HIV & AIDS | Health FAQ

Focus on resistance to HIV offers insight into how to fight the virus

Credit: CC0 Public Domain

Of the 40 million people around the world infected with HIV, less than one per cent have immune systems strong enough to suppress the virus for extended periods of time. These special immune systems are known as “elite controllers.” But how do they actually fight HIV? Canadian scientists think they’ve found an important clue.

Working in collaboration with a team from the Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), researchers at the Laboratory of Antiviral Immunity of Université du Québec à Trois-Rivières (UQTR) have found that genetic mutations affecting the capsid, the structure surrounding the HIV genome, make it possible for a protein called TRIM5α to trigger the immune system of elite controllers.

This discovery, recently published in PLOS Pathogens, sheds light on the role that TRIM5α plays in the human body. In elite controllers, the protein sets off a mechanism that protects against HIV-1, the type of HIV responsible for the global pandemic. “In most infected individuals, TRIM5α’s triggering ability is so weak that it has no effect on the virus, but in elite controllers, TRIM5α seems to play a role in naturally inhibiting HIV-1,” said lead author Natacha Mérindol, a postdoctoral researcher at the UQTR lab.

There is no vaccine or cure for HIV-1. That’s why it’s important to understand why the virus is naturally inhibited in elite controllers, said Mérindol, who works under the direction of UQTR medical biology professor Lionel Berthoux, head of the lab, and Dr.Cécile Tremblay, a professor at Université de Montréal’s Faculty of Medicine and a clinical researcher at CRCHUM.

Different from the vast majority

Elite controllers are HIV-infected people whose immune system performs better at fighting HIV-1 than in the vast majority of HIV patients. They are infected with the virus, but the infection is much weaker than usual. “They have very strong immune systems that can control the infection – it’s as if they were receiving treatment, even when they aren’t,” said Mérindol.

“Our HIV-positive patients played an essential role in making this research possible and we would like to thank them for their incredible generosity and availability,” said Tremblay, a microbiologist and infectious disease specialist at the CHUM. “It’s an important study that could advance research on HIV vaccines.”

“Thanks to the dedicated patients and researchers from different universities, we were able to learn more and advance the fight against HIV,” added Mohamed El-Far, a fellow researcher at CRCHUM.

Studies had previously suggested that TRIM5α helps protect against HIV-1, prompting the researchers to analyze the virus found in many elite-controller patients who are part of the Canadian Cohort of HIV+ Slow Progressors, a group administered by the Fonds de Recherche du Québec – Santé’s AIDS and Infectious Disease Network (FRQS-SIDA/MI). The researchers compared blood samples of patients from two cohorts (elite controllers and normal progressors) who weren’t undergoing retroviral treatment.

TRIM5α: under the microscope

“Our goal was to examine a specific part of the virus: the capsid – it’s the ‘virus coat,’ which determines sensitivity to TRIM5α,” explained Berthoux, who directed the study. The capsid’s role is to protect the virus’s ribonucleic acid (RNA), which holds its genetic information, but the body’s immune system attacks it through a variety of mechanisms.

Those attacks lead to mutations that help them escape some of the immune mechanisms involved. The research team observed that the capsid’s gene carries a high number of mutations, but that these mutations made HIV-1 sensitive to TRIM5α activity, leading the team to wonder about the effects of a TRIM5α attack on the capsid in elite controllers.

They found that, in these patients, the interaction between TRIM5α and the capsid triggers an antiviral state that reduces cellular sensitivity to HIV-1. The signal sent by TRIM5α is strong enough for the cell to become resistant in this subset of the patient population, whereas TRIM5α’s signal is not as effective in normal patients.

This mechanism could be used to develop immunity strategies that inhibit HIV-1. One possible therapeutic strategy would be to genetically modify TRIM5α to increase its triggering ability, which would ultimately protect people from HIV. Since TRIM5α’s activation capacity is too weak in normal patients, this would mean mutating TRIM5α to increase its capacity to target HIV-1, which would therefore reduce the capacity of HIV-1 to propagate in the patient.

