There was one study that saw 0 participants who contracted HIV during the trial according to the data on the FDA PDF [0]. Was 2,000 participants in Africa who were identified as potentially at risk, aged 16-25.
> YEZTUGO demonstrated superiority with a 100% reduction in the risk of incident HIV-1 infection over TRUVADA (Table 13).
~2,000 given YEZTUGO with 0 infections by the end.
~1,000 given TRUVADA with 16 infections by the end.
Now, this is a great study result if accurate. Substantially better. However, 100% protection is misleading clickbait article. The company does not claim to be 100% effective anywhere I can see... and at best they lifted this statement from this study to use as clickbait.
First, on the article itself. That title is just misleading clickbait.
In the same article we go from:
> The first 100% effective HIV prevention drug is approved and going global
to a couple paragaphs in:
> sold under the brand name Yeztugo – a class of drugs known as capsid inhibitors, which provide almost 100% protection against HIV infection
To a little bit later:
> The pre-exposure prophylaxis (PrEP) provides HIV-negative individuals around 99% protection from contracting the devastating virus through sex.
So... that is terrible writing about a topic like this.
From what I have seen there is no difference in effectiveness of this drug compared to the pills we already have if you actually take them properly.
I would love to be proven wrong, but this seems basically the same efficacy numbers we see for truvada and descovy.
That doesnt mean it is not still valuable, properly taking the pill every day is a huge component of that. I know I plan on looking at the shot personally.
But the reporting on this article is extremely shady.
All aside from the healthy criticism on the clickbait title, I found the approach to make it royalty-free (presumably for generic production) and free of cost access to uninsured individuals incredibly fascinating. How will they manage to cover R&D costs? That’s the primary reason pharmaceutical companies use to justify exorbitant drug prices. Was this a result of a philanthropic endeavor?
What is the target audience for these bi-anual shots? Only populations at high risk or are we supposed to start vaccinating everyone that is sexually active?
Btw, nothing on the article about potential side effects.
What's to prevent HIV from evolving past the protection? Strains of gonorrhea (a bacteria) has evolved to get around antibiotics. Won't that happen with HIV? Or is a virus not able to adapt?
Beyond efficacy, having a drug that only needs to be taken twice per year is a huge deal. Adherence is critical for treatments to succeed, and it's much easier to ensure that patients are on their meds twice per year. It's also much safer for vulnerable people, where getting caught with HIV medications (say daily pills) could be dangerous
That sounds great, but the "100%" part makes me worry. I don't know a lot of 100% effective medicines, there are always corner cases, and if they are claiming there aren't they are either exceptionally awesome, or lying. The experience teaches me liars are more common that exceptional awesomeness...
Given that sugar pills still have a curative effect on some portion of patients and that 100% effective sounds pretty unscientific as a figure (nothing is 100% hence the need to use statistical confidence). I pray that I am wrong in smelling something being rotten in this lot but only time will tell.
In terms of difficulty was the HIV drug harder to develop than the COVID vaccine? If so, how much harder? The resolution of the AIDS epidemic, granted the logistics and targeting now needed, is such a brilliant milestone.
The problem with this drug is that it inhibits one of the final stages in viral replication. This means that before it can work the virus has already infected the cell and added its RNA to the host cells DNA permanently.
So if a patient is exposed to HIV while on the drug, this will not prevent their cells from being infected with the virus. The infected cells will not subsequently create any virus, and therefore additional cells will not be infected, however nothing prevents actual exogenous HIV from infecting cells while on this drug.
That means that if someone discontinues the drug, cells that have been infected with HIV during the time they were on the drug can start producing it causing AIDS.
It’s great that there’s a drug that works as well as this for chronic use, but nobody should think that it’s actually preventing infection. It’s allowing infection but inhibiting viral replication post infection.
Unless low-risk people are getting shots twice a year too, I don't see this as reaching the goals that are as monumental as the article and Gilead suggests.
