India to be hit as pharma giant pulls plug on AIDS vaccine

The road map to bringing the HIVAIDS pandemic under control by 2030 has been badly impacted after vaccine research was abruptly stopped by Belgiumbased pharma giant Janssen Pharmaceuticals in December 2022 This happened after a vaccine trial involving 3900plus transgender individuals and cisgender men with multiple sexual partners failed to protect them from HIV Health experts say this will have adverse an impact on India and are waiting for the company to make its study publicThe UNAIDS report of 2021 showed that 39 million people across the globe were living with HIVAIDS and despite 25 million receiving ART antiretroviral therapy medication at least 15 million die each year and are replaced by an equal number of new infections In India HIVAIDS numbers are on the riseStatistics raise concernAccording to the report 22 million people are living with HIVAIDS in the country and more than 1 lakh new infections are seen every year India was looking forward to two gamechangersmdashthe protective or preventive HIV vaccine for the adolescent and adult population and new curative medicines which were expected to be available in two to three years as ART is not a curative line of treatment said Dr Subhash Hira professor of global health at University of Washington Seattle and a global pioneer in treating HIVAIDS for the past 40 yearsAlso Read Retired govt staffer gets pension five years laterAsked to explain Dr Hira said ldquoAfrica and Asia will be adversely affected due to the failure of the HIV vaccine trial Secondly research and testing on curative medicine will be further delayed as very little research is ongoing due to the outbreak of COVID19 The world is still struggling with older pandemics such as HIVAIDS tuberculosis and reemerging sexually transmitted infections which will continue to be a glaring challengerdquoDr Wiqar Shaikh professor of medicine Grant Medical College and Sir JJ Group of Hospitals has expressed disappointment about the failed trial He said that the failed HIV vaccine had been in development since 2019 and was given to 3900 participants who were 18 to 60 years old through October 2022 However the data shows that it does not protect against HIV when compared to a placebo as announced by Janssen Pharmaceuticals He added that due to the setback there will not be another potential AIDS vaccine for another three to five yearsThe recent trial the Mosaico trial was conducted at the Fred Hutchinson Cancer Research Centre in Seattle and the US Army Medical Research and Development CommandWorldwide problemAccording to Dr Shaikh more than 15 million people across the world were infected with HIV while 65 lakh people died due to it in 2021 In India as per the data available there were 63000 new HIV infections and 24000 HIVrelated deaths that yearThe studyAccording to Dr Hira the study evaluated a mosaicbased adenovirus serotype 26 vector administered during four vaccination visits over one year A mix of soluble proteins Clade CMosaic gp140 was also administered during visits three and four The Mosaico analysis indicated that the regimen did not protect against HIV and the study is not expected to meet its primary endpoint No safety issues with the vaccine regimen were identified In light of this the study was discontinued and further analyses are underwayldquoThe history of HIV vaccine development has had numerous setbacks and each research ldquobreakthroughrdquo presented with more challenges and hurdles since 2000 The replication cycle of HIV is not only fast about 24 hours but is also prone to frequent errors churning out mutants of itself that recombine into new strains as the virus is transmitted from person to personDeveloping a single vaccine able to eradicate over 60 dominant HIV strains as well as the innumerable number of recombinant strainsmdashand on a global levelmdashbecomes more challenging Secondly specialised white blood cells called CD4 Tcells initiate the immune response by signalling killer cells to the site of the infection Ironically these are the very cells that HIV targets for infection Thirdly the eradication of HIV is thwarted by the virusrsquos ability to hide from the bodyrsquos immune defences Soon after infection while other HIV is circulating freely in the bloodstream a subset of the virus called provirus embeds itself in hidden cellular sanctuaries called latent reservoirs Once inside these cells HIV is shielded from host immunityrdquosaid Dr HiraHe added ldquoRecently discovered broad neutralising antibodies bNAbs have the ability to kill a broad spectrum of HIV variantsmdashup to 95 per cent in some casesmdashthereby limiting the virusrsquo ability to infect and spread To date scientists have yet to identify an effective means to induce a bNAbs response to levels where it may be considered protective and such a broad immune response would likely take months or even years to developrdquo39kNo of participants the vaccine was tested on