Journal reference:
PLoS Pathogens

Provided by:
University of Montreal

Source

HIV drugs may help Alzheimer’s, says study proposing an undiscovered root cause

PET scan of a human brain with Alzheimer’s disease. Credit: public domain

A major new study on Alzheimer’s disease provides previously unknown evidence of how the brain-robbing illness may originate.

Moreover, it proposes that certain HIV drugs called reverse transcriptase inhibitors could immediately be repurposed for Alzheimer’s patients.

Led by scientists from Sanford Burnham Prebys Medical Discovery Institute in San Diego, the study finds that, as long suspected, Alzheimer’s is a genetic disease. But in nearly all cases, it’s not inherited. Rather, it arises during a patient’s lifetime by genetic rearrangements in neurons. Sequences of DNA are copied, altered and inserted back into the genome.

The genetic rearranging isn’t random mutation, but a process that recombines DNA into different patterns. This reshuffling creates a mosaic of slightly differing cells. The immune system uses a similar process to make antibodies, but nothing like it has been seen in the human brain.

Reverse transcriptase inhibitors might also ward off Alzheimer’s in those with Down syndrome, who develop Alzheimer’s as they age, the study said.

The study was published Wednesday in the journal Nature.

Confirmation of the findings is required, said Dr. Jerold Chun, the lead author. But Chun says testing with the HIV drugs should begin immediately. Even a low degree of effectiveness would be better than what is now available.

The study combines single and multiple-cell analytical methods to examine 13 donated human brains, some normal, some with Alzheimer’s. Its findings jibe with epidemiological data from elderly HIV patients. They have been treated with reverse transcriptase inhibitors for decades, and almost never get Alzheimer’s.

The first documented case of Alzheimer’s in an HIV-positive individual was reported in 2016.

Cautious praise for the study came from Dr. Paul Aisen, a longtime Alzheimer’s researcher who specializes in clinical trials. Aisen heads the University of Southern California Alzheimer’s Therapeutic Research Institute in San Diego.

“The authors carefully demonstrate that there are extensive modifications to genetic material in the Alzheimer’s disease brain,” Aisen said by email.

“These are changes that occur with aging, rather than inherited genetic characteristics. While this is an intriguing idea, the actual contribution of this age-related genetic change remains uncertain.”

Fred “Rusty” Gage, president of the Salk Institute and a noted brain expert, said the study’s results back up the claim that DNA sequences are copied and inserted back into the neuronal genome.

“These results are quite striking and could have implications for Alzheimer’s disease diagnosis and progression,” Gage said by email.

About 5.7 million Americans today have been diagnosed with Alzheimer’s disease, according to the Alzheimer’s Association. That number is expected to double by 2060, according to the Centers for Disease Control and Prevention.

In recent years, Alzheimer’s researchers have changed their view of the disease. They now say Alzheimer’s begins decades before symptoms appear. Eventually, the damage eating away at the brain becomes severe enough to affect cognition and memory.

So increasingly, researchers are looking for the earliest possible signs that Alzheimer’s is developing, before mental functions are affected.

The study traces the ultimate cause to the genetic rearrangements, so blocking this reshuffling should block Alzheimer’s.

The reshuffling can be likened to a copy-and-paste function in affected neurons. But instead of making an exact copy, the process scrambles DNA segments, then reinserts them back into the neuron’s genome.

Normal brains also show genetic variation in individual cells. Research suggests this condition is a normal part of brain development. Instead of having billions of identical neurons, each may vary slightly in a way that helps the brain work, Chun said.

This process goes wrong in producing the Alzheimer’s-causing variations, derived from a gene called APP. Certain variants of this gene are strongly linked with Alzheimer’s.

Because genes produce proteins, these rearrangements of the APP gene likely produce variations of toxic brain proteins called beta amyloid, known to be involved in Alzheimer’s.

Some of these genetic variants are found in a very rare form of Alzheimer’s that is directly inherited. Virtually all people with these variations come down with Alzheimer’s.

