Saving Lives With “Test and Treat” Strategy for HIV-Infected Individuals
9 years ago
Antiretroviral Therapies have proven to help those who are HIV positive to enjoy a happy and full life. Those receiving treatment can have relatively normal lifespans. Decades of research and testing has made this outcome possible. Yet, there are many worldwide who are infected but who do not receive regular care or treatment. This causes a rise in mortality and poorer quality of life. So, in an effort to reach out and ensure that everyone is tested and treated without some falling through the cracks, a program was instituted in one region that had promising results as a HIV treatment as prevention approach.
A ‘test and treat’ method was applied to one area where HIV care was lacking. Program goals were to make testing and treatment simpler and faster while at the same time reducing the time between testing and therapy. Participants were tested for HIV along with a CD4 count and received results during the same visit. Included in that initial visit were both counseling prior to treatment and eligibility for antiretroviral therapy.
Faster Treatment Saves Lives
The time between HIV infection confirmation and the beginning of a patient’s therapy was greatly reduced – down to around five days – where previously it hovered at almost two months. Due to the efficient manner in which these cases were handled, the numbers showed that more patients received their treatments and followed through. Even better was how drastically the mortality numbers fell. One estimate puts the mortality rate at 13%, where before it was nearly 40%. When the program started little information had been gathered on the HIV positive population. This made it a bit more challenging to determine just how successful the test and treat method was. Undeniably, however, it met with great results that instill confidence in this type of streamlined care.
The success of this program highlights the need to implement HIV treatment as prevention in other areas. Some revision may need to take place so that it fits the needs of the region. Another matter meriting consideration is the cost. Researchers figured that for each patient who survived, the cost was US$235. This basically covered the first year of treatments and intervention. So from a financial standpoint, the cost is minimal compared with the outcome, making the program one that is feasible just about anywhere.
Multiple Variants Hurt Outcome for HIV Patients
9 years ago
Not all trials are conclusive or yield the results that scientists expect but everyday brings us closer to an HIV cure. Indeed, they still provide insight into matters not yet fully understood. That was certainly the case in a study recently conducted. The study took the results taken from two separate HIV vaccine trials and examined them together. The findings helped researchers determine what factors could lead to poorer patient outcomes on a clinical level. Both trial outcomes were compared to see how initial infection and viral characteristics could possibly be used to foresee the success of a patient’s treatment. While the study failed to be definitive, it has led scientists to look at matters in a different light.
The Results of the Study
HIV-1 on its own would establish, early on in the infection, its viral population. Once set, it generally remains constant. The patient is tested for viral load. Within a short time from the time of infection, this viral load can become relatively stable. This leads to a good prognosis for those pursuing treatment therapies. Outcomes begin to vary, however, as the viral population varies. When there is more than one viral variant, the colony becomes complex. This makes it unstable. Those who present with HIV infection but have multiple viral variants, usually have higher viral loads. It is easier for clinicians to predict a homogeneous population of the virus when compared to the alternative. These one-variant communities follow the step-by-step progression of the disease in a way that makes treatment more effective.
On the other hand, the unpredictability of variant viral populations can be tricky to treat. By comparing previous studies, it is hoped that what determines the variants, and how the host and virus interact in the initial phases of infection, will come to the fore. Being able to have a clearer picture of viral population workings and how it relates to the host’s response (especially during the early stages) could prove invaluable. Researchers expect that, upon learning the answers to these questions, a better strategy against the viral infection can be formulated, hopefully in vaccine form and later into an HIV cure.
DC Proves Needle Exchanges Have Value for Prevention
9 years ago
by ADMIN
in HIV Prevention
Sometimes, less is more. For HIV prevention programs, this is truly the case in needle exchange programs. One simple idea, in concept and execution, has saved one city millions of dollars and has prevented over 100 new cases of HIV in just two short years.
The needle exchange program is one of the easiest ways to help prevent HIV (and other viral infection) outbreaks and new cases in general. Along with that, it is by far one of the most cost effective tools on the war front against AIDS today. The program’s success is also helping in the ongoing debate over program funding. One study has put that success into numbers.
Simple idea, big results – that sums up the program. Basically, patients who need prescription medications that are administered via needles must return their used needles before they are given their next doses. For a while, the government aided in the funding for these and similar programs. Congress placed a ban on programs such as this in 1998. The ban prohibited the use of federal funds for needle exchange programs. States and their cities were, of course, allowed to use their own funds to support the programs, but many were unable to do so.
