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The World Health Organization (WHO) Disease Outbreak News confirmed the mpox outbreak in South Africa has expanded. 

The sudden appearance of unlinked mpox cases in South Africa without a history of international travel, the high HIV prevalence among confirmed cases, and the high case-fatality ratio suggest that community transmission of the mpox virus is underway

As of July 9, 2024, 20 confirmed mpox cases, with three related fatalities in Gauteng, Western Cape, and KwaZulu-Natalhave provinces, have been reported since May 2024.

These mpox cases are South Africa's first since 2022, when five cases were reported, none fatal.

The WHO stated, 'Discussions are underway regarding options for vaccine procurement.'

Currently, two mpox vaccines are being deployed in other African countries.

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WHO Mpox outbreak in South Africa map July 2024
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Doxycycline and MenB vaccination prevent bacterial sexually transmitted infections
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A vaccine candidate for control of the cytomegalovirus (“CMV”) in patients undergoing liver transplantation dosed its initial patient in a multi-center, placebo-controlled, randomized Phase 2 clinical study.

Initially developed by the City of Hope, Triplex was exclusively licensed to Helocyte.

Triplex is a universal (non-HLA-restricted) recombinant Modified Vaccinia Ankara viral vector vaccine engineered to induce a robust and durable virus-specific T cell response to three immuno-dominant proteins [UL83 (pp65), UL123 (IE1), UL122 (IE2)] linked to CMV complications in the post-transplant setting.

The trial is funded by a grant from the U.S.S NIH’s National Institute of Allergy and Infectious Diseases to the University of Washington Seattle. This grant has provided $9 million to date, with an estimated additional $12 million over the next four years in support of the Phase 2 clinical trial.

Ajit Limaye, M.D., Professor of Medicine and Director of the Solid Organ Transplant Infectious Disease Program at the University of Washington and Principal Investigator of the “CMV vaccine in Orthotopic Liver Transplant” trial, said in a press release on May 14, 2024, “There remains a significant unmet medical need to develop new therapies that can reduce the frequency and severity of CMV events in the organ transplant setting, where CMV continues to present life-threatening complications that directly impact patient outcomes and survival.”

According to the U.S. CDC, CMV is a common virus for people of all ages.

In the U.S., nearly one in three children is already infected with CMV by age five. About 1 out of 200 babies are born with congenital CMV.

And over half of adults have been infected with CMV by age 40.

Once CMV is in a person’s body, it stays there for life and can reactivate. According to the CDC, most people with CMV infection have no symptoms and aren’t aware that they have been infected.

Helocyte is a clinical-stage company developing novel immunotherapies to prevent and treat cancer and infectious diseases, including CMV and HIV.

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by Sasin Tipchai
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It has been about three decades since the U.S. Food and Drug Administration approved the first monoclonal antibody. Since then, antibody engineering has dramatically evolved. 

The recent pandemic was the first time monoclonal antibody-based therapies were produced in significant quantities to combat a new infectious disease. Globally, clinics administered hundreds of thousands of antibody injections over the first two years of the pandemic.

Antibody therapy worked... until it didn't.

The U.S. CDC says the infectious virus's rapid evolution outpaced the benefits derived from antibodies.

According to Michael Dumiak's article published by IAVI on April 25, 2024, this experience and other issues have researchers assessing the future of antibody therapies for treating or preventing infectious diseases, including some of the most complicated pathogens, such as HIV and antibiotic-resistant bacteria.

A potential application is blocking mother-to-child transmission of HIV during birth and through the breastfeeding period.

"We are in the position that if you want more antibodies for infectious disease, you need to be very cautious," says Rino Rappuoli, scientific director of the Biotecnopolo di Siena Foundation in Italy.

The unedited, complete IAVI article is posted at this link.

Note: As of May 5, 2024, the U.S. FDA has not approved an HIV vaccine candidate.

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by Jimmy Ho
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Although antiretroviral treatment (ART) can help manage the impact of the Human Immunodeficiency Virus (HIV), it is not a cure. People living with HIV need to take the treatment for their entire lives to suppress viral replication and protect their immune systems.

To address this clinical need, ACTG, a global clinical trials network focused on HIV and other infectious diseases, today announced the opening of A5374, a phase 1/2a study evaluating the safety, tolerability, and antiviral effect of a novel combination regimen that includes therapeutic T-cell vaccines, two broadly neutralizing antibodies (3BNC117-LS, 10-1074-LS), and an immune-system boosting treatment among people living with HIV who started ART during acute HIV infection.

This study hypothesizes that this combination regimen will be safe and result in a more extended period of viral control during a closely monitored pause in ART (known as an analytic treatment interruption) compared to placebo.

The approach being studied in A5374 is part of a potential path toward enabling the immune system to manage HIV in the absence of ART for weeks or months.

