A new device intends to make diagnosing AIDS easier and more accessible for people in developing countries.
The instrument would eliminate the need for expensive equipment and highly trained staff, resources that are not available in many areas where the HIV epidemic is most severe.
HIV kills by destroying a particular type of disease-fighting white blood cells called CD4+ T lymphocytes. Full-blown AIDS sets in when patients’ CD4 counts fall below a critical level and they are unable to fight off infections. That’s when antiretroviral drugs are critical.
But counting CD4 cells requires a blood sample and a lab equipped to analyze it. In many areas hardest hit by the AIDS epidemic – much of sub-Saharan Africa, for example, “there is just no way to get the patient or the blood very easily to the lab,” said Rashid Bashir, head of the bioengineering department at the University of Illinois at Urbana-Champaign.
Lab on a chip
So, Bashir and colleagues have developed a prototype “lab on a chip” with all the equipment and chemicals to do the job in a 3-centimeter-by-4-centimeter cartridge.
Scientists have discovered a new gene that may have the ability to prevent human immunodeficiency virus (HIV) from spreading once it enters the body, according to a study published in the journal Nature.
Researchers from King’s College London in the UK say the gene, called MX2, could lead to new effective and less toxic treatment against HIV – the virus that causes acquired immunodeficiency syndrome (AIDS).
For the study, the researchers conducted experiments on human cells, in which they introduced the HIV virus to two different cell lines. One cell line had the MX2 gene “switched on,” while the other cell line had no MX2 expression.
On observing the effects, the researchers found that in the cells in which the MX2 gene was expressed, the HIV virus was unable to replicate, therefore stopping new viruses from being produced.
In the cell line in which the MX2 gene was switched off, the HIV virus replicated and spread.
In the back of a skid row community health center, a woman with teardrop tattoos under her eyes begins to tell her story.
To a circle of other women, she says she ran away from home and joined a gang at 13. She started injecting PCP, and as a teen spent time in jail. By 22, she worked as a prostitute. At 37, she was diagnosed with HIV.
Now 50, the woman known as Hilda tells the circle that the only time she took her HIV medication was when she was in jail. “Why?” someone asks. “I wanted to die,” she answers.
Welcome to a weekly support session sponsored by the Ladies of Diversity, a federally funded program that works to give HIV-positive homeless women of color a reason to stay connected to medical services. Leaders allowed the Los Angeles Times to attend one gathering on the condition that clients be identified only by their first names.
The organization aims to better understand the challenges that keep infected black and Latina women from connecting to HIV care, said Tina Henderson, an HIV/AIDS researcher for 20 years and the program manager of the Ladies of Diversity.
California is one of eight states where such a project has been given money by the federal Health Resources and Services Administration.
David was skeptical. It sounded too good to be true. A once-a-day pill that could help healthy people avoid HIV infection?
But David also knew he was at high risk because his partner was HIV-positive.
So after careful research, the 21-year-old Oakland resident decided to join an unusual program that will give the drug known as Truvada to more than 100 East Bay youths, along with safe-sex counseling and other sexual health services.
Those overseeing the program hope it can help solve a serious problem: The number of people nationwide who are newly infected with HIV, the virus that can cause AIDS, has held steady at about 50,000 annually in recent years after dropping sharply in the late 1980s, despite health professionals’ best efforts to tackle the problem.
“There is a degree of frustration — we don’t seem to be able to reduce the level of transmission,” said George Lemp, director of the University of California Office of the President’s HIV/AIDS Research Program.
“A lot of people felt that we needed more aggressive approaches,” he said.
According to UNAIDS estimates, the four countries with the most severe epidemics are Botswana, Lesotho, South Africa, and Swaziland. In these countries, HIV prevalence ranges from 13-21% and 23-30% in adult males and females, respectively.
Until recently, we have had surprisingly poor estimates of country-wide HIV prevalence. For a long time, all country estimates of HIV prevalence were based on anonymous testing of pregnant woman at antenatal clinics. This has been the best available data, but sexually active women are hardly a representative sample of the whole population.
Only with the start of more representative surveys that included HIV testing in the mid 2000’s (such as the Demographic and Health Surveys that we analyzed) did we really begin to understand exactly how severe the epidemics were.
Known as the OraQuick In-Home HIV test, the test was developed by OraSure Technologies, Inc.
“The test has the potential to identify large numbers of previously undiagnosed HIV infections, especially if used by those unlikely to use standard screening methods,” the FDA said in a new release.
“Knowing your status is an important factor in the effort to prevent the spread of HIV,” said Dr. Karen Midthun, director of the FDA’s Center for Biologics Evaluation and Research. “The availability of a home-use HIV test kit provides another option for individuals to get tested so that they can seek medical care, if appropriate.”
The FDA says clinical studies of the test showed a 92 percent sensitivity rate, which means that of every 12 HIV-infected individuals tested with the kit, one negative result could be expected.
Thirty-four million people live with HIV today, and 1.7 million became newly infected in 2011. But on the eve of World AIDS Day, many experts see room for some optimism.
Studies now show that identifying — and effectively treating — people who are HIV-positive early in the course of their infections will not only reduce sickness and deaths for those patients but will also reduce the risk of spreading the virus to others. That’s because the antiretroviral medications keep the levels of virus low in a patient’s body.
For those reasons, the U.S. Preventive Services Task Force this month released draft advice for the government and U.S. physicians proposing that HIV screens should be routine for most people — not just those whose behavior puts them at high risk. A commentary by AIDS experts published in the Canadian journal CMAJ suggested the same thing for our neighbors to the north. The advice is in line with CDC guidelines as well as with ones from a variety of medical groups.
“Yet less than a third of HIV-infected people in the United States are being treated successfully for their infection such that the virus is fully suppressed, and similarly low percentages have been observed in other countries,” noted a statement released by the National Institutes of Health. It was coauthored by Dr. Anthony Fauci (director of the National Institute of Allergy and Infectious Diseases), Jack Whitescarver (director of the NIH Office of AIDS Research) and NIH director Dr. Francis Collins.
Scientists have come up with a test for the virus that causes AIDS that is ten times more sensitive and a fraction of the cost of existing methods, offering the promise of better diagnosis and treatment in the developing world.
The test uses nanotechnology to give a result that can be seen with the naked eye by turning a sample red or blue, according to research from scientists at Imperial College in London published in the journal Nature Nanotechnology.
"Our approach affords for improved sensitivity, does not require sophisticated instrumentation and it is ten times cheaper," Molly Stevens, who led the research, told Reuters.
Simple and quick HIV tests that analyze saliva already exist but they can only pick up the virus when it reaches relatively high concentrations in the body.
Patients stepping into Johns Hopkins University’s HIV clinic in east Baltimore do not just see a doctor or get prescriptions for their antiretroviral drugs. Many also get help finding a place to live or bus fare to make it to their next appointment.
Such care that goes beyond the examination table and into patients’ often challenging lives has been key to helping poorer HIV patients – particularly blacks and women – live long, healthier lives, according to a 15-year study published on Thursday in the journal Clinical Infectious Diseases.
Researchers at the university followed 6,366 patients in the mostly black, low-income part of a city marked by abandoned buildings and plagued by an illegal drug trade that drew national attention on the gritty television series "The Wire."