In late 2007, this ban was lifted in DC. Almost immediately, the Department of Health reinstituted the needle exchange program and programs for HIV testing, plus programs for aid addiction treatment. Once the ban lifted and the programs went into effect, researchers began to track the programs’ progress.
When comparing the numbers, from those during the ban to those after, impressive results were seen. The team first determined how many new injection drug use (IDU) cases presenting with HIV has occurred. Using the information they had gathered, an estimated 296 cases of HIV would have presented during two more years of the program funding ban. This is compared to the 176 injection drug users who did become infected with HIV with the programs in effect. Lifting the ban saved over 100 people from possibly contracting HIV in just two short years! There are financial benefits as well. Treatment for 120 people would have cost millions. It is estimated that taxpayers saved $44.3 million.
DC is not the only area benefiting from these types of programs. Regions across the US are reporting similar results.
How the Immune System Can Detect HIV
9 years ago
by ADMIN
in HIV Research
New HIV research has been revealing the workings of the human immune system. The hidden inner workings hold keys to solving some of the most formidable infections facing humankind. One such unlocked mystery is the discovery that one of the immune system’s sensor cells – cGAS – can detect HIV-1.
The cellular molecule, cGAS, is what sounds the alarm when there is an invasion of foreign matter. It has been believed, up until now, that cGAS could not detect retroviruses (such as HIV-1) because of the structural design of its DNA. Human DNA has two strands connected by molecular rungs. Retroviruses have just one strand. Researchers, therefore, concluded that this was one reason the body has trouble ridding itself of the intruder.
The HIV1 can, however, join together. They do this by twisting around each other to form a double strand. While these are more likely to be detected, the strand is often too short and passes through the cGAS radar. Here, however, is where the next piece in this chess game comes into play. The molecular building blocks of these DNA strands, called guanosines, can be detected by cGAS. It does not matter whether the HIV-1 is in its single-strand mode or not. Actually, it hardly mattered at all. What triggered the greatest immune response was the amount of guanosines. When more was added, the cellular defense response increased significantly. This strong reaction declined when the amount was lessened and all but stopped when it was removed altogether.
When HIV-1 infects a body, it imposes its DNA onto the healthy cell’s DNA. The result is a DNA that is curiously lacking in guanosines. It could be a reason as to why HIV-1 is particularly adept at cloaking – being virtually undetected by its host. However, some patients present with such a high number of HIV DNA that the guanosines that do remain still alert the cells, and the defense systems are activated. In these instances, the virus can remain suppressed indefinitely. This strong immune response is believed to be because of the detection of these all-important guanosines and the sensitive radar that detects it, cGAS.
Antibodies in the Future of HIV Treatment
9 years ago
Antibodies, also known as Y-shaped proteins produced by plasma cells, play an important role in keeping us healthy and free from infection. Now, HIV research scientists have identified a protein known as bNAbs. It stands for ‘broadly neutralizing antibodies’ and it may hold the promise of preventing HIV infections. The virus has spikes on it – not unlike many villains – and it uses these to bind and take over healthy cells.
The envelope spike or protein is the preferred target for the bNAbs. They are well equipped to recognize and subdue the virus. However, each type of bNAb is programmed to target specific epitopes or antigens on the spike. Certain bNAbs, therefore, have greater success in suppressing the virus than others. What most known bNAbs do have in common is that they tend to recognize the envelope spike in its closed position.
A virus will attach itself to a healthy cell, but in doing so the spike will open and close – depending on the stage it’s in. One lab has discovered a particular bNAb that can detect the virus when the spike is closed but also when it is partially opened. It was found while the research team was studying the antibodies of those whose bodies successfully control the HIV infection on their own. What is this special antibody called? 8ANC195. Continued efforts to see how 8ANS195 does what it does may lead to big things.
This could prove extremely beneficial in aiding those who are battling with HIV infection. These bNAbs could prove invaluable in identifying and neutralizing HIV that has gone undetected by the immune system. Seeing as most bNAbs target the virus when the envelope spike is closed, the virus with an open spike is free to continue unhindered. Now, with the discovery of antibodies that can detect the virus in its different forms, treatments can be more effective.
For HIV research, the promise of hope offered by these special bNAbs comes with more good news – it could be available in treatments in a short period of time. Clinical trials are already under way. Also, plans to make the antibodies even more effective are in the works. Researchers feel that introducing this bNAb to the cocktail will enhance the treatment therapies currently used.
