Tag: AIDS and HIV

Boosting engagement in heterosexual men may reduce HIV in Uganda

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Newswise — A study looking at 15 years of HIV transmission and suppression in Uganda reveals how closing gender gaps in treatment could slash infection rates.

Providing more heterosexual men with easy access to HIV treatment and care could help to suppress the virus and rapidly cut transmission to their female partners, shows a new study published in Nature Microbiology.

The research, led by scientists from Imperial College London and the Rakai Health Sciences Program in Uganda, analysed 15 years of data from 2003-2018, during which the US President’s Emergency Plan For AIDS Relief (PEPFAR) has delivered an extensive programme of HIV/AIDS testing, prevention, and treatment.

This included distributing Antiretroviral Therapy (ART) drugs, which supress the virus so a person is no longer infectious. The analysis shows that the PEPFAR program and other services have greatly reduced new infections among young women and heterosexual men, but that reductions were less substantial in women aged 25 and above.

This is thought to be because women are more likely to reach viral suppression through uptake and effective use of HIV treatment, preventing them from passing HIV to their male partners, but that the same is not true the other way around.

Gender disparity

The analysis showed that the number of women reaching and maintaining undetectable (non-transmissible) levels of HIV infection were 1.5 to 2 times higher than men across all ages by the year 2018. The analysis shows that had men reached the same levels of virus suppression as women, around half the new infections that occurred between 2016 and 2018 could have been avoided.

The team also reconstructed transmission networks based on the genetic code of the virus from thousands of participants, which confirmed that overall, the proportion of transmissions from men is increasing and is now at 63% of all transmissions in the area – even though a greater number of women are living with HIV than men.

The team say the disparity could be because men need to travel for work, that clinics are closed when they are back home, or for other reasons, including social stigma.

Dr Oliver Ratmann, senior author of the study from the Department of Mathematics at Imperial, said: “In this evolving battle against HIV, it is critical we adapt our strategies, bridge gaps in care, and ensure that individuals, regardless of their gender, have access to the lifesaving benefits of ART.

“It is important to design services in a way that everybody who would like to use them is able and feels empowered to do so. By routinely monitoring the changing dynamics of the epidemic and striving for equity in HIV care, we can move closer to the ultimate goal of controlling and, one day, eliminating HIV transmission.”

Dr Kate Grabowski, a co-author of the study from the Johns Hopkins School of Medicine, added: “The continued success of the President’s Emergency Plan for AIDS Relief (PEPFAR) in reducing infections and saving lives is crucial for ending HIV transmission. With United States Congress currently evaluating PEPFAR funding, our evidence strongly supports the program’s efficacy and provides a clear roadmap to ending the pandemic through enhanced HIV treatment coverage, particularly among men.”

Closing the gap in transmission

The team used data from the Rakai Community Cohort Study (RCCS) in southern Uganda, a region where more than 9% of adults are living with HIV – approximately 20 times higher than in the US. Since 2003, a period predating the widespread availability of ART in Africa, RCCS has enrolled nearly 37,000 individuals, tracking changes in HIV infection as new interventions came on board.

The analysis tracked evolving heterosexual HIV epidemic dynamics in 36 communities over a 15-year span of RCCS surveillance data, including records of new infections, deep sequence HIV genomic data, HIV treatment uptake, viral suppression, and behavioural information.

Analyses in earlier years showed that the highest number of new HIV cases in southern Uganda was among adolescent girls and young women aged 15-24 years. In more recent years tracked in the new study, women 25-34 years old have become a new focal group, experiencing a slower decline in new infections than other age groups. This is alongside a significant difference in the declines in new infections between men and women, with those among boys and men declining much faster.

To estimate the likely impact of getting men to the same level of viral suppression, the team applied statistical models based on the data about transmission dynamics. The resulting projections indicate that closing the viral suppression gap in men could have effectively halved rates of new infections among women and eliminated gender disparities in acquiring HIV.

