IamA - I’m Dr. Chil-Yong Kang, Western University researcher seeking preventative AIDS vaccine. AMA!

Beers at the spoke later?

I'll be in the lab today, sorry.

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I am proud to be at Western too! Proceeds will be given to the sponsoring company and royalties will then go to Western.

Hi, i just wanted to thank you for this IAMA, my uncle has AIDS and his brother already died of it. I really hope you have success in your research! I really apreciate your work.

Thank you.

This is amazing news! In the press, it has been said that the team is getting ready for phase II and phase III clinical trials - how quickly do you predict the roll-out of phase II?

Hopefully within a year.

How close do you think we are to finding a cure for HIV / AIDS?

In my opinion we are looking at about another 8 years.

But, why 8 years? Does formulating a medicine really takes that long? Or you still doesn't have the "right" technology? Thanks for doing this AMA.

It takes a long time to perfect the manufacturing process and go through all the clinical trials.

Creating a vaccine for HIV/AIDS would make you very famous, and likely wealthy. How would you deal with all of that attention and renown? What do you think would change in your life?

Well, I’m interested in the saving lives of human beings and being wealthy is not my priority. Think of the impact of the smallpox vaccine by Jenner. He’s saved millions of lives over the years and it is now completely eradicated.

Dr Kang, what do you think will be the major disease plaguing the global population 50 years from now? Do you think malaria and hiv will still be as big a problem then?

I hope we know how to control AIDS and Malaria 50 years form now. It’s difficult to forsee what new emerging diseases will come in 50 years time. I hope TB can be prevented by effective vaccines by then.

No question. Just wanted to say that you and your team kick ass.

Thank you.

Dr. Kang, what is your thoughts on what can be done against the anti-vax side and their activity?

The anti-vaccine is an expression of ill-informed information and so many vaccines have saved millions of lives. This is the most effective way to prevent infectious diseases.

Besides financial support, what are some of the things that would help your research right now?

Identifying a good BSL3 GMP facility who can manufacture our vaccine.

Hi Dr. Kang - I was a 4th year student of yours almost 10 years ago (looking at VSV defective interfering particles). Was this the project that Chad was working on? I remember some testing with non-human primates going on in the US while I was there, but I don't remember exactly what it was. Much of the research others were doing was "over my head" at the time. Anyways, congratulations on the good news so far. Many people are jumping on this very optimistically, and it definitely is great news, but others are skeptical that it's "just Phase I". Do you think this is a bit of media getting ahead of themselves and over-exaggerating a positive result before further testing? We hear of "cancer cures" and "breakthroughs in HIV/AIDS research" but much of it is very premature. What are your thoughts on this?

Chad was one of my graduate students working on this project.

It took us a long time to come to this point to have this vaccine in human clinical trials. We hope this vaccine will prevent HIV infection.

Thanks for your reply. Wow that's great. He was the most hard working grad students I've ever seen. Good for him! Also, if anyone from the lab is reading this, you deserve some recognition - a lot of us understand how much work goes into these projects. Congrats so far! I'm in Public Health now - I will be watching anxiously and optimistically for news from the Phase II and III trials.

Thank you.

Hi Dr Kang. How many years of your life would you say you've put into the vaccine?It's very noble work you're doing.

We started our basic science work of HIV two decades ago and it took us about 10 years to develop the vaccine.

What are some of the limitations of the AIDS vaccine you've developed? Have you considered developing a vaccine that will not be susceptible to heat so that you can target main AIDS - stricken countries (Africa, etc) without proper refreigeration systems?

The vaccine that we have developed is for prevention and is relatively stable and doesn't require cold chain for distribution.

Dr Kang,

I had you in Micro2500 last year and I really enjoyed it.

My question is: Has there been any political backlash from individuals or groups such as Westboro Baptist Church because of the nature of your work with HIV/AIDS and finding a vaccine?

Thanks for your time!

Nice to hear from you, Goblin! There were 240 students in our class - how did you enjoy it?

No, fortunately I haven’t received any backlash from individuals.

I was wondering if you are going to privatize this vaccine or allow it to be public use. As drug companies (if privatize and patent) is allowed to charge this vaccine at large rates.

I hope this vaccine will be available to everyone.

Do you believe that an interdisciplinary education in the sciences is more valuable than one that is highly specialized in one subject, at least in undergrad?

Yes, interdisciplinary science is very important.

Do medical companies sponsor your research?

Yes, I have already committed to giving lectures at pharmaceutical companies in the near future. They are interested in our strategy in vaccine development.

Knowing how fast Aids mutates, how fast do you predict there will be a new strain not covered by the vaccine?

We know that HIV mutates fast. That means one nucleotide change out of 10,000 per round of replication. However the essential components of the HIV gene will not change and since we are using the whole virus there are many epitopes represented by all structural proteins. Therefore some changes in the HIV genome will not affect the efficacy of vaccine.

HIV resistance to antiretroviral therapy is greatly due to it's constant genetic mutation - will your vaccine stand "the test of time", per say? Will the "first genetically modified killed whole virus vaccine (SAV001-H)" be as useful in the next five to ten years as it might be today?

The drug resistant HIV arose when we use antiretroviral therapeutic agent. Therefore we are using the combination of three different drugs for treatment of HIV infected individuals. This will reduce virus load however it will not clear the virus infection. Our vaccine will be effective in five years' time even though there will be some mutations in the virus.

Which past student of yours are you most proud of?

Besides GoblinKumm? ;)

So many of my former students are faculty members in various universities around the world and I'm proud of all of them.

Hi Dr. Kang!

Who do you admire most in the world? :)

Albert Schweitzer is my hero.