But this “familial” form constitutes only a few percent of all Alzheimer’s cases. The vast majority of “sporadic” Alzheimer’s cases shows genetic tendencies, but fall far short of a perfect correlation.

The study provides an explanation for sporadic Alzheimer’s: Because these genetic changes only occur in the brain, they don’t show up when a person’s genome is sequenced.

In addition, it may explain the failures of amyloid-based therapy. Billions of dollars have been spent developing drugs according to what is known as the “amyloid hypothesis,” with virtually nothing to show for it.

Chun said this may be because the amyloid drugs are aimed at a single molecular target, and there’s molecular diversity in amyloid.

“What our data strongly supports is that there could be many, many other targets that would have been missed by these single molecularly targeted therapeutics,” Chun said.

This means the amyloid hypothesis is essentially correct, but doesn’t go deep enough, Chun said.

In an accompanying perspective article, two University of California, San Diego Alzheimer’s researchers said the study was also important because it provided the “surprising existence” in the brain of what is called “somatic gene recombination.”

“This phenomenon, which has previously been reported only in antibody generation in immune cells, increases the diversity of proteins encoded by a given gene through DNA-shuffling mechanisms, wrote Guoliang Chai and Joseph G. Gleeson.

“The study hints at a previously unanticipated mechanism in the development of Alzheimer’s, and expands our understanding of the genesis of brain mosaicism,” they wrote. “But whether accumulation of (the recombined DNA) in neurons is a cause of or is caused by Alzheimer’s disease remains to be proved.”

Aisen cautioned that some studies indicate that Alzheimer’s is more likely linked to defects in removing amyloid, not their manufacture.

“So while there could be therapeutic implications of these new findings, additional clarification of this mechanism is needed,” Aisen said.

Doctors could use the HIV drugs on Alzheimer’s patients as an “off-label” use, Chun said. But that would require careful ethical consideration.

On the positive side, there’s no treatment now that affects the underlying neurodegeneration Alzheimer’s brings, and the safety profile of the HIV drugs is well-known.

“Let’s say this only works 25 percent of the time, that’s still 1.5 million patients in the United States, not to speak of their families,” he said.

And even a modest effect of preserving cognition for a few years would mean a great deal to those families, he said.

However, all drugs have risks, and Alzheimer’s patients tend to be elderly and may have other conditions.

Such off-label use also doesn’t provide a scientific basis for officially approving the drugs for Alzheimer’s. That’s the job of a properly designed clinical trial.

Designing such a trial will be complicated, Chun said. There’s the need to accurately find the patients who will likely benefit. Brain scans for amyloid deposits, which are now available, might help. But as for now, actual detection of the pathological brain mosaicism in living people isn’t possible.

The APP-linked variations spread with the help of an enzyme called reverse transcriptase that HIV uses to replicate, the study says.

With the help of reverse transcriptase, HIV copies its genome into the genome of infected cells. Since it becomes part of the cell’s DNA, HIV is very hard for the immune system to reach. Reverse transcriptase inhibitors, a regular part of HIV therapy, block this process.

Reverse transcriptase is also naturally found in the human body, and presumably plays an important function.

“Evolutionary biologists that have looked at the human genome, have estimated that nearly half of our genome was created by reverse transcription,” he said.

Whether HIV’s reverse transcriptase is identical to the human version isn’t known, Chun said.

Research funding was provided by The Shaffer Family Foundation; The Bruce Ford & Anne Smith Bundy Foundation; Sanford Burnham Prebys; the National Institutes of Health; and the government of Taiwan.

Journal reference:
Nature

Source

Cellphone technology developed to detect HIV

HIV infecting a human cell. Credit: NIH

The management of human immunodeficiency virus 1 (HIV), an autoimmune disorder that cripples the immune system by attacking healthy cells, remains a major global health challenge in developing countries that lack infrastructure and trained medical professionals. Investigators from Brigham and Women’s Hospital have designed a portable and affordable mobile diagnostic tool, utilizing a cellphone and nanotechnology, with the ability to detect HIV viruses and monitor its management in resource-limited regions. The novel platform is described in a paper published recently in Nature Communications.

