel takes still far too long. When the first probe reaches another galaxy mankind is probably already gone or we are back in post war dark ages.
> space travel takes still far too long.
Who cares about humans, as a traveling satellite i will have all the time in the universe, literally
Who cares about humans, as a traveling satellite i will have all the time in the universe, literally
And then? What the purpose of a conscience at a faraway planet?
Something like
We Are Legion (We Are Bob)?
whats the purpose of conscience in this planet? purpose is not necessary, though one could say discovery is a purpose, boldly go where no man has gone before
I wonder if people will view it as sufficient that a digital copy of 'them' (or at least something identical to them at the point of copying) exists, despite their original biological minds eventually perishing.
It excites me to think about discovering the origin of our consciousness and being able to transfer that.
It excites me to think about discovering the origin of our consciousness and being able to transfer that.
I definitely want to believe. Then we can explore other galaxies.
But I still can't even imagine what consciousness is.
Maybe we'll create new intelligences, punt on the consciousness question, and delegate the task to them.
But I still can't even imagine what consciousness is.
Maybe we'll create new intelligences, punt on the consciousness question, and delegate the task to them.
Ya, that'd suck. But consider. Tardigrades are pretty tough. And elephants have x10 more cancer fighting genes than us apes.
Pretty soon, parents will be picking their kid's eye color and temperament. For better or worse. Surely future humans will become a great deal hardier than ourselves.
Pretty soon, parents will be picking their kid's eye color and temperament. For better or worse. Surely future humans will become a great deal hardier than ourselves.
Genetics is complex and we don't even can handle complexity in computer programs.
Maybe we can choose eye color, but temperament? Far too complex, far too many possible side effects.
Just look what happened of the dream that AI could help with Corona
https://www.technologyreview.com/2021/07/30/1030329/machine-...
Maybe we can choose eye color, but temperament? Far too complex, far too many possible side effects.
Just look what happened of the dream that AI could help with Corona
https://www.technologyreview.com/2021/07/30/1030329/machine-...
> Surely future humans will become a great deal hardier than ourselves.
It is currently trending in the other direction.
It is currently trending in the other direction.
Sometimes I find it a little depressing that (at least through my laymen eyes) we are nearing a technological plateau and that more research into physics is unlikely to get us to a world describe in traditional science fiction with FTL drives and large metal spaceships that can take you from planet to planet.
FTL drive is not needed; people think too small.
FTL drive is not needed; people think too small.
That's absolutely true, but I wonder what it will take to take that point home for everybody.
The first big project. After that there will be movies explanations stories expectations all that stuff. And to some degree it's already out there. We have those things now related to travel that's not faster than light.
And tell somebody put something together for real, FPL is just a whole lot more sexy.
And tell somebody put something together for real, FPL is just a whole lot more sexy.
I've read a couple scifi stories about sophisticated alien civilizations with FTL drives who were then shocked when they found out humans were just folding space and had instantaneous travel. HFY! Obviously it's fiction, and who knows if it'll ever happen or if it's possible - but my point is that we don't know what we don't know, and it could be way cooler than we can even imagine.
As a counter point, here is Chamath talking about the advent of room temperature superconductors in 20 to 30 years
https://streamable.com/ku3orn
https://streamable.com/ku3orn
We haven't even developed normal pressure room temperature superconductivity, let alone mass manufacture.
Also, why should I privilege what Chamath has to say on this subject more than any random commentator?
Also, why should I privilege what Chamath has to say on this subject more than any random commentator?
"we are nearing a technological plateau"
Well, using that analogy, I would say, it took us indeed great efforts to reach it, but now we have vast land to colonize - meaning applying all that groundbreaking research into everything. There are so many more technologies avaiable, than just what you can buy on the market.
Sci-Fi is very possible.
edit: oh and about FTL:
I know I do not really understand quantum physics and co. but I think I understand, that no one really understands it yet - so I do not expect FTL in my lifetime, but I would not rule it out.
Well, using that analogy, I would say, it took us indeed great efforts to reach it, but now we have vast land to colonize - meaning applying all that groundbreaking research into everything. There are so many more technologies avaiable, than just what you can buy on the market.
Sci-Fi is very possible.
edit: oh and about FTL:
I know I do not really understand quantum physics and co. but I think I understand, that no one really understands it yet - so I do not expect FTL in my lifetime, but I would not rule it out.
Disagree that we are reaching a technical plateau at all. Maybe in some parts of particle and AMO physics, but cosmology continues to advance and we are continuing to learn a lot.
Don't be. Science usually hours plateaus but if we've learned anything from history is that there's always mountains ahead. The problem is we're searching on the dark. A flat spot doesn't mean we're at the top. In fact, we even know there's a lot of mountains ahead, we just aren't sure how to climb them yet or what we'll find along the way. But that's no reason not to climb them.
It might help if we had literature fleshing out some ideas of how alternatives could work. Ie how we could become a species more in harmony with a large biosphere - ala Jim Henson’s Dark Crystal. Though it’d have to be a human way of life.
> a species more in harmony with a large biosphere
Garden Earth.
The biggest cultural change for attaining "sustainability" is metaphoric, from extraction to management. Maybe somewhat ironically, proponents should go all Old Testament. Stewards of the Earth and so forth.
Many of our prior cultures had at least some form of this. I don't know when or why we stopped being so. Maybe due to the Enlightenment and then Industrialization.
I vividly remember reading René Descartes as a kid and being shocked by his violent language and metaphors. Stuff like "We must wrest Nature's secrets and make her submit to our will" (paraphrasing, from memory).
Garden Earth.
The biggest cultural change for attaining "sustainability" is metaphoric, from extraction to management. Maybe somewhat ironically, proponents should go all Old Testament. Stewards of the Earth and so forth.
Many of our prior cultures had at least some form of this. I don't know when or why we stopped being so. Maybe due to the Enlightenment and then Industrialization.
I vividly remember reading René Descartes as a kid and being shocked by his violent language and metaphors. Stuff like "We must wrest Nature's secrets and make her submit to our will" (paraphrasing, from memory).
I don't agree.
There is so much to learn about the world around us without even hitting physics limits.
And then so much to do with that knowledge.
I am not worried we will run out of problems to solve.
There is so much to learn about the world around us without even hitting physics limits.
And then so much to do with that knowledge.
I am not worried we will run out of problems to solve.
If we can get good enough at bioengineering, a 50,000 year flight to another star using conventional propulsion might not be such a big deal.
The seeming requirement of FTL to explore the universe is 100% a function of our short life span. If we can't make spacecraft go faster we have to make ourselves last longer.
The seeming requirement of FTL to explore the universe is 100% a function of our short life span. If we can't make spacecraft go faster we have to make ourselves last longer.
We'll also have to take food for the whole duration, or develop a taste for hydrogen atoms alongside a functioning Bussard ramjet.
Oh, the rocket equation really doesn't like option 1.
(Hypothesis: any process we can devise to turn hydrogen into sustenance will be orders of magnitude less efficient than using it as propellant.)
Oh, the rocket equation really doesn't like option 1.
(Hypothesis: any process we can devise to turn hydrogen into sustenance will be orders of magnitude less efficient than using it as propellant.)
Food can be recycled pretty effectively, and if were that good at biotech I assume we could improve on the current state of the art.
They already recycle water very effectively on the ISS. It's the machine that "turns yesterday's coffee into today's coffee."
Of course if we were that good at biotech we could probably hibernate a good chunk of the flight time too. Might be necessary to wake up periodically to reset the body, but you could probably hibernate most of the duration. Maybe you'd do it with some kind of weird circadian cycle with extremely elongated sleep periods, sleeping like 10X-100X as long as you are awake. During each wake period you check to make sure everything is working properly.
You would not need a Bussard ramjet for the long duration flights I'm thinking of. A nuclear thermal rocket could get you a good deal past solar system escape velocity. Nuclear pulse propulsion could get you up to at least single digit percentages of the speed of light if you didn't mind a little boom-boom. Then you just cruse along on an interstellar transfer orbit until you do a retro-burn to enter the destination star system a few tens of thousands of years later. These are all technologies that are already feasible at least on paper. No new physics is needed.
They already recycle water very effectively on the ISS. It's the machine that "turns yesterday's coffee into today's coffee."
Of course if we were that good at biotech we could probably hibernate a good chunk of the flight time too. Might be necessary to wake up periodically to reset the body, but you could probably hibernate most of the duration. Maybe you'd do it with some kind of weird circadian cycle with extremely elongated sleep periods, sleeping like 10X-100X as long as you are awake. During each wake period you check to make sure everything is working properly.
You would not need a Bussard ramjet for the long duration flights I'm thinking of. A nuclear thermal rocket could get you a good deal past solar system escape velocity. Nuclear pulse propulsion could get you up to at least single digit percentages of the speed of light if you didn't mind a little boom-boom. Then you just cruse along on an interstellar transfer orbit until you do a retro-burn to enter the destination star system a few tens of thousands of years later. These are all technologies that are already feasible at least on paper. No new physics is needed.
We would only small amounts of food, if we could efficiently recycle it. Right now, we use plants/animals and solar energy to upcycle our waste products into food. However, there are no physical reasons that we couldn’t use electricity and managed bioreactors to do that instead.
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Great video! If you wonder, how we know things look like this, here is a talk about it: 34C3 - Free Electron Lasers
https://www.youtube.com/watch?v=RKqof77pKBc
https://www.youtube.com/watch?v=RKqof77pKBc
That was awesome. What a great presenter. Thanks
That is a fantastic video. Also, omg biochemistry is just staggeringly amazing. Whilst that video is short, the information it contains is just staggering when you think of the years and years of research that's been done on that virus.
Good luck to Moderna.
Good luck to Moderna.
That video is just insane. The way the HIV virus completely hacks the T-cell to become a factory seems akin to a very complicated computer hack. It would be elegant if it weren't so deadly.
Natural selection is a very powerful process.
* given enough time
when executed over millions of years
In practice this is what we observe, but the combinatorics are so ridiculously large that its hard to understand how it works. A very small protein of say 200 amino acid residues has 21^200 configurations. If every atom in the universe was another universe, and every atom in those universes was a universe, you'd still need 10^20 grandpappy universes to represent each configuration as a distinct atom in the grandchild universe. Given that these configurations confer meaningful chemical and mechanical utility, sometimes with discontinuities in effect, it's really odd to me that it all somehow works.
Much shorter time frames than that are still powerful, especially for something like a virus.
>To me it's absolutely mind-blowing to think that this entire process developed on its own, in dark,
Richard Dawkins has a very good explanation for this in The Blind Watchmaker.
>and is mindlessly progressing along so effectively that despite all of our technological capability we can barely contain it.
There's technological capability and America's punishment fetish because people who get aids "deserve it". If we really wanted to, we would have had one.
Richard Dawkins has a very good explanation for this in The Blind Watchmaker.
>and is mindlessly progressing along so effectively that despite all of our technological capability we can barely contain it.
There's technological capability and America's punishment fetish because people who get aids "deserve it". If we really wanted to, we would have had one.
