Unfortunately, these tests require complex and expensive equipment, as well as at least three days (often more) to provide results. Considering distant areas, such as sub-Saharan Africa, where medical assistance is difficult to reach, this kind of testing is completely unavailable. However, things are changing to positive since the Imperial College London and DNA Electronics have come up with the amazingly handy device.

USB stick as a test for HIV

The recently designed device requires a small sample of blood, and the results are provided within half an hour. The technology uses cell phone chip, and the drop of blood is placed on the specified spot on USB stick. USB stick is connected to the computer through the adequate application. If the virus particles are present in the bloodstream, the acidity of the testing medium changes generates the charge registered by a chip. Chip transforms it into an electrical signal, and the results are displayed on the computer screen via USB. The device is rather fast and accurate, and it requires no significant room, maintenance or additional technology.

Large scale of benefits

Clinicians have great expectations from this convenient device. The most important are the possibility to keep up with the patients taking HAART easily and to follow their blood level of viral particles continuously. The aim of the therapy is to lower the concentration of virus as much as possible, but there are multiple situations when the infection rebounds. In these moments, it is essential to catch the increase of virus concentration and to adjust the therapy. Another benefit refers to following if the patients are sticking to their therapies regularly. Also, since the device requires no other specific equipment, it is the perfect solution for remote observation of the patients and monitoring of the distant areas.

The future development

Currently, the device is still being carefully tested in clinical practice, and the results are statistically processed, but the general plan is to make it available for worldwide use some time shortly. It particularly refers to areas, such as sub-Saharan Africa and other regions with the extreme percent of the HIV-positive population. Also, the same team of scientists is trying to use this device for the same type of testing on other viruses and bacteria. Development of the diagnostic test for hepatitis is the current plan.

The post Modern technology provides powerful HIV testing appeared first on AIDS 2002.

At this point, HAART therapy, a combination of several powerful drugs is still in the focus of treatment. The goal is to get the HIV patient into remission, which means to lower his viral load to undetectable concentrations, to free him from transmission and infections associated with HIV. In the case of remission, the patient still has the viral particles present in the body, but the clinical presentation and the risks are fully controlled. The definite cure would free the patient’s body from virus completely.

Study of TLR-7 agonist

One of the clinical trials announced for 2017. Is the clinical trial of TLR-7 agonist scheduled to begin in February 2017. After successful lab testing and great results gained after applying this treatment to monkeys, TLR-7 is finally facing real patients. Steve Deeks, MD, the leader of this research plans to include the patients who had viral load lower than 10 000 copies per milliliter before HAART. The antiretroviral therapy will remain in the same regime, but at some point, patients will receive pills containing TLR-7 agonist too. The main idea of the treatment is to boost previously medium T-cell response and use powerful immune reactions to clear the body from HIV completely or at least to keep it from rebounding for years.

 The mechanism behind “shock and kill” treatment

The main role of TLR-7 agonist is to target CD4 T cells and “shock” them. CD4 T-cells represent the reservoir of the HIV capable of dodging average immune response and enable virus particles to replicate swimmingly. TLR-7 agonist should target them, present them to other immune cells and enable their destruction by cytotoxic mechanisms of other T-cells. This leads to a decrease of the total viral reservoir, and it boosts, emphasizes natural immune response. So, this treatment does not interfere with viral replication, neither it destroys the virus directly. Its role is to empower the functions of already present immune cells and to ease their targeting and killing infected CD4 cells.

The prognosis for TLR-7 agonist treatment

In theory, this approach makes sense, and it fits into some wider proven theories. Also, the treatment passed the lab testing successfully and the lab animals, including monkeys, have shown significant improvement so far. Some human clinical trials have begun early this year, but the results are still not published. The first big trial on HIV patients is scheduled for the beginning of 2017. And the researchers expect some groundbreaking results and changes in overall approach to HIV curing.

The post High hopes for new HIV treatment in 2017 appeared first on AIDS 2002.