“Early detection of HIV is critical to prevent disease progression and transmission, and it requires long-term monitoring, which can be a burden for families that have to travel to reach a clinic or hospital,” said senior author Hadi Shafiee, Ph.D., a principal investigator in the Division of Engineering in Medicine and Renal Division of Medicine at the Brigham. “This rapid and low-cost cellphone system represents a new method for detecting acute infection, which would reduce the risk of virus transmission and could also be used to detect early treatment failure.”

Traditional virus monitoring methods for HIV are expensive, requiring the use of polymerase chain reaction (PCR). Shafiee and his colleagues sought to design an affordable, simple tool that makes HIV testing and monitoring possible for individuals in developing countries with less access to medical care.

Utilizing nanotechnology, a microchip, a cellphone and a 3-D-printed phone attachment, the researchers created a platform that can detect the RNA nucleic acids of the virus from a single drop of blood. The device detects the amplified HIV nucleic acids through on-phone monitoring of the motion of DNA-engineered beads without using bulky or expensive equipment. The detection precision was evaluated for specificity and sensitivity.

Researchers found that the platform allowed the detection of HIV with 99.1 percent specificity and 94.6 percent sensitivity at a clinically relevant threshold value of 1,000 virus particles/ml, with results within one hour. Notably, the total material cost of the microchip, phone attachment and reagents was less than $5 per test.

“Health workers in developing countries could easily use these devices when they travel to perform HIV testing and monitoring. Because the test is so quick, critical decisions about the next medical step could be made right there,” said Shafiee. “This would eliminate the burden of trips to the medical clinic and provide individuals with a more efficient means for managing their HIV.”

“We could use this same technology as a rapid and low-cost diagnostic tool for other viruses and bacteria as well,” said lead author Mohamed Shehata Draz, ¬¬Ph.D., an instructor in the Division of Engineering in Medicine and Renal Division of Medicine at the Brigham.. “This platform could help a lot of people worldwide.”

Journal reference:
Nature Communications

Provided by:
Brigham and Women’s Hospital

Source

Young HIV patients experience near-normal lifespan

The average American born in 2015 is expected to live to 78.8 years of age. HIV patients aren’t far behind. A Lancet study finds a 20-year-old who begins treatment for HIV today can live to an estimated 78 years due in part to advances in antiretroviral therapy, reports the BBC.

The latest drugs are better at keeping the virus from replicating and prevent resistance, are less toxic, have fewer side effects, and are more likely to be taken effectively as they often involve only one daily pill, the study notes.

Young HIV patients are also starting treatment sooner and benefit from improved screening and prevention programs, say University of Bristol researchers, who reviewed 18 studies involving 88,500 patients in Europe and North America.

They found patients who began treatment between 2008 and 2010 were less likely to die over the next three years than those who began treatment between 1996 and 2007, per a release.

Twenty-year-olds who started treatment between 2008 and 2010 and survived their first year were also expected to live to 73 for men and 76 for women, compared to 63 for men and 67 for women who started treatment years earlier.

Adults urged to get vaccinated

A nurse displays a tetanus, diphtheria and pertussis whooping cough vaccine at a free medical and dental health clinic in Los Angeles

(Copyright Reuters 2017)

Too many U.S. adults are not getting vaccinated, putting themselves and others at risk, immunization experts say.

According to the latest available data, about 44 percent of adults over age 19 had a flu shot; 20 percent had a Tdap vaccine, which protects against tetanus, diphtheria and pertussis; and 20 percent of 19-to-64-year-olds at risk of pneumonia had that vaccine (compared to 60 percent of those over 65).

Just 27 percent of those over age 60 were vaccinated against herpes zoster, which cuts the risk of shingles in half, according to new guidelines from the Advisory Committee on Immunization Practices (ACIP) published in Annals of Internal Medicine.

"Vaccinations not only protect you. They also protect those around you," ACIP liaison Dr. Sandra Fryhofer said by email, yet, "vaccination coverage rates for adults are abysmal."