I haven't read the book. Can you please summarize Richard Dawkins's explanation? I am quite curious how something this complex can be generated by nature.
>and is mindlessly progressing along so effectively that despite all of our technological capability we can barely contain it.
In theory we already have the technology to eliminate HIV. People taking PrEP have a >99% reduced chance to catch HIV. The drugs used to treat HIV can reduce viral levels in HIV+ people to the point that it's impossible for them to transmit it.
In theory we already have the technology to eliminate HIV. People taking PrEP have a >99% reduced chance to catch HIV. The drugs used to treat HIV can reduce viral levels in HIV+ people to the point that it's impossible for them to transmit it.
If only we had a Project Warpspeed for AIDS.
Caused by the initial shock of AIDS, and ongoing activism, there has been consistent funding from federal and various private sources in development. Thanks to these efforts, antiretrovirals are widely available, making AIDS a "solved" problem in the sense that you can prevent AIDS onset indefinitely with the right medication.
Right now, the problem is more about actually accessing the people who might have HIV, getting them to test themselves regularly, and then giving them access to HIV medication if they are positive. Often these people are on the fringes of society. A vaccine would be an ideal tool to reach these people than asking them to get tested regularly.
HIV is a way harder virus to develop a vaccine for than SARS-CoV-2. For starters, once you have it, HIV is way more dangerous. Most people with covid don't need medical attention at all, they can deal with it themselves. Meanwhile, someone infected with HIV is basically sentenced to death in a couple of years if they aren't medicated (>90% mortality rate). The current covid pandemic is so severe because covid spreads so much better than HIV does. Our immune system can't really deal with HIV in a way that we survive the encounter. With SARS-CoV-2 you only need to slightly nudge the immune system into the right direction. That's a way easier task.
HIV also has an immensely large mutation rate. The genetic diversity in a single individual is larger than the genetic diversity of one entire yearly influenza outbreak. So you need to come up with defenses that help against a gigantic set of HIV viruses. We still need to vaccinate people yearly with an influenza shot, because we can't create universal influenza vaccines yet. It's an open problem similar to how a HIV vaccine is an open problem.
TLDR: There is already something like warp speed for HIV, but we were mostly lucky that it was so easy to come up with a covid vaccine.
Right now, the problem is more about actually accessing the people who might have HIV, getting them to test themselves regularly, and then giving them access to HIV medication if they are positive. Often these people are on the fringes of society. A vaccine would be an ideal tool to reach these people than asking them to get tested regularly.
HIV is a way harder virus to develop a vaccine for than SARS-CoV-2. For starters, once you have it, HIV is way more dangerous. Most people with covid don't need medical attention at all, they can deal with it themselves. Meanwhile, someone infected with HIV is basically sentenced to death in a couple of years if they aren't medicated (>90% mortality rate). The current covid pandemic is so severe because covid spreads so much better than HIV does. Our immune system can't really deal with HIV in a way that we survive the encounter. With SARS-CoV-2 you only need to slightly nudge the immune system into the right direction. That's a way easier task.
HIV also has an immensely large mutation rate. The genetic diversity in a single individual is larger than the genetic diversity of one entire yearly influenza outbreak. So you need to come up with defenses that help against a gigantic set of HIV viruses. We still need to vaccinate people yearly with an influenza shot, because we can't create universal influenza vaccines yet. It's an open problem similar to how a HIV vaccine is an open problem.
TLDR: There is already something like warp speed for HIV, but we were mostly lucky that it was so easy to come up with a covid vaccine.
apparently HAART sort of ages people's organs, according to patients' testimonials. that's better than dying of AIDS but still not ideal.
also, doesn't your immune system lose like 30% of its T-cells after you seroconvert, but prior to developing AIDS? iirc that's why HIV+ people are considered immunocompromised regardless of viral load.
also, doesn't your immune system lose like 30% of its T-cells after you seroconvert, but prior to developing AIDS? iirc that's why HIV+ people are considered immunocompromised regardless of viral load.
Yeah, HAART is not side effect free, but one has come a long way from the initial retrovirals which had way more severe side effects.
As for the CD4+ T cells, you are right that their numbers decrease before it's called AIDS. In some individuals the counts can successfully recover to "normal" levels. According to studies, it depends on how early you start treatment.
https://www.aidsmap.com/news/dec-2018/cd4-count-recovery-fre...
https://www.nature.com/articles/mi201558
As for the CD4+ T cells, you are right that their numbers decrease before it's called AIDS. In some individuals the counts can successfully recover to "normal" levels. According to studies, it depends on how early you start treatment.
https://www.aidsmap.com/news/dec-2018/cd4-count-recovery-fre...
https://www.nature.com/articles/mi201558
The history of HIV research has had a lot of valiant work. We have had several vaccine attempts in the past, that have all been unsuccessful.
And despite President-level dismissal of HIV/AIDS at the time, significant resources were devoted to it in the 80s, such that even though we didn't make huge progress against HIV at the time, the research on HIV progressed the rest of the field.
And a lot of our anti-viral drugs have come out of HIV research as well.
A modern Project Warpspeed probably wouldn't be quite as successful as a Covid19 Warpspeed, because a lot of the first ideas have already been attempted. But with the new sorts of designs that mRNA vaccines allow, there's a lot more that's possible now.
And despite President-level dismissal of HIV/AIDS at the time, significant resources were devoted to it in the 80s, such that even though we didn't make huge progress against HIV at the time, the research on HIV progressed the rest of the field.
And a lot of our anti-viral drugs have come out of HIV research as well.
A modern Project Warpspeed probably wouldn't be quite as successful as a Covid19 Warpspeed, because a lot of the first ideas have already been attempted. But with the new sorts of designs that mRNA vaccines allow, there's a lot more that's possible now.
Most in congress didn’t think they would be impacted by AIDS.
Most won't be. HIV spreads by things that most in congress are unlikely to take part in. (sharing needles). While there are a lot of sex scandals in congress, the form of those activities is mostly low risk (low odds that the partner has HIV, and sex in a form that makes spread unlikely).
Of course the above is about odds. Individual exceptions do not prove me wrong.
That doesn't mean HIV isn't horrible. It also doesn't mean congress is right for the right reasons.
Of course the above is about odds. Individual exceptions do not prove me wrong.
That doesn't mean HIV isn't horrible. It also doesn't mean congress is right for the right reasons.
Congress depends on the blood supply more than average, but the risk to the blood supply was largely ignored because AIDS was supposed to be a homosexual/drug user disease in their minds.
I was shocked to learn that Isaac Asimov died from complications of AIDS acquired via transfusion, but his doctors insisted on keeping it a secret from the public.
For the most part our blood supply has good protection for blood born illness (between rules that prevent the high risk from donating and testing). That wasn't always the case. It is best to keep the mistakes of the past un talked about so that we don't spread fear of the blood supply which would kill far more people.
And until Congress changed parties in 2021, most didn’t think they’d be impacted by COVID.
That’s what they said, but I want to know their vaccination records.
Is HIV uniquely sophisticated, or are there other viruses out in the wild like this?
It makes you question the way we call animals / humans 'complex' life when you see how insanely intricate what happens on such a tiny scale even in something as small as a virus.
We are then "more complex": we contain multitudes, some of which (gut bacteria, mitochondria, gametes) look like entirely separate life forms of their own.
I guess we're many, many orders of magnitude more complex.
I just think it's wrong to call tiny 'simple' life, just because we are so insanely complex.
I just think it's wrong to call tiny 'simple' life, just because we are so insanely complex.
Good luck finding anything that still seems "simple" when you really look towards understanding how it works rather than what it results in. Simple and complex always have to be relative to other things as nothing is absolutely "simple" e.g. even a single atom is an extraordinarily complicated environment which spans many textbooks and degrees worth of interactions and understandings. To say everything is just complex to more super duper extra complex is to just replace the sound of "simple" with the sound of "complex" yet have it mean the exact same thing and use it in the exact same way.
? Animals contain millions of similarly complex processes within them, that is what makes them 'complex' compared to a simple virus.
For some reason, it reminds me of the passion flower: https://i.imgur.com/Efy2Iq4.png
Trigger warning: Trypophobia
The graveyard of HIV vaccines that failed at Phase II is unfortunately large, and this isn't even there yet. I won't be holding my breath on this one. HIV is tricky.
I came here to say make this (lonely) comment. HIV and CoV are very different viruses. Different pathogenesis, different tropism, different social drivers for transmission...
mRNA technology did well in 2020, but it was a very well-funded technology in clinical development for ~10 years before SARS-CoV2 arrived. HIV and Cancer are not low-hanging fruit. I wish them the best, as I hate both those diseases, but I'm not aware that there is anything in the technology that uniquely provides a solution to the problem.
from what I've read, it's not really mRNA that gives Moderna any advantage, as much as being able to raise broadly-neutralizing antibodies (BNAbs) against HIV membrane protein.
but.. it's still not a polyvalent vaccine, it's only targeting one such highly-conserved region, and there's HIV out there that evades BNAbs (5% of HIV+ patients have BNAbs after all, and they eventually progress.. though maybe after changing tropism or something.)
so it may not be all that effective as a strategy, but there's at least some monkey data suggesting it delays or sometimes prevents infection.
More info here: https://www.aidsmap.com/news/mar-2020/hiv-vaccine-generates-...
but.. it's still not a polyvalent vaccine, it's only targeting one such highly-conserved region, and there's HIV out there that evades BNAbs (5% of HIV+ patients have BNAbs after all, and they eventually progress.. though maybe after changing tropism or something.)
so it may not be all that effective as a strategy, but there's at least some monkey data suggesting it delays or sometimes prevents infection.
More info here: https://www.aidsmap.com/news/mar-2020/hiv-vaccine-generates-...
Would this be recommended for anybody sexually active? Or just for people in higher risk like someone with a partner that has HIV or if you're homosexual?
These aren't really the questions to be asked when they just started with a first trial.
If it's 99% effective and has close to zero sideeffects that's very different from 60% effective and significant sideeffects. In both cases there are probably some people you'd recommend it to, but in the first case you may just recommend it to everyone, in the second case probably not.
If it's 99% effective and has close to zero sideeffects that's very different from 60% effective and significant sideeffects. In both cases there are probably some people you'd recommend it to, but in the first case you may just recommend it to everyone, in the second case probably not.
Given that it requires sexual contact to contract, I bet we could vaccinate a small portion of high risk people and effectively eradicate the disease entirely, without ever needing to vaccinate everyone.
> vaccinate a small portion of high risk people and effectively eradicate the disease
You could remove it as an endemic disease in the US and Europe. In places like South Africa where a third of the population is infected, nothing less that a blanket vaccination campaign would work.
(And of course it is not easy to find out who the high risk people are when both HIV and sexual promiscuity are stigmatised, so you might need to vaccinate everyone anyway to avoid costly errors...)
You could remove it as an endemic disease in the US and Europe. In places like South Africa where a third of the population is infected, nothing less that a blanket vaccination campaign would work.