Case history of the first HIV co-infection

A 38-year-old male with an acute retroviral syndrome (ARS) following previous multiple unprotected sexual contacts with male partners was presented at the clinic. The person was included into the Quest trial (AZT, 3TC, Abacavir, Amprenavir for 25 months, with from 19 to 25 months, vaccination by Alvac vCP 1452 and stop all treatment at month 25). During the therapy, viremia declined from >106 HIV-1 RNA copies/ml (c/mL) and remained <200 c/mL while the patient was on HAART. A month after ending the treatment, viremia rebounded to 80’000 c/mL, then declined to 20’000 c/ml and raised again, two weeks later, at 200’000c/ml (second rebound), to finally fluctuate between 200’000-400’000 c/mL for five months before HAART re-initiation. Patient manifested worsening of the clinical picture, and the diagnostic procedure had begun.

Applied methods and not so positive results

Protease (Pr), reverse transcriptase (RT) gag and C2V3 gene sequencing documented an initial infection by subtype AE during the ARS.Subtype B rapidly replaced AE at the time of the second rebound. To discriminate between co-infection and super-infection we set up a subtype-specific PCR (end Pr-proximal third of RT) using subtype specific primers for AE and B designed according to patient’s sequences. The subtype-specific PCR confirmed:

One/ the absence of B subtype in both plasma and proviral DNA before the second viremia rebound

Two/ the emergence, during the second rebound and later on of B subtype as the majority subtype in both DNA and plasma. The C2V3 sequences of the B subtype were related to B Brazilian strains. This correlates with a Brazilian trip of the patient where several unprotected sexual contacts three weeks before B emergence took place. In in vitro cultures B subtype primary isolate had a much higher replicative capacity than AE subtype.

The explanation of the findings

Declined viremia during HAART indicates the sensitivity of this HIV-positive patients to combined antiretroviral drugs, and this refers to previously diagnosed AE subtype of HIV. The subsequent increase of viremia following interruption of HAART correlates with the first phase of superinfection. B subtype of HIV is responsible for the second rebound and worsening of the clinical manifestations due to B subtype takeover in the bloodstream. This patient suffered two separate HIV infections caused by two different subtypes of virus in different periods of time, which strongly suggests that superinfection is possible in vivo and manifests amazing genetic diversity of HIV.

Conclusions

The case described above is considered to be the first documented case of HIV-1 superinfection. These findings have a great importance for a general approach to HIV treatment and for various researches striving to create a definite cure for this disease. In the case of increased percent of superinfections, genetic diversity of HIV-1 would become even more complex. That would aggravate the vaccine development and the searches for an effective cure. Finally, the possibility of super-infection would alternate public health strategies.

The post Background of HIV superinfection appeared first on AIDS 2002.

What I’m talking about is the mindset of HIV/AIDS victims and the appropriate approach of those around them.

The world dropping beneath you

Yes, that’s exactly what most described it when they were sitting in the doctor’s office facing their physician telling them the situation they are in.

“You’re HIV positive.”

Their world crumbled, their future ruined, their young lives ended right there surrounded by white walls, and white sheets, in front of someone wearing a white coat. The world dropped beneath them.

Some felt a jarring stillness, others towering waves of grief – and underneath it all is quaking terror.

Kübler-Ross Model  

There are five stages that a person undergoes when diagnosed with a fatal illness. Its acronym is DABDA, which stands for Denial, Anger, Bargaining, Depression, and Acceptance.

In the first stage an HIV/AIDS patient might refuse to believe what he’s hearing. He thinks it’s only a nightmare or the doctor’s diagnosis is inaccurate, something went wrong through the screening process somehow.

The second stage is anger. It’s where the victim shouts “Why me? It’s so unfair! There are so many who deserves this, yet why me?” This stage is where the victim becomes a danger, not only to himself, but also to others around him.

Let’s take a look at a report last year where a woman, 19 of age, allegedly admitted of purposely infecting over 300 men after finding out she was HIV positive. Although the report’s authenticity could not be confirmed it still left most people in shock to the horror of the claim.