Hi Dr. Kang! I recently read in the press that you're still looking into sponsorship for the next phases of the vaccine trials. How is that progressing and what kind of sponsor-partners are you seeking?

Our sponsoring industrial partner is able and willing to support up to Phase 2 human clinical trials. However we need collaboration with multinational pharmaceutical companies, governments, or philanthropists to support phase 3 human clinical trials since it costs approximately 70 million dollars.

What is your opinion of George Shaw's (a leader whose opinon I trust) observation that even with neutralizing antibodies present, HIV escapes not by mutating the common epitope, but by high glycosolation? A virus that doesnt have to suffer a loss of infectivity by this glycan shield is just selected out-doesnt this negate the premise of vaccines against HIV?

By using killed whole-virus vaccine, we are presenting the native structure of all viral proteins to vaccinees. We can only tell whether or not this killed whole-virus vaccine will protect HIV infection from clinical trials.

How do you find test subjects for your trials? Will all your trials be done in Canada or will you be doing some in other countries as well? I see this is a preventative vaccine, are you also working on anything for those already infected? Thank you :)

Yes, we have done the phase 1 human trials in the states. We are having phase 2 and 3 trials in the states, Canada, and western Europe.

Where in the world do you think that your work could have the biggest potential impact? Do you see it as helping the AIDS problem in Africa or would the cost of the vaccine be prohibitive?

All around the world.

Just wanted to say thank you for doing what you do! Very cool to see this coming out of Western.

Thank you.

Hi Professor! I have more of a "motivational" sort of question. I am a MSc student at Western and it is very common to see students not super excited about projects in the very beginning. Most of the thing seem useless and we rarely feel like it will lead us somewhere (I'm sure everybody in research felt like that at some point!). But big accomplishments like this have to start somewhere. My question is...involving all your research projects. What were you looking for at the first place? Were you already thinking about a vaccine or you were basically studying disease development/pathways or something like that took you to where you are now? Thank you,

Well, I took my post doctoral training in professor Temin's lab working on retroviruses in the mid-70's. We thought that we could make a significant contribution for understanding the basic science of HIV and therefore we started working on the molecular biology of HIV. I thought the vaccine against HIV would be developed in a relatively short period of time. However a effective vaccine was not created in 20 years time. Therefore we started our vaccine development project with our experience about 10 years ago.

How can an average person help you and your colleagues in what you do? In which way can we support your cause?

They can find a sponsor for our research.

How do you feel today sir? How do you and your team cope with the pressure?

I am under pressure all the time and we are working as hard as we can.

Bravo to you and your team! To be so close to a working vaccine is a testament to your perserverence, dedication and passion. My hat is off to all of the fine folk in lab coats everywhere. Keep it up.

Thank you.

What opportunities does your lab offer for undergraduate students in terms of research? It seems that with such a possible breakthrough it would a very inspiring means of getting young scholars interested in clinical research and microbiology.

I have some undergraduate volunteer students in my lab. We give opportunities to train in the laboratory. Unfortunately I cannot accommodate more than 3 students at a time.

Thanks for your reply!

Have a good day.

Dr. Kang,

Congratulations on your success. Could you explain how far you have come with the vaccine, and how much more needs to be done until it can be used on humans?

We have just completed phase 1 human clinical trial. We are planning to initiate Phase 2 trial within a year, following with phase 3 clinical trial which will measure efficacy of the vaccine.

The phase 3 trial will take approximately 3 years.

What are you most looking forward to in the medical field over the next couple of decades? (Edit: missing word)

I think neuroscience is a very important area of medicine in the future. So is emerging viral diseases.

Dr. Kang, what are your thoughts on Dr. Gero Hütter's research regarding the treatment of HIV/AIDS?

It's interesting but it has limited applications.

I know you are working on a vaccine, why did Phase I involve people who are already living with HIV? How did this help them?

Phase 1 is designed to look at the safety of the vaccine in humans. The USFDA has recommended to use HIV positive asymptomatic patients for the Phase 1 clinical trials.

Do you have any preliminary estimates on the cost of the vaccine for individuals (initially, and over time), and has your team been in contact with the Ministry of Health to discuss the potential for costs to be covered by provincial health plans?

No, it's difficult to estimate the cost of the vaccines at the present time. Hopefully it will be an affordable price.

Are there any diseases similar to HIV/AIDS which might be cured/prevented by your vaccine?

No.

It seems that whenever new vaccines are developed and produced, some people are hesitant to accept it for fear of contracting the disease. The article you posted says your vaccine uses a whole killed virus, but how can you be sure that every single virus in every single vaccine is dead?

Just FYI I am a huge believer in the importance of vaccines and in no way doubt the safety of yours, I am just interested in hearing your explanation so I can pass it on to others that may be cynical.

Thank you so much for devoting your time to this AMA, I am very proud to be a Western student today :)

We have inactivated the virus completely by a chemical known as AT-2 and gamma irradiation. And we have checked remnants of live virus in our vaccine and found none. This was one of the concerns of the USFDA and we had to satisfy their requirements.

Hi Dr. Kang

I don't have a question but wanted to let you know that your speech in the fall about your desire to set up a world institute of virology was beautiful and powerful. I enjoyed your second year course last year! Best of luck with the research!

Thank you.

Why Western? Out of all the universities and research places in the world, why did you choose Western?

Western is an excellent academic institution and I have excellent infrastructure at Western to do my research.

Considering this week is your university's Frosh Week, what has been your craziest experience with a frosh, student, first-year med student, etc.?

I’ve been too busy working on my research to engage with frosh but I wish them the best of luck!