(And of course it is not easy to find out who the high risk people are when both HIV and sexual promiscuity are stigmatised, so you might need to vaccinate everyone anyway to avoid costly errors...)
Too bad it doesn't require sexual contact to contract.
You mean HIV? Yeah, you can get it from fluid-to-blood contact, accidentally getting yourself with a needle, or someone trying to use a contaminated needle as a bio-weapon. Microscopic cuts under your fingernails are important, so you should wear gloves for sure.
I think it will be rolled out to those most at risk at first, including those who are already infected.
This may actually reduce the HIV infection rate to a large degree. Or people don't take the effing vaccine despite the benefits. Then yes, probably anybody sexually active should get it.
This may actually reduce the HIV infection rate to a large degree. Or people don't take the effing vaccine despite the benefits. Then yes, probably anybody sexually active should get it.
> probably anybody sexually active should get it.
Agree - if we can get rid of HIV we should. I looked at the exclusion criteria in the trial and it didn't mention use of a prophylactic. Widely available prophylactics have been a huge success with preventing HIV, I wonder how that will impact the trial.
https://clinicaltrials.gov/ct2/show/NCT05001373
Agree - if we can get rid of HIV we should. I looked at the exclusion criteria in the trial and it didn't mention use of a prophylactic. Widely available prophylactics have been a huge success with preventing HIV, I wonder how that will impact the trial.
https://clinicaltrials.gov/ct2/show/NCT05001373
No, the point is that you could probably extinguish HIV with a very low vaccination rate - if the vaccination rate in the at-risk population is high enough.
"Anybody taking the vaccine" (not "everybody") will actually not eradicate the virus, but rather protect those who take the vaccine. Much like now with Covid.
"Anybody taking the vaccine" (not "everybody") will actually not eradicate the virus, but rather protect those who take the vaccine. Much like now with Covid.
The prophylactics should not affect clinical trials a lot. Obviously the organizers need to track who also takes prophylactics. It would be unethical to only enroll participants (especially those at higher risk) who don't take prophylactics because they could get the placebo and then they have zero protection.
Everything else is just a question of the statistical signal detection. Those Studies are planned and designed to provide such a signal, with all we know about HIV prevalence (which is already quite low, in most industrial countries, speaking statistically and for the overall population) and the effectiveness of prophylactic treatment.
Also what I'm hearing the prophylactic treatment is not much fun either... I rather see the danger of participants getting the placebo, drop the prophylactics and think they are protected...
Everything else is just a question of the statistical signal detection. Those Studies are planned and designed to provide such a signal, with all we know about HIV prevalence (which is already quite low, in most industrial countries, speaking statistically and for the overall population) and the effectiveness of prophylactic treatment.
Also what I'm hearing the prophylactic treatment is not much fun either... I rather see the danger of participants getting the placebo, drop the prophylactics and think they are protected...
It's tricky, because between condoms, PREP and PEP (pre- and post-exposure drugs) and treatments now being good enough that life expectancy with HIV is nearly the same as without, it'd take very low risks of side effects before giving it to everyone would cause more harm than not giving it.
So the safety profile will be hugely important in determining how widely to use it.
So the safety profile will be hugely important in determining how widely to use it.
What is the market price for such treatments?
At moment there is PrEP for that case.
https://www.cdc.gov/hiv/basics/prep.html
I think the idea in long term would, should be to replace PrEP.
https://www.cdc.gov/hiv/basics/prep.html
I think the idea in long term would, should be to replace PrEP.
They will want you to take both the vaccine and PrEP, because (surprise!) the vaccine will not be 100% effective.
No vaccine is 100% effective. No medicine seems to be 100% effective either. This is a known issue, and it always has been. Good thing we don't need it to be to eradicate an illness.
It won't be necessary for most folks to take both, though, that's just not how things work.
It won't be necessary for most folks to take both, though, that's just not how things work.
Let’s wait for the results before we decide what they mean
I think marketingwise the vaccine will have a very, very hard time against PrEP, unless it can be proven that it's just as effective. And what about booster shots? It would be highly unethical to give someone an experimental vaccine INSTEAD of just PrEP. But if we don't do that, we can never find out how good the vaccine works. A dilemma.
> I think marketingwise the vaccine will have a very, very hard time against PrEP
Probably not. PrEP has some nasty side effects. Those who take it need to get their organ function checked every few months (I think just kidneys?).
Of course this vaccine is just entering trials. We have no idea how effective it is, or what the side effects might be. As such we can only guess and hope that it is better than PrEP - though that is a somewhat low bar.
Probably not. PrEP has some nasty side effects. Those who take it need to get their organ function checked every few months (I think just kidneys?).
Of course this vaccine is just entering trials. We have no idea how effective it is, or what the side effects might be. As such we can only guess and hope that it is better than PrEP - though that is a somewhat low bar.
To be clear, Truvada (or Descovy) for vast majority of people will have essentially no side effects. There is a small increase in chance of kidney disease, mainly for those with other risk factors, the risk profile is similar to over the counter ibuprofen.
"HIV-positive individuals who use Truvada to control their infection are more likely to experience kidney damage and bone density loss than those who take it to prevent HIV infection, as so-called pre-exposure prophylaxis (PrEP)[2]. But “no significant health effects have been seen in people who are HIV-negative and have taken PrEP for up to 5 years,” according to the U.S. Department of Health and Human Services. Numerous studies have shown that the risk of HIV-negative Truvada users developing kidney disease is not statistically significantly different from those taking placebo[3]."
https://healthfeedback.org/claimreview/hiv-drug-truvada-link...
"HIV-positive individuals who use Truvada to control their infection are more likely to experience kidney damage and bone density loss than those who take it to prevent HIV infection, as so-called pre-exposure prophylaxis (PrEP)[2]. But “no significant health effects have been seen in people who are HIV-negative and have taken PrEP for up to 5 years,” according to the U.S. Department of Health and Human Services. Numerous studies have shown that the risk of HIV-negative Truvada users developing kidney disease is not statistically significantly different from those taking placebo[3]."
https://healthfeedback.org/claimreview/hiv-drug-truvada-link...
> PrEP has some nasty side effects. Those who take it need to get their organ function checked every few months (I think just kidneys?).
Please don’t spread this FUD. The side effects are rare and reversible by stopping the medicine. The checks are also required to check for other STIs.
Please don’t spread this FUD. The side effects are rare and reversible by stopping the medicine. The checks are also required to check for other STIs.
That doesn't mean they are not nasty or don't need be checked for. Better than HIV/AIDS for sure, but common enough that a vaccine could be better.
Take a pill every day vs. get a vaccine every few years? I don't think the vaccine will have a marketing problem.
I think the first guys who tryed PrEP had to have also big balls to play with the fire.
The price for PrEP is also very different from country to country. In some countrys it's almost for free, in some others is very, very expensive.
The price for PrEP is also very different from country to country. In some countrys it's almost for free, in some others is very, very expensive.
I hope it's cheap enough to deploy large volumes to Africa. Desperately needed there.
Unpopular opinion but Africa also desperately needs to fix the root cause of its HIV spread. Maybe this vaccine would give some relief and give them a chance to start over, but if there is a rampant culture of rape/unprotected sex with many partners the same region will just get ravaged by the next STD and stick them back in the same rut.
Yikes. This is actually a field that I do research in, and this analysis just really, really doesn't hold water. Of course there are sociological contributors to the spread of HIV on the African continent. But the idea that there's a "culture of rape" is pretty far off base, if only because Africa is an incredibly diverse continent so there's not a shared culture of pretty much anything. For a much more accurate look at the development of the AIDS pandemic in Africa, I recommend Jacques Pépin, The Origin of AIDS.
Yeah, I probably could have phrased my original comment better. I didn't mean to imply the areas in Africa with HIV issues have a culture of rape. I said "if there is a rampant culture of rape/unprotected sex with many partners the same region will just get ravaged by the next STD and stick them back in the same rut." (emphasis added).
My point being, if we have a magic pill that cures them of a given STD, but there are underlying cultural problems that contribute to elevated STD transmission (such as unprotected sex or rape), etc., then the magic pill is only a bandaid that doesn't address the underlying elevated STD transmission problem.
As a sibling comment stated, maybe the problem is that these Africans believe homeopathic cures like special tea leaves will protect them from HIV when in reality they are just all having unprotected sex, so it's both a cultural and educational issue.
My point being, if we have a magic pill that cures them of a given STD, but there are underlying cultural problems that contribute to elevated STD transmission (such as unprotected sex or rape), etc., then the magic pill is only a bandaid that doesn't address the underlying elevated STD transmission problem.
As a sibling comment stated, maybe the problem is that these Africans believe homeopathic cures like special tea leaves will protect them from HIV when in reality they are just all having unprotected sex, so it's both a cultural and educational issue.
Double yikes to "these Africans." Pretty sure misplaced belief in homeopathy is not a distinctively African phenomenon.
But to the point: the major driver of the early explosion of HIV on the continent was almost certainly large-scale vaccination and medical treatment campaigns by colonial governments, which injected staggering numbers of people in rural areas without adequate disinfection of needles.
In the present, the sociological drivers of HIV spread do include rates of nonconsensual sex (particularly between teen girls and older men). More important factors, however, are historical and contemporary patterns of urban/rural migration and long-distance transit networks. The distinctive forms of cyclical migration created by the shape of the mining industry in apartheid South Africa are the largest reason that the pandemic is so much worse in that region than anywhere else on the continent.
Research is pretty clear that Africans understand that condoms work to prevent HIV transmission - there have now been decades of public education campaigns on the subject. That doesn't mean they are always used, of course, but it's not a knowledge problem.
But to the point: the major driver of the early explosion of HIV on the continent was almost certainly large-scale vaccination and medical treatment campaigns by colonial governments, which injected staggering numbers of people in rural areas without adequate disinfection of needles.
In the present, the sociological drivers of HIV spread do include rates of nonconsensual sex (particularly between teen girls and older men). More important factors, however, are historical and contemporary patterns of urban/rural migration and long-distance transit networks. The distinctive forms of cyclical migration created by the shape of the mining industry in apartheid South Africa are the largest reason that the pandemic is so much worse in that region than anywhere else on the continent.
Research is pretty clear that Africans understand that condoms work to prevent HIV transmission - there have now been decades of public education campaigns on the subject. That doesn't mean they are always used, of course, but it's not a knowledge problem.
>But to the point: the major driver of the early explosion of HIV on the continent was almost certainly large-scale vaccination and medical treatment campaigns by colonial governments, which injected staggering numbers of people in rural areas without adequate disinfection of needles.
Colonial governments were mostly out of Africa after the 1960s.
>In the present, the sociological drivers of HIV spread do include rates of nonconsensual sex (particularly between teen girls and older men). More important factors, however, are historical and contemporary patterns of urban/rural migration and long-distance transit networks. The distinctive forms of cyclical migration created by the shape of the mining industry in apartheid South Africa are the largest reason that the pandemic is so much worse in that region than anywhere else on the continent.
