After 40 years of the first cases of HIV being discovered, science is getting closer and closer to a possible cure for the virus, but so far there is still no specific medication that can completely eliminate it from the body of an infected person. Who guarantees this is infectious disease specialist Laís Seriacopi, who attends to the use of Post-Exposure Prophylaxis (PrEP) and Pre-Exposure Prophylaxis (PEP) at the outpatient clinic of Hospital Heliópolis, in the South Zone of São Paulo. For those who are unaware of the medications, they are used to prevent exposure to HIV.
PEP is used when an individual has direct exposure to the virus and is effective when started within 72 hours post-exposure, with greater effectiveness in the first 24 hours. PrEP is prevention medication before conscious exposure to the virus, such as by sex workers, people who are going to have casual sex or participate in sex parties, for example.
As much as there is still no medication aimed at healing, science is already organizing itself for a possible vaccine that has this purpose. The infectious disease specialist explains that there is a specific clinical trial currently taking place in the United States.
“The vaccine is starting to be tested now. the modern [laboratório farmacêutico norte-americano] announced in January of this year a clinical trial in phase one with the application of a test vaccine in human patients”, he says.
In an official note released at the time, the laboratory stated that the tests will be applied to three different groups. The first totals 48 healthy and HIV-negative participants, who will receive one or two doses of the mRNA-1244 vaccine. Of these, 32 will receive an extra dose with a strengthened version of the formula, mRNA-1644v2-Core and, finally, another eight volunteers will receive only this more reinforced variation. In total, there will be 56 participants.
“In the past, this immunizer has already been tested in mice and seems to have had a positive response – so much so that it is now being tested in humans. This vaccine uses messenger RNA technology, the same that Moderna used in the immunization against Covid-19 and which was very successful. We are all very excited about this trial”, celebrates the infectious disease specialist, who reinforces that studies on the vaccine are initial and that there is no other type of medication that cures HIV.
“There is no medicine, no treatment or any other effort that offers a cure at the moment. There are some studies and experiments that show patients living with HIV who are maintaining an undetectable viral load – which prevents transmission of the virus – but this does not represent a cure yet,” she says.
The specialist also warns of the danger of adopting alternative therapies in search of a cure for the virus.
“Mutamba tea – one of the widely used alternative therapies – has many side effects. It is a medicinal plant that has a relaxation principle, people use it to fight insomnia, anxiety and stress, but in no way should it be ingested for the purpose of curing HIV”, emphasizes the specialist, who also comments on ozone therapy.
“Ozone therapy, for example, is another therapy that is not indicated for people living with HIV. We do not have robust evidence of its effectiveness in controlling the virus, in addition to the fact that it can cause skin irritation, bruising, pain at the injection site, among other reactions”, he says.
Another alternative therapy that has gained evidence in recent years and that is not recommended by the infectologist is raw food.
“Radivorismo – a diet based on 100% raw food – is another alternative that has no scientific proof of a positive effect in the fight against HIV. A risk that these therapies bring to people living with the virus is low immunity, which can cause problems for the advancement of treatment”, he concludes.
While in the United States the clinical trial of Moderna is taking place, here in Brazil we also see efforts in search of the long-awaited vaccine for HIV. O
is a study that takes place in eight countries in the Americas and Europe, with an average of 3,800 participants distributed among Brazil, Italy, Mexico, Peru, Poland, Spain and the United States.
In Brazil alone, according to the Ministry of Health, about 920,000 Brazilians are living with HIV. Of this total, 89% were diagnosed, 77% are on antiretroviral treatment and 94% of those on treatment no longer transmit HIV, as they have an undetectable viral load.
In Brazil, Hospital Emílio Ribas is responsible for coordinating the Mosaic Project. Infectologist Bernardo Porto, who is part of the research group, explains that the Mosaic Project aims to develop a “potential vaccine to prevent the sexual transmission of HIV type 1”.
“The study brings as a novelty a technology, which, from a viral vector platform, is capable of stimulating the production of an immune defense response against more than 90% of the subtypes and recombinant forms of HIV”, explains the infectologist.
Porto also says that, to generate these immune responses to more than 90% of the variability of the virus, research uses a “mosaic of genes from these different subtypes and recombinant forms of HIV type 1”.
“This mosaic is coupled to adenovirus 26 – a viral vector -, which will act as a ‘trojan horse’, carrying the genetic structures of HIV, allowing its recognition by the immune system and the organization of a defense response, without the risk of infection and illness by the virus”, he says.
The infectious disease specialist says that until today one of the biggest challenges in the search for an effective vaccine against HIV infection is “precisely to contemplate this immense genetic variability”. With the technology employed, the Mosaic study aims to achieve this goal. At the moment, the project is in phase 3, where the selected participants are divided into two groups: placebo and vaccine.
“Both the volunteers and researchers involved in the study are blinded to the allocation of participants between the two groups. There is a routine of at least 14 face-to-face visits to research centers, where multiprofessional health care, exam collection, counseling and the application of the four doses provided for in the study are carried out”, he details.
“After the completion of the dose application visits, the follow-up of these volunteers continues for at least one more year after the last application in the study, with consultations and exams scheduled according to the study protocol”, he concludes.
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