“We expect that controlling HIV in the absence of ART will require a combination of novel treatments to decrease the number of cells harboring HIV and simultaneously stimulate the immune system to keep the virus from replicating,” said ACTG Chair Judith Currier, M.D., M.Sc., University of California Los Angeles in a press release.

“A5374 is a pivotal trial, and we hope it will provide us with important insights into how to boost the immune system to control HIV.”

ACTG says carefully monitored analytic treatment interruptions are an essential part of HIV cure clinical trials. They can help determine whether a research intervention can reduce latent HIV (HIV that is “hidden” in different cells and tissues but not replicating) or increase immune function and delay or prevent latent HIV from actively replicating.

While there are no U.S. FDA-approved HIV prevention vaccines today, clinical development accelerated in 2023, with vaccine candidates utilizing innovative technologies such as mRNA.

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ACTG is the largest HIV clinical trials network
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Butantan-DV Dengue Vaccine

Butantan-DV Dengue Vaccine Clinical Trials, Dosage, Indication, News, Side Effects

Butantan Institute's tetravalent, live attenuated, single-dose Butantan-DV Dengue Vaccine conducts phase 3 clinical trials. The attenuated dengue vaccine results from a partnership between Butantan, the U.S. National Institutes of Health (NIH), and the American Type Culture Archive (ATCC). Development of the tetravalent dengue vaccine began at Butantan Institute in 2010 with FAPESP's support, using a formulation created by researchers affiliated with the NIH.

Butantan-DV is a cocktail of four live-attenuated dengue viruses (DENVs). Three dengue serotypes are near full-length DENV genomes, whereas only one component (DENV-2) is a chimeric vaccine virus. This chimeric virus contains two structural genes of DENV-2 on the same attenuated DENV-4 genetic background as the DENV-4 component of the vaccine. Consequently, Butantan-DV contains more homologous immunogenic dengue proteins for each serotype in the cocktail (including non-structural proteins for three of the four serotypes) than the other two highly chimeric vaccines.

Human phase 1 clinical trials in Brazil started in 2013, with the support of the Butantan Foundation and Brazil's national development bank, BNDES. The ongoing Phase 3 clinical trial results showed in an article published by The Lancet on August 5, 2024, that the vaccine is safe and 79.6% effective for all age groups between 2 and 59 and people with or without a prior history of infection by the dengue virus. A phase 3 study funded by Instituto Butantan and others published an Original Article in the NEJM that found a single dose of Butantan-DV prevented symptomatic DENV-1 and DENV-2, regardless of dengue serostatus at baseline, through 2 years of follow-up. As of February 15, 2024, the Phase III Trial to Evaluate Efficacy and Safety of a Tetravalent Dengue Vaccine was updated. Results from phase 3 of the clinical trial published in The Lancet Infectious Diseases in November 2024 showed 89% protection against severe dengue and dengue with warning signs and prolonged efficacy and safety for up to five years.

As of February 2025, Butantan has been discussing with the Ministry of Health how to incorporate the vaccine and a delivery schedule. "In 2025, we are working on the final stages of adjusting the processes and producing the initial batches, expecting to deliver 1 million doses, representing 1 million vaccinated people. In 2026, we would scale up and deliver another 60 million doses. In 2027, another 40 million doses, to achieve the vaccination curve for the Brazilian population," explained Esper Kallás in a media statement on February 19, 2025.

Instituto Butantan is the leading producer of immunobiologicals (vaccines) in Brazil.

Butantan-DV Dengue Vaccine Availability 2025

On December 16, 2024, the Company submitted for Butantan-DV approval in Brazil. In January 2025, the Butantan Institute submitted a report to Brazil's health surveillance agency (ANVISA), applying for the vaccine's registration in Brazil. ANVISA does not prohibit the production of vaccines before the licensor. If approved in 2025, Butantan-DV will be the world's first single-dose vaccine against dengue. The Institute plans to produce around 1 million doses in 2025, mainly for Brazil's Ministry of Health via the national vaccination program, and 100 million more doses by the end of 2027.

Butantan-DV Dengue Vaccine Dosage

Butantan-DV Dengue Vaccine is a single dose administration.

Butantan-DV Dengue Vaccine Indication

Butantan-DV Dengue Vaccine offers people protection against four types of the dengue virus.

Butantan-DV Dengue Vaccine Side Effects

In a phase 3 study, solicited systemic vaccine- or placebo-related adverse events within 21 days after injection were more common with Butantan-DV than with placebo (58.3% of participants vs. 45.6%).

Butantan-DV Dengue Vaccine News

February 19, 2025 - “We are providing the Butantan Institute with all the necessary infrastructure to ensure that we can produce the vaccine properly, as we are again experiencing a dengue epidemic. There is only one way to end dengue in our country, and that is to be able to put the vaccine in the arms of all Brazilians. In this sense, we have the full commitment of Butantan, the government, and the secretariat to focus on this,” said Eleuses. 