That's being very disingenuous. What makes periodic migration by miners in South Africa different from large-scale worker migrations elsewhere in the world? Mexican farm workers to the US, half of China, or for that matter Canadian, Russian, and Australian miners, or oil-rig workers everywhere. It's not so much the migration patterns, but what the migrants do (or don't do) when "back home".
Colonial governments were mostly out of Africa after the 1960s.
>In the present, the sociological drivers of HIV spread do include rates of nonconsensual sex (particularly between teen girls and older men). More important factors, however, are historical and contemporary patterns of urban/rural migration and long-distance transit networks. The distinctive forms of cyclical migration created by the shape of the mining industry in apartheid South Africa are the largest reason that the pandemic is so much worse in that region than anywhere else on the continent.
That's being very disingenuous. What makes periodic migration by miners in South Africa different from large-scale worker migrations elsewhere in the world? Mexican farm workers to the US, half of China, or for that matter Canadian, Russian, and Australian miners, or oil-rig workers everywhere. It's not so much the migration patterns, but what the migrants do (or don't do) when "back home".
> Colonial governments were mostly out of Africa after the 1960s.
HIV was probably spreading in the Belgian Congo in the 1920s. It likely spread to the US in the 60s. It takes a decade for HIV to turn into AIDS, which is why we think of the pandemic as starting in the 80s.
HIV was probably spreading in the Belgian Congo in the 1920s. It likely spread to the US in the 60s. It takes a decade for HIV to turn into AIDS, which is why we think of the pandemic as starting in the 80s.
> It takes a decade for HIV to turn into AIDS
The median time is a little longer than that, but the range goes down to less than a year. We think about it as starting in the 1980s because that's when the diverse manifestations were recognized as a common syndrome, not because that's when symptoms first appeared in the US (in fact, there is a case retroactively identified as a death from full-blown AIDS in the US in 1969.)
The median time is a little longer than that, but the range goes down to less than a year. We think about it as starting in the 1980s because that's when the diverse manifestations were recognized as a common syndrome, not because that's when symptoms first appeared in the US (in fact, there is a case retroactively identified as a death from full-blown AIDS in the US in 1969.)
I don't think it's particularly helpful to "yikes" everything, because I'm not intending to offend, be racist, etc.
I admit I am not an expert. I formed an opinion after scanning the official wiki on the topic (https://en.wikipedia.org/wiki/HIV/AIDS_in_Africa) which says things like: "High-risk behavioral patterns are largely responsible for the significantly greater spread of HIV/AIDS in Sub-Saharan Africa than in other parts of the world. Chief among these are the traditionally liberal attitudes espoused by many communities inhabiting the subcontinent toward multiple sexual partners and pre-marital and outside marriage sexual activity." and don't mention anything about migration patterns being the more important factors.
So if this is actually your field of study, it would be helpful if the wikipedia article were updated with the latest research.
I admit I am not an expert. I formed an opinion after scanning the official wiki on the topic (https://en.wikipedia.org/wiki/HIV/AIDS_in_Africa) which says things like: "High-risk behavioral patterns are largely responsible for the significantly greater spread of HIV/AIDS in Sub-Saharan Africa than in other parts of the world. Chief among these are the traditionally liberal attitudes espoused by many communities inhabiting the subcontinent toward multiple sexual partners and pre-marital and outside marriage sexual activity." and don't mention anything about migration patterns being the more important factors.
So if this is actually your field of study, it would be helpful if the wikipedia article were updated with the latest research.
It's okay, everyone expresses an ignorant opinion at some point. We aren't born knowing everything and we have to keep learning as the world changes. What's important is that we recognize that we can put a foot in our mouth and offend people without knowing it. But, it's important to accept and digest feedback. The feedback can be bad or good but it should at least be considered, and hearing "yikes" is pretty mild all things considered.
That said, I really think you should reflect on how much research you did (read a wikipedia page) before stating that Africa's high HIV rates compared to the rest of the world are due to "a culture of rape/unprotected sex" or quack-medicine. (Also, I don't see "rape" anywhere on the wiki article you linked.)
That said, I really think you should reflect on how much research you did (read a wikipedia page) before stating that Africa's high HIV rates compared to the rest of the world are due to "a culture of rape/unprotected sex" or quack-medicine. (Also, I don't see "rape" anywhere on the wiki article you linked.)
> That said, I really think you should reflect on how much research you did (read a wikipedia page) before stating that Africa's high HIV rates compared to the rest of the world are due to "a culture of rape/unprotected sex" or quack-medicine.
I never stated those things authoritatively. I threw them out as potential example factors because those were things I saw during my brief wikipedia foray.
> (Also, I don't see "rape" anywhere on the wiki article you linked.)
Yeah because it wasn't on that page but a related page:
https://en.wikipedia.org/wiki/Virgin_cleansing_myth
I never stated those things authoritatively. I threw them out as potential example factors because those were things I saw during my brief wikipedia foray.
> (Also, I don't see "rape" anywhere on the wiki article you linked.)
Yeah because it wasn't on that page but a related page:
https://en.wikipedia.org/wiki/Virgin_cleansing_myth
> But to the point: the major driver of the early explosion of HIV on the continent was almost certainly large-scale vaccination and medical treatment campaigns by colonial governments, which injected staggering numbers of people in rural areas without adequate disinfection of needles.
Do you have a citation for that? I’ve never seen it authoritatively claimed and “almost certainly” seems strong for something which isn’t at the standards for inclusion on the Wikipedia page.
Do you have a citation for that? I’ve never seen it authoritatively claimed and “almost certainly” seems strong for something which isn’t at the standards for inclusion on the Wikipedia page.
Unsterile needles are included on this wiki page https://en.wikipedia.org/wiki/History_of_HIV/AIDS#Emergence
Is there not an issue of “dry sex”, where men prefer unlubricated partners which without protection can contribute to a greater likelihood of transmission?
I think a bigger issue that would need to be addressed is the distrust of Western medicine, the beliefs that they know how to prevent HIV, that HIV was caused by the West in order to kill them, and the belief that they already know the cure of HIV.
There are parallels between the disinformation in the anti-vax Covid community, and the disinformation in regards HIV in Africa.
There are parallels between the disinformation in the anti-vax Covid community, and the disinformation in regards HIV in Africa.
Additionally, unless you can convince the majority in Africa to take the vaccine, partial vaccine deployment would put a evolutionary pressure on the virus to evade the vaccine and re-infect the world with a resistant strain.
This happened in Papua New Guinea with polio. I listened to a podcast about it: https://www.bbc.co.uk/programmes/w3ct2g6d
> or if you're homosexual?
HIV transmission is related to sexual activity not sexual orientation. Being in an open relationship, cheating on your partner, performing unprotected sex, are all examples of behaviors that put people at "higher risk". Being attracted to your own gender does not.
HIV transmission is related to sexual activity not sexual orientation. Being in an open relationship, cheating on your partner, performing unprotected sex, are all examples of behaviors that put people at "higher risk". Being attracted to your own gender does not.
HIV transmission is 18 times more likely with receptive anal sex than with receptive vaginal sex and 69% of the HIV positive people in the USA are active gay men.
So yes, being a homosexual man is a huge risk factor and probably more significant than being in an open relationship, cheating on your partner or performing unprotected sex unless you live in Sub-Saharan Africa.
So yes, being a homosexual man is a huge risk factor and probably more significant than being in an open relationship, cheating on your partner or performing unprotected sex unless you live in Sub-Saharan Africa.
The risk factor in the US is "man who has sex with men", not "gay man". Factors can combine: e.g. "gay virgin" is a lower risk factor than "straight + multiple partners".
HIV transmission is partially related to attributes that are correlated with sexual orientation, the most prominent of which is the fact that the chance of transmission is much higher for anal sex than it is for vaginal sex.
From personal experience, anal sex is definitely not limited to sex between men. I'm going to guess that there are entire websites dedicated to that, and there are definitely sections of porn websites dedicated to it. Additionally, sex between men encompasses much more than anal sex.
Which all goes back to teh point: HIV transmission isn't related to sexual orientation, even if some sex acts are traditionally attributed to one specific sort of orientation.
Which all goes back to teh point: HIV transmission isn't related to sexual orientation, even if some sex acts are traditionally attributed to one specific sort of orientation.
I feel like you aren’t queer because this isn’t what we think about it.
I’m bi, and hiv is a big deal in the gay community. I know people who have it, we have clinics around dedicated to treating people with it. Straight people can do anal, straight people can get it otherwise, but this is hitting gay/bi men way harder. It’s okay to acknowledge that
I’m bi, and hiv is a big deal in the gay community. I know people who have it, we have clinics around dedicated to treating people with it. Straight people can do anal, straight people can get it otherwise, but this is hitting gay/bi men way harder. It’s okay to acknowledge that
The argument you are addressing is a strawman. Nobody claimed that anal sex is limited only to sex between men. Anal sex is, however, far more common in frequency among homosexual men than between heterosexual couples, and significantly increases the risk of HIV transmission compared to vaginal sex, therefore it is a risk factor that is strongly correlated with sexual orientation.
That's a bit misleading. Attraction doesn't change the risk but certain types of activities (anal sex) are significantly more prone to bleeding which drastically increases spread rate.
There is a correlation between unprotected anal intercourse and HIV, which is why male homosexuals are especially at danger.
As a male who is bisexual, this isn’t true. Transmitting hiv via unprotected vaginal sex is actually pretty rare, something like 1/1000 or under. And gay/bi men also tend to be more promiscuous. But of course a straight male and woman could do anal sex and that would be the same risk rate that gay men have, which is higher.
Im pretty sure that HIV is much more prevalent in homosexual communities [1].
[1] https://www.cdc.gov/hiv/group/msm/index.html
It doesn't change the fact that homosexuals have much much higher incidents of HIV/AIDs.
They knew that.
I guess people who have a lot of partners and unprotected sex such as people who do porn or sex workers as well as people with partners that are positive.
Not to mention members of the gay community.
I will tell you at right now even if it has a recommendation for all people many will not in first world. HIV still is "gay disease" to most thinking and many will not want to admit risk of getting it. This is largest problem to solve if you are wanting to remove HIV from population. I think maybe best focus are bi sexuals, they are representing "cross over point" from gay population into straights where it maybe can spread more in future.
One would also think of confusion in people as a shared risk regardless of where any of us may be. Despite best efforts, everyone has a risk unless they are inactive.
That depends. Do senior CDC or NIH staff stand to collect patent royalties on its administration? The former (and probably informally mandatory). If not, then the latter. Given Stéphane Bancel's and others' recent trading, then I wouldn't bank on this one being a winner.
As with any preventative medicine it boils down to risk/benefit and (unfortunately) economics. FDA approval process should expose most of the risk/benefit equation and the manufacturer will set the price. When all of that is said and done you will have a lot more information with which to consider your question.
Very good news. I have known many people that have died of the virus.
AIDS is a tough one. It has a shifting antigen. If anyone remembers Stephen King's The Stand, that was the premise for Captain Trips.