The third stage is bargaining usually done on one’s knee, hands clasped together, begging for an extended life from a higher power. Next stage is depression. The victim enters a catatonic state; unresponsive and always sleeping. They’re more a danger to themselves than to others at this phase.

And last is acceptance where they have accepted their fate. Where a soothing calmness takes over and they tell themselves that it’s going to be alright.

Getting through

Through the whole DABDA stages it’s of utmost importance that friends and family members are there to provide emotional support. Avoid victim-blaming, as some people are won’t to do.

Instead, find ways to help them cope. One of the best ways to do this is to simply listen and provide a shoulder to cry on. Remind them that they still have a life; that other victims have learned to live with the situation. And they can too.

Attend meetings and find groups where they can interact with others who might share some knowledge on how to get through the toughest days, where they are surrounded by people who can truly understand what they feel.

Expect to absorb a lot of negative emotion from the victim. It’s going to be difficult, it’s going to be tough, but you have to remain strong to remind them that it’s going to be okay.

The post The DABDA Process of HIV/AIDS Victims appeared first on AIDS 2002.

In almost thirty years of human immunodeficiency virus (HIV), the virus that causes AIDS, the gay community has borne its fair share of victims.

A quote from Edmund White, gay novelist, captured the impact of the AIDS pandemic on the gay community when he said, “To have been oppressed in the fifties, freed in the sixties, exalted in the seventies, and wiped out in the eighties is a quick itinerary for a whole culture to follow. For we are witnessing not just the death of individuals but a menace to an entire culture.”

AIDS is not just a gay disease; it affects people from all walks of life, all corners of the planet and all age groups. The stigma of AIDS being a gay disease began early in the history of the pandemic as a scientist labeled the disease Gay-Related Immune Disorder (GRID). The name was changed to AIDS in 1982 when the disease continued to show up among a wide variety of individuals.

Even though AIDS targets all groups of people, the gay community has been disproportionately affected.

Current Statistics on the Status of AIDS in the Gay Community

In the United States, HIV infections are on the rise among gay men, the only risk group showing an increasing number of infections.

According to the Center for Disease Control and Prevention (CDC), nearly half of the one million people living with HIV in the USA are gay/bisexual. Among the gay population, there are a total of approximately 27,000 new cases annually. The rise of infections has been on-going since the 1990’s.

These statistics are causing grave concern among gay community advocates and activists. Sept. 27, 2009 marked the second anniversary of National Gay Men’s HIV/AIDS Awareness Day. This specific campaign targets the younger generation who were not around during the deadly early days of the AIDS pandemic. Activists believe this national awareness day is a necessary tool in addition to the World AIDS Day campaign

AIDS Prevention the Best Course of Action

Educating the new generation of gay/bisexual men is considered paramount in halting the upward trend of infections. At the beginning of the AIDS crisis, the education campaign on prevention worked to stem the tide of the pandemic.

Dr. Jonathan Mermin of the National Center for HIV/AIDS, in a statement on Sept. 27, 2009 said, “we must not only expand access to services, we must confront challenges such as complacency, homophobia, and stigma that gay and bisexual men continue to face.”

This homophobia and stigma can prevent men from getting tested for the disease and thus they are not armed with necessary knowledge of their status. The National Institute of Health (NIH) reports that up to 40,000 individuals are unaware they are HIV positive.

Recent Progress in AIDS Research

By 1984, 3,500 Americans were diagnosed with AIDS; 1,500 of those people died. By 1987, 36,000 were diagnosed and almost 21,000 people had died from AIDS. As of 2006, according to the NIH, 520,000 Americans had succumbed to the disease.

Combination antiretroviral therapy continues to be the single most important tool in the fight against AIDS. Since the first use of antiretrovirals over a decade ago, there has been a dramatic decrease in HIV – related deaths. However, the NIH says these therapies are now associated with a series of serious side effects and long term complications.

