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Ad26.Mos4.HIV is a tetravalent, recombinant, replication-incompetent adenovirus serotype 26 (Ad26)-vectored investigational vaccine designed to prevent HIV infection. It encodes two mosaic HIV‑1 Gag and Pol proteins and two mosaic Env proteins in a 1:1:1:1 ratio, aiming to induce broad immune responses against diverse global strains of HIV‑1[1][2][3]. The "mosaic" immunogens are engineered from elements of multiple HIV subtypes to maximize coverage of circulating viral variants[2][6]. The regimen typically involves four injections over one year; the final two doses are co-administered with a bivalent protein boost containing clade C gp140 and mosaic gp140 envelope proteins adjuvanted with aluminum phosphate[2][6]. Developed using Janssen's proprietary AdVac technology, the vaccine has been evaluated in multiple phase 1/2a and phase 3 clinical trials for safety, immunogenicity, and efficacy as an AIDS preventive measure[3][5]. While it generated robust binding antibody responses and cellular immunity in early studies, large-scale efficacy trials did not demonstrate sufficient protection against HIV acquisition[6].
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