If they can inoculate against AIDS, then the human race may just survive the next millennium.
AIDS is a tough one. It has a shifting antigen. If anyone remembers Stephen King's The Stand, that was the premise for Captain Trips.
If they can inoculate against AIDS, then the human race may just survive the next millennium.
AIDS can already be treated in a way that doesn't shorten lifespans significantly.
Indeed, as long as the health system is willing to pay for the medications.
That's not necessarily a given.
Even in EU countries (former HIV researcher, had MD colleagues in a country with budget issues).
That's not necessarily a given.
Even in EU countries (former HIV researcher, had MD colleagues in a country with budget issues).
In (Southern) Africa, HIV/AIDS is considered more manageable than Type II diabetes.
Yes but we can still increase quality of life (not taking pills everyday) and global accessibility with developing a vaccine.
I was purely speaking about lifespan.
>If they can inoculate against AIDS, then the human race may just survive the next millennium.
Can you elaborate as to how this would improve the prospects of humanity as a whole? If anything, such a development would enable a greater proliferation of other dangerous pathogens.
Can you elaborate as to how this would improve the prospects of humanity as a whole? If anything, such a development would enable a greater proliferation of other dangerous pathogens.
Former HIV researcher here.
Right now, HIV is a manageable condition, but ONLY because of the availability of drugs which suppress the virus. The virus eventually learns how to get around the drugs, at which point the patient either switches drugs or dies in a few years.
Without drugs, HIV is (near) 100% fatal. And since it takes a few years to kill, infected people have plenty of time to pass it on. Which they do.
Also, the first HIV infection feels like a minor cold. Most people would not even know they were HIV positive (until their immune system collapsed), were it not for lab testing.
Then just apply some basic epidemiology to these facts, and you see that you have a disease which has the potential to infect (and thus kill) a sizeable percent of the population. As in double-digit percentages.
Right now, HIV is a manageable condition, but ONLY because of the availability of drugs which suppress the virus. The virus eventually learns how to get around the drugs, at which point the patient either switches drugs or dies in a few years.
Without drugs, HIV is (near) 100% fatal. And since it takes a few years to kill, infected people have plenty of time to pass it on. Which they do.
Also, the first HIV infection feels like a minor cold. Most people would not even know they were HIV positive (until their immune system collapsed), were it not for lab testing.
Then just apply some basic epidemiology to these facts, and you see that you have a disease which has the potential to infect (and thus kill) a sizeable percent of the population. As in double-digit percentages.
I don't think the GP comment was being that specific. An HIV vaccine would be huge, but the fundamental research that was necessary to get to the point of a viable vaccine (pending successful trials, obviously) would pay dividends far beyond just HIV.
What's your perspective on the future effectivity (or decline) of current PrEP treatments?
> If anything, such a development would enable a greater proliferation of other dangerous pathogens.
No, it wouldn't necessarily.
While it's true that a vaccine would apply selection pressure and create a fitness gradient for HIV to evolve against, the virus is still bound by its genetics.
The rate at which we're developing vaccines is increasing dramatically. If our new methods are good enough to quickly adapt, then HIV may have a limited state space left to explore. A single remarkable vaccine could even do this on its own if we're lucky.
The virus can't easily descend down a fitness well to make a jump to a new gradient (ie. dramatic change of receptor bindings).
If you're talking about novel viruses, that's a wholly unrelated issue. There's of course a giant reservoir of zoonotic viruses that may one day make a leap to humans, but if anything, our work to rapidly develop vaccines may give us an increased advantage against new viruses if and when they arise.
Finally, if you're talking "hygiene hypothesis", that under-stimulation of the immune system creates auto immune disorders, has increased interaction with gut flora, or changes the dynamics with which cancer clearance happens, then you may be onto something. But this is a huge unknown where we have a lot of study left to do.
(On a personal note, I left my pursuit of biochem because when I studied it, the prospects looked to be moving at glacial pace and the tools felt akin to using punch cards and truth tables. The problems are massive, dynamical, and it looked too daunting. After the last decade and a half of bio discoveries and innovations, I've changed my outlook completely and am incredibly bullish on biotech. We are going to make incredible strides in the next few decades that will in many ways mirror the rise of tech. I want to find my way back to the field someday.)
No, it wouldn't necessarily.
While it's true that a vaccine would apply selection pressure and create a fitness gradient for HIV to evolve against, the virus is still bound by its genetics.
The rate at which we're developing vaccines is increasing dramatically. If our new methods are good enough to quickly adapt, then HIV may have a limited state space left to explore. A single remarkable vaccine could even do this on its own if we're lucky.
The virus can't easily descend down a fitness well to make a jump to a new gradient (ie. dramatic change of receptor bindings).
If you're talking about novel viruses, that's a wholly unrelated issue. There's of course a giant reservoir of zoonotic viruses that may one day make a leap to humans, but if anything, our work to rapidly develop vaccines may give us an increased advantage against new viruses if and when they arise.
Finally, if you're talking "hygiene hypothesis", that under-stimulation of the immune system creates auto immune disorders, has increased interaction with gut flora, or changes the dynamics with which cancer clearance happens, then you may be onto something. But this is a huge unknown where we have a lot of study left to do.
(On a personal note, I left my pursuit of biochem because when I studied it, the prospects looked to be moving at glacial pace and the tools felt akin to using punch cards and truth tables. The problems are massive, dynamical, and it looked too daunting. After the last decade and a half of bio discoveries and innovations, I've changed my outlook completely and am incredibly bullish on biotech. We are going to make incredible strides in the next few decades that will in many ways mirror the rise of tech. I want to find my way back to the field someday.)
Until we develop an inoculation against nuclear war, I wouldn't get overly excited about the next millennium.
dont forget global warming.
bioengineering more heat-tolerant plants and mechanisms to carbon sink seem to be more easily solved than bioengineering radiation-resistant humans, but then again predicting future development is almost impossible.
Bioengineering can have its own negative externalities, and in practice incentives may misalign in such a way that we solve an immediate problem but also create a new one that will manifest later and hence someone else will have to deal with it. I d much rather we address the current problem directly by bringing the climate back to where it would be without human pollution.
Idk. The body seems to adapt to radiation and some excess guardian genes may prevent malignant growth. Of course you cannot live through the gamma blast area, but surely the fallout zones may be manageable.
On the other hand chemistry is highly temperature sensitive and at some point proteins will just denature. Then again you cannot have rapid growth without water, as plants need evaporation to transport minerals and such from the soil into the plant. And what about phosphorus anyway? Soon most soils may be nothing but dirt. You cannot work around the phosphorus erosion. Once it's lost, it's lost. We better start recycling our feces and the dead now. You kinda need to harden all life, not just humans and crops.
On the other hand chemistry is highly temperature sensitive and at some point proteins will just denature. Then again you cannot have rapid growth without water, as plants need evaporation to transport minerals and such from the soil into the plant. And what about phosphorus anyway? Soon most soils may be nothing but dirt. You cannot work around the phosphorus erosion. Once it's lost, it's lost. We better start recycling our feces and the dead now. You kinda need to harden all life, not just humans and crops.
my understanding is that by itself global warming won't kill a large proportion of humans (heat waves and extreme weather events). it's the famine that will get us. That will lead, inevitably, to war.
Neither nuclear war nor climate change has the ability to destroy ALL of humanity.
just a question of time
[deleted]
weimerica(4)
Current anti-viral therapy has made AIDS a chronic disease. We don’t need a vaccine to survive, though it would be helpful in eliminating the disease.
AIDS killed a million people in 2016. HIV medications help only when taken diligently, which is actually problematic even in developed countries where the most advanced treatments are available, and is much more difficult in poorer countries. Even with treatment HIV infections are a burden on people, interfering with normal adult activities like sex (convincing people to use condoms is a challenge) and having children.
To quote Seven of Nine, survival is insufficient. We could survive without a vaccine or a treatment, it would mean tens of thousands of years and billions of people dying from AIDS until our species adapts and HIV becomes just another retrovirus (as some other primate species have with related SIV viruses). We should aim higher than "survival" and end the suffering caused by HIV, and with a vaccine we could do so in this century.
To quote Seven of Nine, survival is insufficient. We could survive without a vaccine or a treatment, it would mean tens of thousands of years and billions of people dying from AIDS until our species adapts and HIV becomes just another retrovirus (as some other primate species have with related SIV viruses). We should aim higher than "survival" and end the suffering caused by HIV, and with a vaccine we could do so in this century.
No, just no.
AIDS killed 700,000 in 2020.[1]. That’s worldwide. It’s not even in the top 10.
Diarrheal diseases, entirely preventable with clean water supply, kill three times as many.[2]
Or heart disease which killed ten times as many.
[1] https://www.unaids.org/en/resources/fact-sheet [2] https://www.who.int/news-room/fact-sheets/detail/the-top-10-...
AIDS killed 700,000 in 2020.[1]. That’s worldwide. It’s not even in the top 10.
Diarrheal diseases, entirely preventable with clean water supply, kill three times as many.[2]
Or heart disease which killed ten times as many.
[1] https://www.unaids.org/en/resources/fact-sheet [2] https://www.who.int/news-room/fact-sheets/detail/the-top-10-...
...what exactly is your point? That other preventable illnesses exist and kill more people, therefore an HIV vaccine is uninteresting? That 700k dead does not justify the effort to eradicate HIV, and that we should just continue to rely on long-term treatment regiments?
I think he was pointing that massive dollars have gone for AIDS research but it is not what should be our high priority compared to other death causes. In America and world both, AIDS is small fries for death cause.
That is a really difficult call to make because research into HIV/AIDS has generated a great deal of information about viruses and potential ways of treating or controlling them. This is similar to the arguments about the space program being an expensive and largely irrelevant exercise even though all sorts of critical technology for weather satellites, solar power, electronic communications and so on came more or less directly from exploration and development of space.
> In America and world both, AIDS is small fries for death cause.
The critical distinction is outcomes: until relatively recently, the only outcome of an HIV infection was eventual death from AIDS. This is still the default outcome in most of the world.
Plenty of things kill more people than AIDS, but most of them have substantially less severe individual outcomes: many people survive them, or the social/political solutions are substantially more tenable (healthier eating, access to potable water). And that's even before we consider how AIDS research has advanced the field of medical virology as a whole.
The critical distinction is outcomes: until relatively recently, the only outcome of an HIV infection was eventual death from AIDS. This is still the default outcome in most of the world.
Plenty of things kill more people than AIDS, but most of them have substantially less severe individual outcomes: many people survive them, or the social/political solutions are substantially more tenable (healthier eating, access to potable water). And that's even before we consider how AIDS research has advanced the field of medical virology as a whole.
Does nobody read comments before replying?
My entire statement was “we don’t need an AIDS vaccine to survive as the human race”.
If AIDS was risking our survival than diarrheal diseases should as well?
My entire statement was “we don’t need an AIDS vaccine to survive as the human race”.
If AIDS was risking our survival than diarrheal diseases should as well?