Fryhofer, an Atlanta physician and adjunct associate professor at Emory University School of Medicine, also pointed to racial and ethnic disparities in vaccination rates, with whites more likely than all other groups to be vaccinated. And she noted that adults with health insurance are two to five times more likely to be appropriately vaccinated.

"It’s a double whammy for those without insurance. They don’t have insurance coverage if they get sick and they don’t have insurance coverage to pay for vaccinations that can help them stay well," said Fryhofer, who was also a member of the working group that came up with the new guidelines.

Dr. Walter Orenstein, associate director of the Emory Vaccine Center in Atlanta, called adult vaccine uptake "disappointing" and said it is substantially below the rates achieved for most recommended vaccines for young children.

"All adults should be vaccinated against influenza annually, receive a booster of a tetanus vaccine every 10 years, two different types of pneumococcal vaccine when they turn 65, and a vaccine to prevent shingles when they reach age 60," Orenstein said by email.

If you weren’t vaccinated as a child, you may need additional vaccines, added Orenstein, who was not involved in the guidelines. "All pregnant women should receive influenza vaccine, which protects them and their newborns, as well as a dose of a vaccine that protects their newborns against whooping cough," he said.

Some of the important changes made in the 2017 guidelines, according to Fryhofer and Orenstein, include the recommendation that everyone aged 6 months and older should still be vaccinated against flu, even this late in the season, but should not use the nasal vaccine, which has been found not to work very well.

Another new guidance says that young people vaccinated against human papilloma virus (HPV) before age 15 need only two vaccine doses, not three, given at least five months apart. If you’re 15 or older and haven’t been vaccinated before, you still need three doses.

People with liver disease should get the hepatitis B vaccine, which also protects against liver cancer. And those with HIV need two doses of a meningococcal vaccine, and doctors should use the same vaccine for all doses.

How well an individual responds to a vaccine – whether or not it works – depends on the health of their immune system, Fryhofer said. "The very young, the old, or anyone with a weakened immune system – including pregnant women – don’t respond as well," she noted.

"Healthy people are more likely to make the most protective antibodies, and that’s another reason why it’s important for them to get vaccinated. They need to stay protected so they won’t spread infection to others who are not so healthy and could die if they get sick," she added.

The Centers for Disease Control and Prevention’s Vaccinations for Adults web page (http://bit.ly/2fzDu1A) can help you determine which vaccines you need, Orenstein said.

Source

Being incarcerated as a juvenile tied to poor health years later

An inmate serving a jail sentence rests his hand on a fence at Maricopa County’s Tent City jail in Phoenix

(Copyright Reuters 2017)

People incarcerated as juveniles may have worse physical and mental health as adults than youths who did not spend time in detention centers or correctional facilities, according to a new study.

"A lot of people think there are potentially harmful effects of being in the justice system, but the long-term effects really haven’t been quantified," said lead author Dr. Elizabeth Barnert, of the David Geffen School of Medicine at the University of California, Los Angeles.

The magnitude of the increased health risks was tied to the time people spent incarcerated, researchers found.

About 1.3 million children under age 18 years are arrested each year, write the researchers in Pediatrics. Of those, 46 percent require some type of immediate medical attention. Additionally 70 percent of incarcerated children have at least one psychiatric disorder.

For the new study, the researchers analyzed data collected from 14,344 participants in the National Longitudinal Study of Adolescent to Adult Health. The researchers aimed to see if their duration of incarceration was linked to general health, functional limitations, depressive symptoms and suicidal thoughts as adults.

Overall, 14 percent reported being incarcerated as children. About half were incarcerated for less than a month, about one-third were incarcerated for one to 12 months and about 15 percent were incarcerated for more than a year.

Compared to participants who were never incarcerated, those who were in the juvenile justice system for less than a month were 41 percent more likely to have symptoms of depression as adults.

Being incarcerated for one to 12 months was tied to a 48 percent increased risk of worse general health as an adult than those who weren’t involved with the juvenile justice system.

