Moderna’s HIV Vaccine to Start Human Trials Early as Wednesday

It actually looks like its mRNA-ness has nothing to do with it, other than making it faster to iterate and scale. Instead, their "new strategy" is to raise broadly-neutralizing antibodies (BNAbs) in patients [0], i.e. antibodies that bind highly-conserved sites on HIV's gp120 protein [1].

I'm still skeptical, and a bit disappointed. if patients sometimes generate their own BNAbs, why haven't we heard of anyone clearing the virus? there are long-term non-progressors (LTNPs) who don't need to take anti-retrovirals for 8+ years, but eventually most of these people do progress to full-blown AIDS. the virus has a completely nutso mutation rate, it'll find its way around..

..which is why HIV is treated with combination therapy (HAART.) it's harder for breakthrough mutations to defeat antivirals if you're defending on multiple fronts. it should be totally feasible for Moderna to make a polyvalent vaccine, which raises several BNAbs by including several mRNAs in a single shot.

maybe they're planning to work up to this eventually? and this Phase I is sort of an exploratory prototype?

0. https://blogs.sciencemag.org/pipeline/archives/2021/04/21/mo... 1. https://en.wikipedia.org/wiki/Broadly_neutralizing_HIV-1_ant...