By that logic we shouldn't use a vaccine for most illnesses since they are not heart disease...
After all, we are only saving a small cities worth of people per year.
After all, we are only saving a small cities worth of people per year.
Is heart disease risking survival of the human race?
Shall we stop bothering about the past 1000 years of medical advances while we're at it, since the human race was surviving fine without?
What point are you actually trying to make?
What point are you actually trying to make?
Is this a serious comment? We shouldn't stop a cause of death because it's not in the top ten?
Helpful is an understatement, it would be life changing for many worldwide. Therapy and prevention measures exist but they're still not available to everyone and can be a significant financial cost, even with insurance. For some, it's still not an affordable option. Mutations and resistance also still occur and although life has been extended significantly, it's still a lingering health issue that requires careful professional monitoring and treatment.
The assumption is that a vaccine would be long lasting, preventative, and likely cheaper if not cheap. That's not only a significant improvement in quality of life in developed countries, that's truly life changing/giving if available in less developed countries. The COVID vaccines and potentially this are examples of capitalism done right.
The assumption is that a vaccine would be long lasting, preventative, and likely cheaper if not cheap. That's not only a significant improvement in quality of life in developed countries, that's truly life changing/giving if available in less developed countries. The COVID vaccines and potentially this are examples of capitalism done right.
Could an HIV vaccine actually cure those already infected?
Because of the way HIV "works" any preventative vaccine would almost certainly be curative or as good as.
The HI virus is very slow (not called "Lentivirus" for nothing) and invests itself in the very stemcells of the cells that would be fighting it. This means it can hide from the immune system, and even the antiviral drugs can only push it back. But by the same token, if it is pushed back into the deepest refuge, it can't really "flood" back into the rest of the body, it has to do so at a a trickle.
If there is a viable vaccine around, even if the virus manages to hide from total extinction in a host at first, it will get squashed whenever it tries to come back into the "light" of the immune system.
At least I hope it will work that way...
The HI virus is very slow (not called "Lentivirus" for nothing) and invests itself in the very stemcells of the cells that would be fighting it. This means it can hide from the immune system, and even the antiviral drugs can only push it back. But by the same token, if it is pushed back into the deepest refuge, it can't really "flood" back into the rest of the body, it has to do so at a a trickle.
If there is a viable vaccine around, even if the virus manages to hide from total extinction in a host at first, it will get squashed whenever it tries to come back into the "light" of the immune system.
At least I hope it will work that way...
I'm a bit confused since HIV works by disabling the immune system, and a vaccine works by priming the immune system.
So... if HIV has already damaged your immune system, can it take advantage of the vaccine?
Perhaps figuring out that is what the tests are for.
So... if HIV has already damaged your immune system, can it take advantage of the vaccine?
Perhaps figuring out that is what the tests are for.
You are confusing HIV infection and AIDS. The former is the virus, the latter is the end-stage disease.
It takes the virus years to reach the viral loads necessary to damage the immune system to a noticeable degree. Sure, HIV has some tricks before that point, but patients are generally not immunocompromised until AIDS enters the picture.
It takes the virus years to reach the viral loads necessary to damage the immune system to a noticeable degree. Sure, HIV has some tricks before that point, but patients are generally not immunocompromised until AIDS enters the picture.
That clears up my confusion. Thanx!
Actually the immune system does fight HIV during the acute infection stage after a person is first exposed, and antibodies are generated. The immune response to HIV is what does most of the damage to the immune system, since a typical immune response to virus infection involves the destruction of infected cells. HIV infects certain immune cells, which will either self-destruct when the infection is detected or will be destroyed by other immune cells.
Also, some people actually develop the so called "broadly neutralizing antibodies" and become immune to AIDs as a consequence.
There have even be experimental treatments where HIV infected patients who also got Leukemia got treated with radiation, and then a stemcell donation from someone with such an immunity. And they are indeed cured (for practical purposes, there are some details...). Unfortunately, those donors are rare and the radiation therapy etc is probably worse than the chronic antiviral therapy, which is why this is not a more common treatment for HIV.
Of course, inducing these particular antibodies has been the goal of various immunization efforts. Unfortunately this proved more challenging than it might seem.
There have even be experimental treatments where HIV infected patients who also got Leukemia got treated with radiation, and then a stemcell donation from someone with such an immunity. And they are indeed cured (for practical purposes, there are some details...). Unfortunately, those donors are rare and the radiation therapy etc is probably worse than the chronic antiviral therapy, which is why this is not a more common treatment for HIV.
Of course, inducing these particular antibodies has been the goal of various immunization efforts. Unfortunately this proved more challenging than it might seem.
It's way better not to catch a disease than to survive it. Vaccines, while they may not entirely get us rid of a disease, will improve the way of life by helping people not getting ill.
Let's not forget the huge success of PrEP (Pre-exposure prophylaxis, or treatment-as-prevention).
But a vaccine, especially if it is affordable and works for a long time will go even further in ending this pandemic that has gone one for 40+ years.
But a vaccine, especially if it is affordable and works for a long time will go even further in ending this pandemic that has gone one for 40+ years.
> We don’t need a vaccine to survive
As long as there’s no antiviral therapy resistance.
As long as there’s no antiviral therapy resistance.
In the developed world. It's still a death sentence in Africa (as is being gay).
I'm actually thinking more about the vaccination against a shifting-antigen bug.
That's big juju.
I'm actually thinking more about the vaccination against a shifting-antigen bug.
That's big juju.
>It's still a death sentence in Africa (as is being gay).
Just to be somewhat anal, AIDS is much more common in Southern Africa, where homosexuality is generally either legal or the laws against it weak and unenforced.
It's also much more correlated with race than sexuality. In South Africa, it affects something like 15% of blacks vs 0.3% of whites. Women are also far more likely to have HIV, especially younger ones. I think it's around 30% for pregnant women.
Outside of the West, AIDS is definitely not something that mainly gay men get.
Just to be somewhat anal, AIDS is much more common in Southern Africa, where homosexuality is generally either legal or the laws against it weak and unenforced.
It's also much more correlated with race than sexuality. In South Africa, it affects something like 15% of blacks vs 0.3% of whites. Women are also far more likely to have HIV, especially younger ones. I think it's around 30% for pregnant women.
Outside of the West, AIDS is definitely not something that mainly gay men get.
It's still a death sentence in [some parts of] Africa (as is being gay).
Precision is next to godliness.
Precision is next to godliness.
Antivirals are too expensive for most of the world.
Exactly this. PreP costs >$20,000 a year.
It's around US$350 a year in Australia [1] under the Pharmaceutical Benefits Scheme (Around US$500 without subsidies). For low-income people, it's around $40 a year. No idea how much less the Indian generics they'd be using in South Africa cost.
Unaffordable pharmaceuticals is a purely American problem and I have no idea why you guys think it's normal or put up with it.
[1] https://www.chemistwarehouse.com.au/buy/100885/tenofovir-dis...
Unaffordable pharmaceuticals is a purely American problem and I have no idea why you guys think it's normal or put up with it.
[1] https://www.chemistwarehouse.com.au/buy/100885/tenofovir-dis...
Some of us don’t think it’s normal, nor do we want to put up with it. Fully 60% of the voting population is deeply invested in seeing their team win regardless of what policies they support. We have to fight both democrats and republicans to make any progress. It’s a tough row to hoe.
Ummm… no?
It’s cheap in Australia because it’s generic. It’s generic now in the US too, and guess what? It’s $40 per month in the US.
https://m.goodrx.com/truvada?sort_type=popularity
It’s cheap in Australia because it’s generic. It’s generic now in the US too, and guess what? It’s $40 per month in the US.
https://m.goodrx.com/truvada?sort_type=popularity
Fair enough. I took the other guy at his word when he said it was $20k. It's definitely not uncommon for pharmaceuticals to cost an order of magnitude (or two) more in the US compared to other countries.
start showing up for elections, for example
What are we supposed to do? Corporations own the government and the people who can afford guns support it.
There are two relatively straightforward things you can do that will help the situation: (a) vote, and (b) campaign to move to get some form of proportional representation become the voting system in your state, both for statewide and national elections.
A major reason why you've entrenched interests is that they have safe seats they can depend on. The US has major issues with acts of gerrymandering that create those safe seats. Most forms of PR are much more resistant to gerrymandering than FPTP is. And if you want people who'll do something regarding healthcare costs, you need to get rid of those safe seats and make them accountable.
A major reason why you've entrenched interests is that they have safe seats they can depend on. The US has major issues with acts of gerrymandering that create those safe seats. Most forms of PR are much more resistant to gerrymandering than FPTP is. And if you want people who'll do something regarding healthcare costs, you need to get rid of those safe seats and make them accountable.
You mention guns, but I'm honestly surprised that pharmaceutical executives being gunned down by grieving family members isn't a daily occurrence.
Given the number of gun owners and the number of pharmaceutical companies that let people die in agony to keep the medical insurance industry afloat, it should surely be a serious enough problem to warrant changes in corporate policy.
Given the number of gun owners and the number of pharmaceutical companies that let people die in agony to keep the medical insurance industry afloat, it should surely be a serious enough problem to warrant changes in corporate policy.
At least in Belgium (where there are several generics available besides the 'brand' Truvada), my out of pocket cost is 5 euro for a month's supply.
If you take PrEP periodically (2+1+1) that will even last you a lot longer (depending on the frequency of course). I am very glad PrEP exists, and already optimistic about its impact in reducing transmissions. But if we can replace this with a one-shot vaccine, that would be groundbreaking.
If you take PrEP periodically (2+1+1) that will even last you a lot longer (depending on the frequency of course). I am very glad PrEP exists, and already optimistic about its impact in reducing transmissions. But if we can replace this with a one-shot vaccine, that would be groundbreaking.
It's not going to be a one-shot vaccine. The least I would think have even the possibility of working is six initial shots (not all the same) given on a very strict schedule, followed by a booster every six months. I would not be surprised if it was twice that for something that actually worked.
How would this vaccine work for people who are already infected?
It wouldn't. Their immune system already has a sample of the virus. Giving them a vaccine would give them nothing they don't already have.
The idea behind a vaccine is the give the immune system a sample before it encounters the real virus, which allows it to respond quicker when the real virus arrives, which allows it to prevent the virus to replicate sufficiently to make the person sick.
For someone who already has the virus, the vaccine won't do anything.
The idea behind a vaccine is the give the immune system a sample before it encounters the real virus, which allows it to respond quicker when the real virus arrives, which allows it to prevent the virus to replicate sufficiently to make the person sick.
For someone who already has the virus, the vaccine won't do anything.
This is somewhat incorrect. Not all vaccines include a sample of the virus they're protecting against (see the mRNA vaccines for covid-19).
Also for some viruses (again see covid-19), it's still advisable to get a vaccine even if you've already been infected. The protection rate and longevity of the vaccines can outweigh infection based antibodies dramatically.