In a New York Times editorial, Dec. 14, 2006, “Rare Good News About Aids”, it was reported that research found that circumcision prevented 60-70 per cent of new AIDS infections.

Mark Schoofs, in the Wall Street Journal, on Nov. 7, 2008, in “A Doctor, A Mutation and a Potential Cure for AIDS“, reported that, “The startling case of an AIDS patient who underwent a bone marrow transplant to treat leukemia is stirring new hope that gene-therapy strategies on the far edges of AIDS research might someday cure the disease.”

Wear a Red Ribbon for World Aids Day

The Red Ribbon is the international symbol of support for people living with AIDS. Red ribbons are worn to raise awareness, and to help eliminate the stigma and prejudice against people living with AIDS.

Donations for the Red Ribbons go to supporting research to combat HIV/AIDS.

Perhaps one day the research will produce a cure. Currently, prevention strategies including safe-sex practices, encouraging risk groups to get tested and education at home and abroad are the best combatant against the AIDS pandemic.

The post An Initiative to Educate: World AIDS Day appeared first on AIDS 2002.

Continuing the fight

According to the report of GSAC (Goa State AIDS Control Society) there have been a significant drop of HIV cases since 2009 and has continued to do so back in 2014. Data are still being compiled in 2015 but experts are foreseeing that disease prevalence will continue to fall this year.

This decline is attributed to the effective dissemination of information regarding the virus. Technology also has a hand in curbing the disease’s progress as raising awareness is easier than ever thanks to various social media platforms.

But progress in this regard shouldn’t lead to complacency. Vigilance should be maintained higher than ever. In order to achieve total elimination of HIV/AIDS, new cases should be stop. Steps such as widespread and target education, pre-exposure prophylaxis, post-exposure prophylaxis, responsible use of contraception, and identification of drug users utilizing unsterile needles are some of the ways to reach this goal.

Targeting vulnerable groups should also be top priority. For instance, in the United States, there is a significance difference between the group of White Women and African American Women regarding new cases of HIV. While the latter only accounts to 13 percent of the female population, this group comprises 64 percent of new emerging cases of the disease.

This is also noted in the southern state of the country which only number 37 percent of the masses and yet represents 50 percent of recent reported incidents.

There’s also the matter of the adherence of those infected. It’s estimated that the overall females living in the U.S. with HIV, 88 percent of those have been diagnosed but only 45 percent are only engaging in treatment, and 32 percent have reached viral suppression.

Viral suppression could only be achieved through strict and consistent adherence to HIV/AIDS therapy which can then lessen the chances of transmitting the disease by as much as 96 percent.

Further support

Among the reasons for this lack of treatment adherence can be ascribed to the expensive medication for the HIV/AIDS virus. But a recent victory in this regard can potentially lessen this problem.

Legal actions taken by the Aids Institute (TAI) and The National Health Law Program (NHeLP) against Aetna, one of America’s largest insurers, has been a success as Aetna recently agreed to lowering the cost of pharmaceutical drugs for people living with HIV/AIDS.

On March 26^th, Aetna announced that medications for HIV would be placed to a generic brand tier in all of its plan. This will result in lower co-payments from $1,000 a month to $5-100 after deductibles which will be effective on June 1, 2015.

Eradicating this disease will take a lot of effort from a lot of people if we are to eliminate it globally. However, with the current state of things, and progress are being made left and right, perhaps that day will not be so far after all.

The post The Goal to Eliminate HIV/AIDS Entirely appeared first on AIDS 2002.

The shortage of personnel also extends to the counselors and social workers who provide essential assistance to victims of sexual abuse and other violence, as well as those who provide care and support to orphans and other vulnerable children.

The critical shortages of health workers have been pointed out by the World Health Organization (WHO) in 57 nations. Africa has 36 countries listed there. Because of these shortages, WHO says that these countries are “very unlikely” to achieve global targets for controlling HIV/AIDS, tuberculosis, and malaria, or reducing maternal and child mortality.