Compared to those not incarcerated, those in the system for more than a year were nearly three times more likely to have functional limitation, over four times more likely to have symptoms of depression and over two times more likely to have suicidal thoughts as adults.

Similarly, a second study published in the same journal found factors that put people at risk for HIV and AIDS were more common among adults who spent time in the juvenile justice system than the general population.

Like the general population, Karen Abram and colleagues at the Northwestern University Feinberg School of Medicine in Chicago write that the prevalence of those risk factors declined over time.

"Like most things in life, the experiences they have as a young person seem to carry over into their adult years," said Ralph DiClemente, of Emory University’s Rollins School of Public Health in Atlanta.

DiClemente, who co-authored an editorial accompanying the new studies, told Reuters Health that juvenile detention can be very traumatic even though children are typically not incarcerated for years at a time.

For example, he said, children may not have a lot of worldly experiences and may have never left their communities, but they’re being put into a facility with a lot of other people.

"They’re fearful and traumatized from being away," he said.

Instead of incarceration, DiClemente said one possible alternative is diversion programs like community service or treatment. Also, introducing programs to promote healthy behaviors and decrease risk are important.

While implementing programs cost money, he said prevention and risk reduction programs may pay off later when people are not needing to be treated for more severe health conditions.

"It becomes an issue of do you pay me now or pay me later," DiClemente said.

Barnert told Reuters Health that juvenile incarceration should be seen as a factor that influences future health.

Some states have age limits that dictate how old a person has to be before they’re involved with the justice system, she said. Incarceration is something that should be discussed in doctors’ offices, but there are obstacles.

"It’s not something professional associations as a whole are addressing well or individual clinicians feel comfortable discussing," she said.

Barnert said future research should trace people’s pathways once they leave the juvenile justice system to pinpoint where health becomes worse.

Source

Gates Foundation to invest up to $140M in HIV prevention device

Scanning electron micrograph of HIV-1 budding from cultured lymphocyte. The multiple round bumps on cell surface represent sites of assembly and budding of virions.

(CDC.gov)

The Bill & Melinda Gates Foundation is investing as much as $140 million to support development of a tiny implantable drug pump it believes could help prevent people in sub-Saharan Africa and elsewhere from becoming infected with HIV, the virus that causes AIDS.

The matchstick-size pump is being developed by Intarcia Therapeutics Inc., a closely held Boston biotechnology company. It can hold six or 12 months’ supply of medicine and is designed to deliver microdoses continuously to patients, ensuring they stay on the treatment.

The new investment, which Intarcia announced Thursday, comes amid a flurry of fresh efforts to develop HIV prevention strategies.

Last week, the National Institute of Allergy and Infectious Diseases announced a global 4,500-patient clinical trial to test whether injections every eight weeks of an experimental HIV drug, cabotegravir, from U.K.-based ViiV Healthcare is effective in preventing HIV infection. Last month, the first efficacy study of an HIV vaccine in seven years was begun in South Africa.

This is “one of the most exciting years ever in HIV prevention,” said Mitchell Warren, executive director of AVAC, a global HIV advocacy organization supported by the Gates Foundation.

Source

GSK’s two-drug HIV therapy shines in two big studies

Signage for GlaxoSmithKline is seen on it’s offices in London, Britain

(REUTERS)

LONDON – GlaxoSmithKline’s already fast-growing HIV drug business has received an important boost with the success of two major clinical studies testing a new two-drug treatment regimen to control the virus that causes AIDS.

The approach is a departure from conventional triple drug cocktails that can cause troublesome side effects, especially among older patients who make up a growing proportion of those treated for the disease.

Antiretroviral therapy has turned HIV from a death sentence into a manageable condition but patients need to stay on treatment for life, so there is a growing focus on making medication as well-tolerated as possible.

GSK has developed the new two-drug cocktail through its majority-owned ViiV Healthcare, in which Pfizer and Shionogi also hold stakes.

Easing back from triple therapy is the opposite approach to that being pursued by HIV market leader Gilead Sciences, which is banking on improving triple regimens, and analysts at Berenberg said it could help GSK gain market share.