In the case of HIV, it's potentially quite different, because HIV is such a unique disease, that yeah, a vaccine might not help anyway. But otherwise, your comment doesn't apply to vaccines in general (and it didn't seem like you were replying towards any specifics of HIV)
Also for some viruses (again see covid-19), it's still advisable to get a vaccine even if you've already been infected. The protection rate and longevity of the vaccines can outweigh infection based antibodies dramatically.
In the case of HIV, it's potentially quite different, because HIV is such a unique disease, that yeah, a vaccine might not help anyway. But otherwise, your comment doesn't apply to vaccines in general (and it didn't seem like you were replying towards any specifics of HIV)
Vaccine for coronavirus recommended for its immune-building benefit even in persons who had infection, this is to reduce likelihood for more infection in the future. I am doubting that this applys on the HIV since nobody is getting it then beating the infection, just supressing it.
Also some evidence that vaccines are helping with long covid https://www.theguardian.com/society/2021/may/18/long-covid-s...
The difference with mRNA vaccines is they let your body build antibodies without it even knowing the virus itself
The difference with mRNA vaccines is they let your body build antibodies without it even knowing the virus itself
Long covid is not sufficiently studied to indicate whether vaccines help.
Many of the patterns associated with long covid suggest that is a mix of one condition that has a mechanism probably similar to chronic fatigue syndrome and the other is the manifestation of long term sequelae that is common with other respiratory viruses.
My guess is that the vaccine might help with the CFS-like symptoms.
Many of the patterns associated with long covid suggest that is a mix of one condition that has a mechanism probably similar to chronic fatigue syndrome and the other is the manifestation of long term sequelae that is common with other respiratory viruses.
My guess is that the vaccine might help with the CFS-like symptoms.
> Also some evidence that vaccines are helping with long covid
By what possible mechanism? Does this imply that long COVID is a result of some small amount of lingering virus?
I was under the impression that long COVID was a result of damage caused by the initial infection - not some continuous infection of the actual virus.
By what possible mechanism? Does this imply that long COVID is a result of some small amount of lingering virus?
I was under the impression that long COVID was a result of damage caused by the initial infection - not some continuous infection of the actual virus.
It probably is not really doing anything, I would think replacing the nocebo of being infected (or supposedly being infected) by SARS-CoV-2 in the past with the placebo of getting vaccinated (more recently, so you get a recency bias boost) makes up most of the "helping". If not that exactly a similar psychological re-targeting effect is probable.
It's still unknown what causes long covid. Lingering virus is one hypothesis that's still plausible. Indeed some people believe it precisely because the vaccines seem to be helping significant numbers of people (but not everyone, they can also make it worse for some people).
A substantial proportion of long covid cases share similarities (particularly demographics) with other syndromes of unknown mechanism, particularly chronic fatigue syndrome.
I don't think it works this way with HIV. As you stated having immunity to a specific HIV presentation does not prevent infection. Any vaccine effective would need to make the body see a pattern it cannot find on it's own. Something universal to HIV, which cannot be evolved around.
This is different from other disease where the immune system doesn't have enough time to response before the disease kills/damages the body.
If the vaccine can prevent HIV signature evasion, it may very well help control/treat the disease, I think.
This is different from other disease where the immune system doesn't have enough time to response before the disease kills/damages the body.
If the vaccine can prevent HIV signature evasion, it may very well help control/treat the disease, I think.
Some vaccines are effective after infection; it's called post-exposure prophylaxis. Some examples are tetanus and rabies.
Depends on the vaccine. There are research programs to develop vaccines that induce people to make broadly neutralizing HIV antibodies. Most people don’t naturally produce these. Such a vaccine could plausibly help people who are already infected.
This is true for many vaccines, but given the unique mechanism HIV uses to attack the immune system, it might actually work in actively infected HIV patients.
> It wouldn't. Their immune system already has a sample of the virus. Giving them a vaccine would give them nothing they don't already have.
What you said applies to most viruses (flu, corona, ...), but not to HIV.
There is a reason we failed to create a HIV vaccine for 30 years, and that reason is that simply presenting the virus just doesn't work.
So this vaccine uses a new quite amazing methodology, instead of presenting the virus, it presents something else designed to trigger the 1 in the million B cell from our bodies which are actually capable of producing a neutralizing antibody. Regular vaccine trigger randomly the other 999999 B cells which produce useless antibodies.
Typically that process takes 10 years for a HIV infected person, after which they produce the proper antibodies.
This approach is called germ-line targeting, and tries to accelerate that 10 year process in 2-3 shots.
What you said applies to most viruses (flu, corona, ...), but not to HIV.
There is a reason we failed to create a HIV vaccine for 30 years, and that reason is that simply presenting the virus just doesn't work.
So this vaccine uses a new quite amazing methodology, instead of presenting the virus, it presents something else designed to trigger the 1 in the million B cell from our bodies which are actually capable of producing a neutralizing antibody. Regular vaccine trigger randomly the other 999999 B cells which produce useless antibodies.
Typically that process takes 10 years for a HIV infected person, after which they produce the proper antibodies.
This approach is called germ-line targeting, and tries to accelerate that 10 year process in 2-3 shots.
Thank goodness. I’m happy PrEP exists, but it gave me intense nausea for weeks before I couldn’t do it anymore. I would love to be able to date and not have to worry about HIV (I’m a trans woman who dates men, most of whom are bisexual). Not having to take another horse pill daily would be great too.
It is so excruciatingly difficult to trial a HIV vaccine that we can easily expect it to take decades.
According to the article, the Phase 1 clinical trail will take under 2 years.
"Moderna is seeking 56 individuals, aged 18 to 50 and who are HIV-negative, for the trial, which is estimated to begin on August 19 and conclude in spring 2023"
I would imagine that larger trials would be conducted in places with rampant HIV spread, right? Which shouldn't take an inordinate amount of time.
"Moderna is seeking 56 individuals, aged 18 to 50 and who are HIV-negative, for the trial, which is estimated to begin on August 19 and conclude in spring 2023"
I would imagine that larger trials would be conducted in places with rampant HIV spread, right? Which shouldn't take an inordinate amount of time.
Phase 1 is not the difficulty here....
With the COVID vaccines, the locations of the clinical trials were chosen for how rapidly the virus was spreading. Some trials even added new geographic areas with high transmission rates while they were still ongoing. Why wouldn't any large scale HIV trial not choose one of the many countries with a high transmission rate?
That's for phase III trials, which I am sure will be conducted in countries like South Africa. This is not there yet, and phase I safety trials are easiest to conduct in the vicinity of the researchers and good hospital infrastructure.
It is maybe that Moderna makes a partnership with larger drug companies for phase ii iii trials. Also maybe they try to conduct in subsaharan aferica where there are large spread rates among straights and disease is more endemic in populations.
Phase 1 is just a safety trial. Imagine how many years it will take to make a statistically sound conclusion of the efficacy rate?
People seem overly optimistic then.
Phase 1 trials are only used to test the safety of the drug, nothing else. Not sure why they plan to take such a long time for this initial phase. Covid was just a couple of weeks.
If the initial stage is already 2 years, I don't see a Phase 3 trial taking less than 3 times that amount of time. It will be super difficult to test. The R0 value of HIV is relatively low.
If the initial stage is already 2 years, I don't see a Phase 3 trial taking less than 3 times that amount of time. It will be super difficult to test. The R0 value of HIV is relatively low.
Phase 1 just checks to see what is the highest dose that can be given without adverse effects. It does not test the effectiveness of the vaccine.
I assume the effectiveness of PrEP doesn't help the case, as infection can now be prevented for those at high risk.
Might be important to keep an eye out for PrEP access progression and these trails around the world...
Might be important to keep an eye out for PrEP access progression and these trails around the world...
What makes it so difficult?
At some point, somebody needs to be exposed to HIV with an unproven vaccine. Current design is just "give it to enough people to show they get HIV statistically lower than their origin populations.
> Moderna is seeking 56 individuals, aged 18 to 50 and who are HIV-negative, for the trial, which is estimated to begin on August 19 and conclude in spring 2023.
Probably a dumb question given that I have little domain knowledge here, but are they really going to get valuable data from 56 individuals? Like, isn't that N really small? How many of them would be expected to contract HIV?
And, I'd imagine that if they are selecting a high-risk population for the trials (e.g., sexually active young gay men), wouldn't a lot of the individuals already be on PREP? Would they have to go off of PREP, and run a potentially much greater risk of contracting HIV if the vaccine doesn't actually work?
Probably a dumb question given that I have little domain knowledge here, but are they really going to get valuable data from 56 individuals? Like, isn't that N really small? How many of them would be expected to contract HIV?
And, I'd imagine that if they are selecting a high-risk population for the trials (e.g., sexually active young gay men), wouldn't a lot of the individuals already be on PREP? Would they have to go off of PREP, and run a potentially much greater risk of contracting HIV if the vaccine doesn't actually work?
From the trial page (https://clinicaltrials.gov/ct2/show/NCT05001373), it's a just phase one study to figure out the safety of the vaccine:
> A Phase 1, Randomized, First-in-human, Open-label Study to Evaluate the Safety and Immunogenicity
> A Phase 1, Randomized, First-in-human, Open-label Study to Evaluate the Safety and Immunogenicity
Having taken the Moderna mRNA Covid-19 vaccine I'd be curious to hear HN'ers thoughts on this part of the article which I wasn't aware of until reading just now:
'Moncef Slaoui, head of Operation Warp Speed until January 2021, was formerly a board member of Moderna and only sold his stake in the company days after his appointment by former President Donald Trump for an estimated $10 million, prompting concerns about the program’s neutrality.'
'Moncef Slaoui, head of Operation Warp Speed until January 2021, was formerly a board member of Moderna and only sold his stake in the company days after his appointment by former President Donald Trump for an estimated $10 million, prompting concerns about the program’s neutrality.'
So, umm, how do you test this vaccine? Are the participants expected to have unprotected sex with HIV-positive people?
No, you give it to 10k people, and give a placebo to another 10k, and let them live their lives, and after 5 years or so you see how many of each group have contracted HIV.
The participants can have unprotected sex with HIV+ people if they want. It’s like the COVID-19 vaccine trials. The study designers didn’t set any parameters around mask use, social distancing, etc. It’s up to each participant to apply harm reduction practices as they see fit.
Notably covid vaccines were approved early because idiots in both arms didn't wear masks, and those in the control arms got very sick and died soon after the trial began.
What is the statistical likelihood of someone in a 10,000 sample size of people catching HIV in any 5 year period? Probably less than 1%?
Depends where you sample from.
In the USA, estimated new HIV infections in 2019 35k. Assuming 350 million Americans, that gives a very rough estimate of 1 case out of 10,000 per year.
You can enrich this by shifting target population. You could do this in the USA by targetting high risk communities, or by moving the trial overseas.
An trial in the USA with 10k in each arm could very likely be constructed to generate at least 10 cases per year. Likely up to 50.
https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...
In the USA, estimated new HIV infections in 2019 35k. Assuming 350 million Americans, that gives a very rough estimate of 1 case out of 10,000 per year.