The shortages are most severe in sub-Saharan Africa, where 3% of the world’s health workers struggle to combat 24% of the global disease burden. WHO estimates that sub-Saharan African faces a shortage of more than 800,000 doctors, nurses, and midwives and an overall shortage of 1.5 million health care workers. What’s more, health workers who do find employment are often distributed very unevenly within countries, as richer and more urban areas typically have many more health workers than poorer and harder to reach rural areas.

Poor Countries Struggle to Build Strong Health Systems

The health worker shortage is brought about predominantly by the challenges in the health systems in poor countries. They encounter difficulties in appointing acceptable numbers of personnel and paying them with reasonable salaries.

One factor underlying this problem is the decades of bad advice given to poor countries by international lenders like the International Monetary Fund and the World Bank. These lenders have required borrowers to contain government spending in order to achieve inflation levels far below what many economists believe is necessary. The result has been that government officials have lacked the flexibility to hire more health personnel or spend the money required to provide adequate salaries, benefits, and working conditions. Even countries that are not heavily indebted to the IMF and World Bank still need their stamp of approval in order to receive essential assistance.

Low salaries and poor job opportunities leads to a phenomenon known as “brain drain,” in which countries who have invested in training health care personnel then see them emigrate in large numbers to wealthier countries. In Ghana, for instance, 50% of medical school graduates emigrate within five years, and 75% within 10 years. Wealthy nations, facing their own shortage of trained personnel, sometimes actively recruit trained health care workers from Africa and other regions.

Many of the health workers who do remain in their home countries lack professional training opportunities, lack adequate supervision, and have unmanageable workloads. They must endure poor and sometimes unsafe working conditions. Basic supplies such as latex gloves and face masks-and equipment to provide standard diagnostic tests-are often unavailable. Without the tools to do their jobs properly, health workers can become demoralized and may emigrate or leave the health sector altogether.

Current global HIV/AIDS and health institutions and initiatives are not aligned well enough with national strategies. For instance, personnel sometimes leave the public health service in order to work for programs that are funded by wealthy countries, weakening public clinics and hospitals where these workers are desperately needed.

HIV/AIDS also has a massive direct effect on the health workforce. It is conservatively estimated that 16% of South Africa’s existing health worker force is HIV-positive, and that Malawi loses nearly 3% of its workforce to HIV/AIDS each year.

What Needs to be Done?

Countries need the flexibility to increase the number of working health care personnel and to improve their salaries. A global advocacy campaign is underway to persuade the wealthiest countries, which largely control the policies of international lenders, to require these agencies to give countries the flexibility they need. The campaign is also encouraging countries to set their own path in making budgetary decisions, independently of the advice of the international lenders. People in many African countries are also pressing their governments to keep a promise made in 2005 to increase spending on health to 15% of the national budget.

The labor policies of wealthy countries must also be changed. These countries must stop actively recruiting health professionals from developing countries, except as part of an agreement with those countries. Wealthy countries should also take steps, such as expanding admission to nursing schools, which will help them become more self-sufficient in meeting their own health worker needs.

Another strategy is to make more effective use of community health workers. These non-professionals are rooted in their communities and are less likely to emigrate in search of better wages and working conditions. They have deep knowledge of their communities, where they are familiar and trusted neighbors.

Sometimes, donor countries and their development agencies have used these community workers as volunteers. But, a better solution is to provide these workers with at least a stipend, if not a living wage, as well as training and supervision by health professionals. For instance, in Haiti and other locations, Partners in Health has successfully used community workers to provide a broad range of services, including drug distribution, disease observation and reporting, clinical referrals, and social support for people with chronic illness, while paying them a stipend.

Finally, the shortage of health care personnel is so severe and health care infrastructure so weak that poor countries need well-targeted aid from international agencies and wealthy countries. Countries that have not already done so also need to develop national human resource plans as a part of comprehensive country health plans involving a wide range of stakeholders. Wealthy countries should then provide the resources needed to finance plans that meet high standards of quality and increase equitable access to health care.