Results of the two Phase III studies, announced late on Monday, showed that the combination of GSK’s dolutegravir and Johnson & Johnson’s rilpivirine worked as well as three- or four-drug regimens.

Dominique Limet, chief executive of ViiV, said the results were "an important milestone in our understanding of how HIV can be treated", since they represent the first late-stage trial evidence for the two-drug approach.

ViiV will release detailed findings from the studies at a medical meeting next year and plans to seek regulatory approval for the new treatment approach in 2017.

It is one of a number of pipeline projects that GSK is banking on to revive its core prescription drug business as new chief executive Emma Walmsley prepares to take over from the end of March.

In all, the company expects important clinical results for between 20 and 30 experimental medicines by the end of 2018.

GSK also announced on Monday it was bolstering scientific expertise on its board by establishing a new science committee, charged with overseeing research.

Source

Wisconsin VA dentist failed to meet proper cleaning standards

TOMAH, Wis. – The health of hundreds of veterans is in question because a dentist at the Tomah Veterans Affairs Medical Center failed to meet proper cleaning standards.

Tomah VA acting medical director Victoria Brahm said Tuesday 592 veterans that received care from the dentist can receive free screenings for Hepatitis B, Hepatitis C and HIV.

At a news conference, Brahm said a dental assistant reported last month that the dentist had not properly cleaned equipment, so an investigation was launched. Brahm says the dental equipment may have been cleaned, but it didn’t meet VA standards.

Fifty-four veterans that had bridge and crown work done received phone calls about the problem. The others affected will receive letters.

Brahm said "I pray no one has an infection," but added the risk is low.

Source

AIDS experts say new vaccine trial may offer hope for a cure

At the end of 2015, about 36.7 million people had been living with HIV/AIDS worldwide, according to UNAIDS. But new initiatives, including a clinical trial for an HIV vaccine in South Africa, as well as a campaign to help children stay free of AIDS, are giving advocates hope that more lives can be saved from the devastating illness in the coming years.

According to the World Health Organization (WHO), one of the primary hurdles societies face in preventing transmission of HIV is individuals’ lack of a diagnosis.

Dr. Rowena Johnston, vice president and director of research at the Foundation for AIDS Research (amfAR), said ensuring people who are at risk of becoming infected with HIV are taking protective medication is another major obstacle. Through research, amfAR’s goal is to develop the scientific basis for a cure to AIDS by 2020.

Johnston called the clinical trial in South Africa “exciting.”

“They have a really good lead, and they understand what might work,” she told FoxNews.com, “and here they are out in the field testing to see if we can prevent HIV through a vaccine.”

The study, called HVTN 702, aims to enroll 5,400 sexually active men and women aged between 18 and 35 at 15 sites across South Africa. Researchers are launching the trial after a 2009 study of the same vaccine in Thailand found HVTN 702 was 31.2 percent effective at preventing HIV infection over the 3.5 years of follow-up after the vaccination.

The Africa trial will be the largest and most advanced HIV vaccine clinical trial to take place in South Africa, where more than 1,000 people a day are infected with HIV.

“HIV is not evenly distributed,” Dr. Beryl A. Koblin, head of the New York Blood Center Laboratory of Infectious Disease Prevention, told FoxNews.com. “[The virus] tends to concentrate in areas that have, particularly among women … high levels of poverty, [where] there may not be a lot of resources."

Like amfAR, the WHO has pledged to put an end to AIDS in the near future, 2030.

Of those people living with HIV/AIDS at the end of 2015, an estimated 1.8 million who were children, according to UNAIDS.

Chip Lyons, president and CEO of the Elizabeth Glasser Pediatric AIDS Foundation, is working through the research and advocacy organization to help children live healthy lives cleared of the potentially life-threatening disease. While he urged the importance of government leadership across the globe, he said they have the tools to achieve their goal.

“We have the approaches, [and] we have the experience and data to accomplish that,” Lyons told FoxNews.com.

Researchers expect to have results for the HVTN 702 trial by late 2020.