You can enrich this by shifting target population. You could do this in the USA by targetting high risk communities, or by moving the trial overseas.
An trial in the USA with 10k in each arm could very likely be constructed to generate at least 10 cases per year. Likely up to 50.
https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...
They're asking for 50-ish volunteers ATM.
Yeah, it's a phase 1 trial. In phase 1 they aren't even really looking at if the vaccine is effective, they're making sure that it's safe/side effects are reasonable, and maybe getting some dosage information out of it.
What you just described is a 'Challenge Trial'. These have been avoided for COVID and would likely be avoided for other diseases too on ethical grounds.
For a common cold, or other lower-impact disease, you could do a challenge trial.
For a common cold, or other lower-impact disease, you could do a challenge trial.
The Bug Chasers would make good volunteers.
https://en.wikipedia.org/wiki/Bugchasing
Looks like finding participants for a challenge trial won't be hard.
Can someone with a better understanding talk about the specifics of how/why a vaccine like this might end up not being effective against HIV (i.e. what makes HIV so good at evading our efforts)? I suspect we've been in this boat many times in the past 40 years: a promising cure is just around the corner.
Two half-baked comments off the top of my head:
-HIV targets, infects and cripples the immune system. While CoV2 infects and replicated aggressively, causing inflammation and fibrosis, HIV goes in, gets a foothold, hides and lingers like an insurgent, slowly exhausting the immune system. Very different approaches and how they are impacted by vaccines may be very different.
-Convincing people to take the vaccine would be hard. Look how hard it is with a respiratory pandemic. It's "easy" to be non-high risk for HIV and people probably believe they can't get it, but people seem to continue getting it.
-Convincing people to take the vaccine would be hard. Look how hard it is with a respiratory pandemic. It's "easy" to be non-high risk for HIV and people probably believe they can't get it, but people seem to continue getting it.
This would be huge news for Africa.
(I'm always surprised at how many people are generally unaware of the rates of HIV in Africa. https://en.wikipedia.org/wiki/HIV/AIDS_in_South_Africa)
(I'm always surprised at how many people are generally unaware of the rates of HIV in Africa. https://en.wikipedia.org/wiki/HIV/AIDS_in_South_Africa)
It's amazing how many awful comments this is drawing. Is this just bots getting autotriggered on keywords or something?
I doubt it's bots. Unfortunately being a tech enthusiast doesn't preclude one from being an awful person. Spend some time on Blind for additional proof.
This is going to be similar to COVID where you have to take multiple shots per year? Should that even be called a vaccine?
[deleted]
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Go to any website of a mRNA COVID vaccine manufacturer and it will plainly state it is not meant to prevent infection. It is highly effective, for a period unknown, at preventing the disease caused by the infection.
AIDs is the disease caused by an HIV infection. COVID-19 is the disease caused by a SARS-COV-2 infection.
AIDs is the disease caused by an HIV infection. COVID-19 is the disease caused by a SARS-COV-2 infection.
So long Moderna, short condom manufacturers isn't a good idea?
HIV/AIDs is a perfect example of why it's dangerous to not distinguish between the two. If you are vaccinated and exposed to SARS-COV-2, you still have a high risk of infection, but because of the vaccine, you have a low risk of that infection developing into the disease known as COVID-19.
If a successful mRNA vaccine is developed to prevent AIDs, it would be extremely important for the vaccinated to know they can still be infected with and spread HIV. It's not any different for SARS-COV-2/COVID-19. The talk in this thread about an mRNA vaccine eradicating HIV is nonsense.
If a successful mRNA vaccine is developed to prevent AIDs, it would be extremely important for the vaccinated to know they can still be infected with and spread HIV. It's not any different for SARS-COV-2/COVID-19. The talk in this thread about an mRNA vaccine eradicating HIV is nonsense.
I know and I appreciate your effort to educate / warn. But you do realize that most of these posts are made by shills ?
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(some strains of) HPV already have vaccines, social conservatism is what is allowing much of cervical cancer to continue in the rich world.
Please don't take HN threads into ideological flamewar. It's not what this site is for.
https://news.ycombinator.com/newsguidelines.html
We detached this subthread from https://news.ycombinator.com/item?id=28211023.
https://news.ycombinator.com/newsguidelines.html
We detached this subthread from https://news.ycombinator.com/item?id=28211023.
Not sure exactly what you mean with social conservatism, but I'd rather call out misplaced optimism.
In the past the approch was to only target young girls before they had sex for the first time, which turned out to not reduce the spread of HPV as much as hoped. Only in recent years the recommendation changed to also vaccinate boys and increasingly also people with previous sexual encounters.
In the past the approch was to only target young girls before they had sex for the first time, which turned out to not reduce the spread of HPV as much as hoped. Only in recent years the recommendation changed to also vaccinate boys and increasingly also people with previous sexual encounters.
> Not sure exactly what you mean with social conservatism
"This is also why social conservatives don't like it when scientific progress makes sex safer or better. Sex outside of their ideal scenario (in marriage, at the husband's wish, for reproduction) should be punished, and steps to mitigate that punishment (STD prevention, pregnancy prevention) should be discouraged or lambasted as immoral."
https://www.theguardian.com/commentisfree/2012/oct/16/conser...
https://www.washingtonpost.com/local/dc-politics/why-the-pol...
"This is also why social conservatives don't like it when scientific progress makes sex safer or better. Sex outside of their ideal scenario (in marriage, at the husband's wish, for reproduction) should be punished, and steps to mitigate that punishment (STD prevention, pregnancy prevention) should be discouraged or lambasted as immoral."
https://www.theguardian.com/commentisfree/2012/oct/16/conser...
https://www.washingtonpost.com/local/dc-politics/why-the-pol...
Although true to a certain extent, it doesn't mean minds can't be changed, just as it is for any other population's negative perception of any vaccine. In my own church I've had this discussion with parents, and I know of at least one who changed their position on HPV vaccination. I credit them with giving the matter thought.
There was a lot of hoopla at the time the vaccine was announced, but other than that I'm not sure where you are getting your information? HPV vaccination rates are increasing, and there is almost no resistance at this point. The US vaccination rates are in line with Europe.
[deleted]
Same with the ones that destroy your liver.
slumdev(3)
portpecos(5)
Religion is a non issue outside of the US. The fundamentalist view on that issue would not just be laughed out of the room in Europe, it would result in aggressive reactions. The main hurdle is vaccine hesitancy, fueled by new age nonsense.
treyhuffine(1)
jmnicolas(5)
Pray that the side effects are well-studied before the CDC decides to administer it to every infant within minutes of birth (like they did with Hep B, another sexually-transmitted disease to which most people will never even be exposed.)
At one point, we should stop saying that hep-* or HIV are STDs, in several countries the bulk of transmissions are from mother to infant during delivery or other means that sex transmissions. With the way the world is connected, these virus can travel easily.
> in several countries the bulk of transmissions are from mother to infant during delivery
Is this the case in the United States, where the CDC makes recommendations?
And if so, why not administer it only to those children of mothers who test positive?
We don't put everyone on a statin simply because most (i.e. more than half of) people will eventually develop heart disease. Instead, we test and administer statins to only those people who have heart disease risk factors.
We don't give everyone bariatric surgery or weight loss drugs simply because most Americans are overweight or obese. Instead, these remedies are administered only to those who are most likely to benefit.
No drug or vaccine is without side effects. It's clear that there's no such thing as informed consent in today's world. The patient cannot be informed because the side effects are hidden from him. And he definitely hasn't consented if coercion was involved in his decision to receive the treatment.
Is this the case in the United States, where the CDC makes recommendations?
And if so, why not administer it only to those children of mothers who test positive?
We don't put everyone on a statin simply because most (i.e. more than half of) people will eventually develop heart disease. Instead, we test and administer statins to only those people who have heart disease risk factors.
We don't give everyone bariatric surgery or weight loss drugs simply because most Americans are overweight or obese. Instead, these remedies are administered only to those who are most likely to benefit.
No drug or vaccine is without side effects. It's clear that there's no such thing as informed consent in today's world. The patient cannot be informed because the side effects are hidden from him. And he definitely hasn't consented if coercion was involved in his decision to receive the treatment.
Because the HepB could disappear within a generation with mass vaccination, the vaccine is rather cheap, almost lifelong and offers a full protection. And I bet it wasn't because of a bunch of antivax. Fuck them for ruining everything.
As a French who was teenager in the 90s, I got vaccinated as almost everyone in my class age, and I am glad that French had it as otherwise I could have catch this fucking virus.
As a French who was teenager in the 90s, I got vaccinated as almost everyone in my class age, and I am glad that French had it as otherwise I could have catch this fucking virus.
> We don't put everyone on a statin simply because
Because there are known side effects that make them not suitable to some people. Pregnant women should not take them (nor those thinking about getting pregnant). Those of Asian decent need a smaller dose. Those who drink alcohol shouldn't take them. Those who take part in extreme exercise shouldn't take them. They cannot be mixed with some other drugs.
The above is off the top of my head. It probably doesn't apply to them all, there are several different statins to choose from, and many different dosages. A doctor really needs to work through the above (and probably more factors I'm not aware of) to figure out what is best for you.
Because there are known side effects that make them not suitable to some people. Pregnant women should not take them (nor those thinking about getting pregnant). Those of Asian decent need a smaller dose. Those who drink alcohol shouldn't take them. Those who take part in extreme exercise shouldn't take them. They cannot be mixed with some other drugs.
The above is off the top of my head. It probably doesn't apply to them all, there are several different statins to choose from, and many different dosages. A doctor really needs to work through the above (and probably more factors I'm not aware of) to figure out what is best for you.
Given that you can enter in life with HIV "given" by the mother, it does not seem too crazy to administer it to some babies (given there is no counter indication for that obviously)
My friend had a HIV vaccine about 5 years from some London kings college trial - has always been fine. On a related coincidence I had the moderna vaccine today.
HIV has resisted efforts to develop a vaccine for 30+ years at this point.
I am already beginning to wonder if the 2020s will be the story of the social transformation caused by mRNA vaccines. An effective and relatively cheap HIV vaccine will be huge.
Apart from Covid and HIV, mRNA is going to have a huge effect on the flu vaccine too. For anyone who doesn't know, predictions are made about what flu strains will dominate the coming winter 4-6+ months ahead of time and the vaccine is made from that. Those predictions may not be accurate, which largely explains the variance of efficacy. mRNA has the potential to reduce that down to 1-2 months so you can potentially react to the actual dominant strains.
Cancer of course isn't a single disease. Even something like lung cancer are a collection of different diseases. But some cancers are caused by viruses. A notable example is cervical cancer where it seems like most cases are caused by HPV strains. Australia is on track to essentially eliminate cervical cancer by 2035 [1]. To be clear, this isn't an mRNA vaccine.
But mRNA vaccines may greatly reduce the time required to develop a vaccine and make it possible to eliminate whole classes of diseases.
This is all super-exciting.
[1]: https://www.vcs.org.au/blog/our-impact/news/australia-can-co....