The cost of doubling Africa’s health workforce was estimated at $2 billion in 2006 and is expected to rise to about $7.7 billion annually by 2010. This would be money well-spent, because it would help ensure the billions of dollars being provided to fight AIDS, tuberculosis, and malaria can be fully and effectively used. It would also help Africa provide better reproductive and sexual health services.

The post Facing the Critical Shortage of AIDS Health Workers appeared first on AIDS 2002.

1. Stay tuned in to your labs
2. Put a plan together
3. Think about starting treatment

In addition to your regular medical exams, there are two special blood tests that your healthcare provider will perform every three to six months. These tests are used to help monitor your HIV progression and overall health, and to help you and your healthcare provider decide when it’s time to start HIV treatment, to see if your meds are working and to know when to change meds:

To know the level of HIV in your body, the viral load test is essential. It measures the amount of HIV in your blood, and you want this number to be as low as possible. One key goal of HIV therapy is to achieve and maintain an undetectable viral load.

The CD4 cell count helps show how strong your immune system is. It counts how many infection-fighting white blood cells you have (also called T cells or T-helper cells). The more CD4 cells you have, the stronger your immune system will be. In the event that your CD4 cell count becomes very diminished, an opportunistic infection might make you susceptible to various diseases.

HIV may not be the only health issue you are currently managing. The better your health is overall, the better you can cope with your HIV infection. Work with your healthcare provider to develop a plan that takes into account all of your health concerns.

As part of your planning, you should have regular medical (i.e., every 3 months) and dental checkups, and seeking medical advice or treatment for conditions like diabetes, high blood pressure or high cholesterol. In addition, if you can avoid smoking, drinking too much alcohol, recreational drug use and sexually transmitted diseases, you will probably find your HIV easier to manage.

A critical consideration of your plan will be figuring out the best time to consider HIV meds and which ones to use first. Take the time to gather the latest information on treatments and work with your healthcare provider to decide what treatment regimen will work best for you and your lifestyle.

You might choose to use HIV meds very early in your disease or you might plan to postpone it until you arrive at a certain viral load or CD4 cell ranges. It’s up to you in partnership with your healthcare provider.

Remember, you are in charge of your own health care. You will choose the healthcare provider you are comfortable working with to help decide which treatments you use and when you want to use them. Take your time and learn about your options.

Current HIV medications can help those living with HIV stay healthier longer. But starting treatment is a big decision. In order to get the maximum benefit from your meds, you need to make a commitment to take them properly. Commitment to your treatment regimen – referred to as “adherence” – is as important as the meds themselves. In fact, 100% adherence to your meds is the most important you can do to help control your HIV and prevent resistance and thus treatment failure. So before you get started, you should do all you can to make sure you are ready – both mentally and physically – to stay with it for the long run.

Your healthcare provider will consider several guidelines, including those issued by the U.S. Department of Health and Human Services (DHHS), in deciding when to recommend that you start treatment. Developed by leading medical experts and public health officials, the DHHS guidelines recommend that HIV treatment be started in:

• Anyone with symptoms of advanced HIV disease (such as opportunistic infections), or with a diagnosis of AIDS should start treatment

• Anyone with a CD4 count less than 200 should start treatment (those with a CD4 count between 200 and 350 may also consider treatment)

• People with a CD4 count in excess of 350 and viral load less than 100,000 should delay treatment

The guidelines are less clear in other situations. You and your healthcare provider should review your numbers frequently and consider the risks and benefits of starting treatment earlier or later.

References:

Department of Health and Human Services (DHHS) Fact Sheet. “HIV and Its Treatment: What You Should Know”.  September 23, 2005.

Department of Health and Human Services (DHHS) Panel on Antiretroviral Guidelines for Adults and Adolescents (a Working Group of the Office of AIDS Research Advisory Council). Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents.  May 4, 2006.

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