Sure, vaccinating high risk sexually active preteens in regions of Africa will dramatically reduce infection in ways that have been insurmountable to those on the frontlines.
But for everyone else, this doesn't seem to materially change anything.
A sexually active adult or accidental/intentional polycule in western nations has no change in user experience. The risk remains both low and essentially the same. Test often if you are in "sex-positive" communities where testing and sharing results isn't taboo. Or do nothing and just imagine you're being responsible. Its the same as before.
PreP users can switch to a 2x yearly regime instead of the current frequency, but that's only for people with partners already.
I just don't see this as good enough unless it turns into like a one time vaccination, done as part of a cocktail in a normal routine checkup.
Should we mandate that all school children take this? Maybe make it a requirement for employment? I'm sure there's negative side effects, but all vaccines and drugs have that.
If we did, we could end a lot of suffering in a decade or two for many at risk people.
Sidebar but HIV has led to some really amazing antiviral research. I really hope that this research will be helpful during the next pandemic. That’s a silver lining for a truly horrible disease.
22 comments
[ 2.4 ms ] story [ 58.5 ms ] threadThere was one study that saw 0 participants who contracted HIV during the trial according to the data on the FDA PDF [0]. Was 2,000 participants in Africa who were identified as potentially at risk, aged 16-25.
> YEZTUGO demonstrated superiority with a 100% reduction in the risk of incident HIV-1 infection over TRUVADA (Table 13).
~2,000 given YEZTUGO with 0 infections by the end. ~1,000 given TRUVADA with 16 infections by the end.
Now, this is a great study result if accurate. Substantially better. However, 100% protection is misleading clickbait article. The company does not claim to be 100% effective anywhere I can see... and at best they lifted this statement from this study to use as clickbait.
0: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/22...
In the same article we go from:
> The first 100% effective HIV prevention drug is approved and going global
to a couple paragaphs in:
> sold under the brand name Yeztugo – a class of drugs known as capsid inhibitors, which provide almost 100% protection against HIV infection
To a little bit later:
> The pre-exposure prophylaxis (PrEP) provides HIV-negative individuals around 99% protection from contracting the devastating virus through sex.
So... that is terrible writing about a topic like this.
From what I have seen there is no difference in effectiveness of this drug compared to the pills we already have if you actually take them properly.
I would love to be proven wrong, but this seems basically the same efficacy numbers we see for truvada and descovy.
That doesnt mean it is not still valuable, properly taking the pill every day is a huge component of that. I know I plan on looking at the shot personally.
But the reporting on this article is extremely shady.
Btw, nothing on the article about potential side effects.
So if a patient is exposed to HIV while on the drug, this will not prevent their cells from being infected with the virus. The infected cells will not subsequently create any virus, and therefore additional cells will not be infected, however nothing prevents actual exogenous HIV from infecting cells while on this drug.
That means that if someone discontinues the drug, cells that have been infected with HIV during the time they were on the drug can start producing it causing AIDS.
It’s great that there’s a drug that works as well as this for chronic use, but nobody should think that it’s actually preventing infection. It’s allowing infection but inhibiting viral replication post infection.
I would love to sit in on branding meetings for pharmaceuticals.
Sure, vaccinating high risk sexually active preteens in regions of Africa will dramatically reduce infection in ways that have been insurmountable to those on the frontlines.
But for everyone else, this doesn't seem to materially change anything.
A sexually active adult or accidental/intentional polycule in western nations has no change in user experience. The risk remains both low and essentially the same. Test often if you are in "sex-positive" communities where testing and sharing results isn't taboo. Or do nothing and just imagine you're being responsible. Its the same as before.
PreP users can switch to a 2x yearly regime instead of the current frequency, but that's only for people with partners already.
I just don't see this as good enough unless it turns into like a one time vaccination, done as part of a cocktail in a normal routine checkup.
If we did, we could end a lot of suffering in a decade or two for many at risk people.