December 16, 2024 - The fact that the Butantan Institute can contribute to the world's first single-dose vaccine against dengue shows that it is worth investing in Brazil's research and the internal development of immunobiologicals. We will wait and respect all the procedures of Anvisa, an agency of the highest competence. But we are confident in the results that will come," says Esper Kallás, director of the Butantan Institute. 

August 5, 2024 - A Commentary published by The Lancet Infectious Disease highlighted the Butantan-DV vaccine's potential.

February 1, 2024 - The New England Journal of Medicine published Phase 3 clinical trial data. The dengue vaccine is safe for participants who have had dengue and those who have never been exposed to the virus before. "Findings from Phase 2 [the previous clinical trial] showed that the four attenuated viral serotypes in Butantan-DV multiply in the human organism and induce a balanced response in terms of antibody production. This leads us to conclude that its efficacy against DENV-3 and DENV-4 will also be good," said virologist Maurício Lacerda Nogueira.

December 16, 2022—The Butantan-DV dengue vaccine, under development by the Butantan Institute, is 79.6% effective in preventing the disease, according to initial phase 3 clinical study results. During the two-year follow-up of the volunteers, there were no cases of severe dengue fever or alarm signs.

Butantan-DV Dengue Vaccine Clinical Trials

ClinicalTrials.gov ID NCT02406729 - Phase III, Double-Blind, Randomized, Placebo-Controlled Trial to Evaluate the Efficacy, Safety, and Immunogenicity of the Dengue 1, 2, 3, 4 (Attenuated) Vaccine From Instituto Butantan. This randomized, multicenter, double-masked, placebo-controlled Phase III study will evaluate the efficacy and safety of a live attenuated, tetravalent, lyophilized dengue vaccine produced by the Butantan Institute. Over a 3-year enrollment period, 16,235 participants received either Butantan-DV (10,259 participants) or a placebo (5976 participants). The overall 2-year vaccine efficacy was 79.6% (95% confidence interval [CI], 70.0 to 86.3) — 73.6% (95% CI, 57.6 to 83.7) among participants with no evidence of previous dengue exposure and 89.2% (95% CI, 77.6 to 95.6) among those with a history of exposure. Vaccine efficacy was 80.1% (95% CI, 66.0 to 88.4) among participants 2 to 6 years of age, 77.8% (95% CI, 55.6 to 89.6) among those 7 to 17 years of age, and 90.0% (95% CI, 68.2 to 97.5) among those 18 to 59 years of age. Efficacy against DENV-1 was 89.5% (95% CI, 78.7 to 95.0), and against DENV-2 was 69.6% (95% CI, 50.8 to 81.5). DENV-3 and DENV-4 were not detected during the follow-up period.

ClinicalTrials.gov ID NCT01696422 - This is a phase II, step-wise, randomized, multicenter, double-masked, and controlled clinical trial to evaluate the safety and immunogenicity of an attenuated tetravalent lyophilized dengue vaccine manufactured by Butantan Institute. Between Nov 5, 2013, and Sept 21, 2015, 300 individuals were enrolled and randomly assigned: 155 (52%) DENV-naive participants and 145 (48%) DENV-exposed participants. Of the 155 DENV-naive participants, 97 (63%) received Butantan-DV, 17 (11%) received TV003, and 41 (27%) received a placebo. Of the 145 DENV-exposed participants, 113 (78%) received Butantan-DV, three (2%) received TV003, and 29 (20%) received a placebo. Butantan-DV and TV003 were immunogenic and well-tolerated; no severe adverse reactions were observed. In step A, rash was the most frequent adverse event (16 [845] of 19 participants in the Butantan-DV group and 13 [76%] of 17 participants in the TV003 group). Viraemia was similar between the Butantan-DV and TV003 groups. Of the 85 DENV-naive participants in the Butantan-DV group who attended all visits for sample collection for seroconversion analysis and thus were included in the per-protocol analysis population, 74 (87%) achieved seroconversion to DENV-1, 78 (92%) to DENV-2, 65 (76%) to DENV-3, and 76 (89%) to DENV-4. Of the 101 DENV-exposed participants in the Butantan-DV group who attended all visits for sample collection for seroconversion analysis, 82 (81%) achieved seroconversion to DENV-1, 79 (78%) to DENV-2, 83 (82%) to DENV-3, and 78 (77%) to DENV-4.

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Availability: 
N/A
Generic: 
TetraVax-DV Vaccine
Drug Class: 
Vaccine
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Last Reviewed: 
Tuesday, March 25, 2025 - 07:10
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Butantan-DV
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FDA First In Class: 
Yes
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