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World AIDS Day – HIV treatments, vaccine and Covid-19 Pandemic.

World-AIDS Day 2020

Covid-19 Pandemic has put all HIV patients in serious risks and slowed down all testings and treatments.

According to UNAIDS:

  • The lockdowns and border closures imposed to stop COVID-19 are impacting both the production of antiretroviral medicines and their distribution, potentially leading to increases in their cost and to supply issues.
  • Recent modelling has estimated that a six-month complete disruption in HIV treatment could lead to more than 500,000 additional deaths from AIDS-related illnesses.
  • If services to prevent mother-to-child transmission of HIV were similarly halted for six months, the estimated increases in new child HIV infections would be 162% in Malawi, 139% in Uganda, 106% in Zimbabwe and 83% in Mozambique.
  • The global experience of tackling HIV can help inform and guide effective, efficient, people-centered and sustainable COVID-19 responses.

COVID-19 is not only directly causing high morbidity and mortality, it is also disrupting essential systems for health and undermining programmes to address HIV and other global health priorities. The global HIV response is heavily dependent on generic medicine manufacturers in India, a country that began to emerge from a national lockdown to slow the spread of COVID-19 in May 2020. As the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) reported, COVID-19 control measures at the point of origin and destination for essential health commodities are already resulting in considerable delays in the delivery of medicines and other health commodities. Repurposing HIV clinic and health-care workers, travel restrictions, messaging that keeps people away from services, emerging human rights abuses and worsening social and economic contexts are also disrupting continuity of services.

Covid-19 Vaccine could be slowing down the researches for HIV-Vaccine.

Is this the case? Let’s have a look at the real facts: to produce a vaccine, scientists need to work on antibodies able to detect the virus in the body and get rid of it. The reality is that our bodies haven’t yet really produced effective antibodies able to completely kill the AIDS Virus (we have no cases of people that have naturally recovered from HIV), whilst for Covid-19, scientists have found that millions of people have (luckily) recovered from the virus allowing researchers to understand what kind of antibodies vaccines should allow our bodies to produce in order to kill the virus.

As reported by Daily Maverick, Mitchell Warren, executive director of AVAC, a US-based HIV advocacy organisation, said: “There is still no conclusive research on what type of immune response an HIV vaccine should be trying to trigger. With HIV, you’re trying to do better than nature, With a Covid-19 vaccine, the jab merely has to do what nature is doing already — in the form of an immune response — just faster. But with HIV, you’re trying to do better than nature because your body isn’t able to successfully fight off the virus.

There is also another huge issue with HIV: differently from SARS-CoV-2 that during its reproduction in the human body creates similar copies to the original virus they originated from, when HIV makes copies of itself, they contain genetic changes, mutations, that make them very different from the virus they originated from. In fact, today we have two different strains of HIV – HIV1 and HIV2 – and it is very complicated to create a vaccine for both strains and their variations.

There is anyway a promising scientific development against HIV and this is represented by the Antibody Mediated Prevention Trials (AMP), which shall be released early next year. Basically, instead of trying to get our bodies develop an immune response to HIV, AMP should be giving people antibodies directly. Findings from these studies could help clarify what type of immune response is needed to prevent HIV infections and in turn guide the type of jab needed.

But is there any HIV Vaccine that is being studied?

Yes, there is…or actually there are. We’ll try to explain them easily using Aisha Abdool Karim’s words written for the Bhekisisa Centre for Health Journalism (TGM owns no rights on the below texts)

1 – HPX2008/HVTN 705: Imbokodo

This trial is testing two different HIV jabs:the first type of vaccine is known as a viral vector, or a “trojan horse” that uses a tame or inactivated virus as a carrier to help prime your immune system to respond to another virus, and this is being tried with HIV.

This shot uses a human adenovirus —  a strain of the common cold virus known as Ad26. This is the same virus that the pharmaceutical company Johnson & Johnson is currently using in its  Covid-19 vaccinetrial. In the case of HIV, the Ad26 virus has been genetically altered so that it sneaks genes that make non-harmful parts of HIV into your body, but without infecting you. Because your body recognises the proteins or structure of HIV, it then starts to produce antibodies and killer T cells to fight it. This way if HIV tries to infect you, your body will already be familiar with its structure and will be able to quickly mount a defence to destroy the virus.

What makes this vaccine unique is that it uses an approach called a ‘mosaic’. Instead of just inserting the genes from one type of HIV, genetic material from several HIV variations from around the world are inserted into the Ad26 adenovirus. This increases the chances that the vaccine could work globally as it encompasses multiple variations of the virus.

The second jab that the Imbokodo trial is testing uses a lab-made protein — clade C gp140 — similar to a protein found on HIV. This works in more or less the same way as a viral vector whereby the vaccineexposes your body to the protein and elicits an immune response that can then be used to fight off the virus when it tries to infect you. In the case of this jab, the protein has been mixed with a booster substance called an adjuvant, which boosts the body’s immune response to the vaccine. This shot uses aluminium phosphate as its adjuvant, which is the same substance that is used in hepatitis A and B vaccines.

2 – HPX3002/HVTN 706: Mosaico

The Mosaico study is testing the same two jabs as the Imbokodo trial. The first vaccine is a viral vector that uses the same human adenovirus — Ad26 — as the Imbokodo study. This shot uses the same mosaic vaccine design as the Imbokodo study where the same genes of different HIV subtypes are inserted into Ad26.

The second jab, like Imbokodo, is a protein vaccine. It uses a clade C gp140 protein — clade C is the subtype or variation of HIV most commonly found in southern Africa — as well as a Mosaic gp140 protein, which is designed to resemble a mix of proteins found on different subtypes of HIV around the world. This protein mix is then combined with an adjuvant or booster, aluminium phosphate, to enable the vaccine to trigger longer-lasting and stronger immunity in our bodies.

3 – PrEPVacc

The trial is testing two vaccine combinations and both jabs consist of a DNA-based vaccine along with a protein-based shot. The first vaccine combination immunises participants with the DNA jab alongside a protein shot called AIDSVAX®B/E. The AIDSVAX shot contains proteins from both HIV subtypes B and E, which are most commonly found in North America and Europe and Southeast Asia.

The second vaccine combination is slightly more complex, as it involves three different shots given together at different intervals of the trial. First, participants are injected with the DNA vaccine in conjunction with a protein shot that closely mimics the structure of the HIV envelope (a protein membrane which surrounds the virus and has sugars attached to the outside). This protein jab is called CN54gp140+MPLA-L and is modelled on those found on the C subtype of HIV. People receive these two shots at the start of the trial and then again after four weeks.

After six months, trial volunteers get another jab called Modified Vaccinia Ankara-Chiang Mai Double Recombinant (MVA-CMDR) — along with the same protein jab that they got in the first month. Forty-eight weeks after receiving their first jab, participants then, once again, receive these two shots — MVA-CMDR and CN54gp140+MPLA-L.

For more and detailed pieces of information, we encourage you to read this article.

Whilst researches go on, let’s keep on protecting ourselves and pay attention, but first of all let’s all get informed as ignorance is the worst virus of them all and is the one that leads to many other viruses.

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