The Associated Press contributed to this report.

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What Are the Signs & Symptoms of HIV for Women?

HIV, or Human Immunodeficiency Virus, is a member of the retrovirus family that causes acquired immunodeficiency syndrome (otherwise known as AIDS). AIDS causes the body’s immune systems to fail, which can lead to life-threatening infections. HIV infection can occur through exposure to contaminated blood or other bodily fluids. According to the World Health Organization, the worldwide population of individuals living with HIV/AIDS at the end of 2008 was 33.4 million, and 2.7 million people were infected during that year alone. The majority of people who get HIV will develop signs of illness within five to 10 years, however, the time between infection and diagnosis can be as long as 15 years. If you are having signs or symptoms of HIV, you should see a doctor immediately.

Flu-like Symptoms

Some people experience flu-like symptoms four to eight weeks after initial infection from the virus. These symptoms can include fatigue, headache, fever and swollen glands. Headaches and fatigue are more common in women and can be stronger than in men.

Abdominal Pain

Women are more likely than men to have abdominal and pelvic pain as a symptom of HIV. In women, these pains can mimic “normal” pains (menstrual pains, for example). This makes it difficult to recognize such pains as symptoms of a larger problem.

Swollen Glands

Swollen glands/lymph nodes are not only an early symptom of HIV; they can also occur later. If swollen glands keep coming back or stay swollen for an extended period, see a doctor and get them checked out.

Weight Loss

Sudden weight loss that is hard or impossible to gain back is another symptom of HIV.

Psychological Symptoms

Psychological symptoms of HIV can include depression, anxiety, sleep disturbances or insomnia and changes in body image.

Gynecological Symptoms

Gynecological symptoms of HIV in women can include an abnormal pap smear, genital ulcers, pelvic inflammatory disease (especially if it is difficult to treat), frequent bouts of vaginal yeast infections or bacterial vaginosis and severe herpes infections.

Other Physical Symptoms

Other physical symptoms of HIV can include frequent low-grade fevers, night sweats, persistent skin rashes, flaky skin, short-term memory loss, severe and persistent diarrhea, vomiting, severe headaches, unusual mouth blemishes, difficulty swallowing and seizures.

Signs and Symptoms of HIV Rash on Wrists

Skin rashes are common problems for people with HIV. As the white cell count drops, the frequency of rashes increases. New and old medications can also cause rashes over the course of years as medications may be changed repeatedly. Bacterial infections and infestations of scabies may also occur, which lead to itch and discomfort for those with HIV. Moreover, patients are susceptible to skin cancer, which has its own side effects and may involve invasive procedures to treat.

Skin Rash and HIV

According to the Australasian College of Dermatologists, about 90 percent of HIV patients will experience skin changes. The spectrum of skin changes is wide-ranging, from seroconversion Illness, which is contracted two to four weeks after exposure to HIV, to viral infections, such as herpes, shingles and warts. HIV patients are also prone to fungal infections, such as thrush, bacterial infections and parasitic infections. In the latter stages of the illness, more serious skin cancers may develop, such as Kaposi’s Sarcoma and melanoma. Good virus control and stabilization of the immune system help HIV patients avoid serious skin conditions or cancers associated with the disorder.

Scabies

Scabies may be at the core of a rash on the wrist. The scabies parasite may manifest as a rash on the wrists, between the fingers, or in the genital region, breasts, buttocks or elbows. The rash will be pink to red in color and very itchy. The scabies mite lives on human skin and is spread by sexual contact, infested clothing, bedding or close personal contact. The condition is treated with a cream. Clothing and bedding must be washed in hot water to prevent reinfestation.

Drug Rashes

Drug rashes are the most common reason for changing HIV medications. These rashes can occur anywhere on the body, including the wrists. Sulfonamides and other antibiotics are common causes of rashes. Newer anti-viral medications are also contributors to rashes, such as nevirapine, efavirenz, delavirdine, amprenavir and abacovir. Skin reactions usually occur over a slow period of time and may take years to fully manifest.