Dr Joseph Kagaayi, previous director of the Rakai Health Sciences program and senior co-author of the study, said: “Our study findings emphasise the importance of addressing disparities in ART uptake and viral suppression between men and women. By doing so, we can not only reduce HIV infections among women but also work towards closing the gender gap in HIV transmission. Achieving these goals will require concerted efforts, informed policies, and strengthened healthcare services.”

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Imperial College London

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December 9, 2023
Stay informed on women’s health issues in the Women’s Helth channel

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According to a recently published article on Axios, women have higher out-of-pocket expenses for their health care than men despite having similar health insurance. Even when removing maternity care from the equation, women each year are paying $15.4 billion more out of pocket for health care. This so-called ‘Pink tax’ reflects the penalty levied on females for everything from tampons and razors—is alive and well in the U.S. healthcare system. Below are some of the latest headlines in the Women’s Health channel on Newswise.

A New AI Model Has Been Developed to Improve Accuracy of Breast Cancer Tumor Removal

-University of North Carolina School of Medicine

Social media and low self-compassion behind rise in cosmetic surgery

-University of South Australia

Exposure to extreme heat associated with adverse health outcomes for pregnant women

-University of California, Irvine

Iron supplements provided in prenatal visits improved outcomes

-UT Southwestern Medical Center

Study finds the placenta holds answers to many unexplained pregnancy losses

-Yale University

Witchcraft accusations an ‘occupational hazard’ for female workers in early modern England

-University of Cambridge

Substance Abuse in Pregnancy Doubles Cardiovascular Risk

-Cedars-Sinai

In major breakthrough, researchers close in on preeclampsia cure

-University of Western Ontario (now Western University)

When it comes to starting a family, timing is everything

-University of Oxford

Using personalized medicine to target gynecological cancers

-University of California, Los Angeles (UCLA), Health Sciences

Internet searches increased for self-managed abortions when Roe vs. Wade was overturned

-University of California, Irvine

Stem cell-derived components may treat underlying causes of PCOS

-University of Chicago Medical Center

High levels of particulate air pollution associated with increased breast cancer incidence

-National Institute of Environmental Health Sciences (NIEHS)

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September 27, 2023
HIV patients can safely undergo hip replacement, study finds

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Newswise — DALLAS – July 26, 2023 – Hip replacement surgery is safe for patients living with human immunodeficiency virus (HIV), researchers at UT Southwestern Medical Center found.

Total hip arthroplasty (THA) is a common procedure performed primarily on older patients suffering from osteoarthritis or osteonecrosis, painful conditions that severely limit mobility and lifestyle choices. But some surgeons have been hesitant to perform THAs on patients with HIV or AIDS due to concerns about complications, including higher risk of infection, need for revision surgery, and increased length of hospital stay.

“Patients living with HIV are at a higher risk for orthopedic-related diseases such as osteoarthritis or osteonecrosis of the hip due to changes in their bone metabolism and effects from their medication regimen,” said Senthil Sambandam, M.D., Assistant Professor of Orthopaedic Surgery, who led the study. “With improvements in HIV treatment leading to increased life expectancies, we are seeing a rise in the need for THA procedures in this patient population. Our study demonstrates that HIV-positive patients can safely undergo THA without concern for increased risk of complications and adds to the growing amount of literature that encourages surgeons to deliver appropriate medical care to a marginalized patient population.”

Using data from the National Inpatient Sample covering 2016-2019, UTSW researchers identified 504 HIV-positive patients who underwent THAs and compared their postoperative complications to a cohort of 493 HIV-negative patients. Their findings, published in the Journal of Clinical Orthopaedics and Trauma, showed that postoperative complications such as pneumonia, periprosthetic infection, wound dehiscence (reopening), and superficial and deep surgical site infection were not significantly different between the HIV-positive and HIV-negative groups. Blood transfusion rates also were lower among the HIV-positive patients.

The study was part of a larger effort by the Department of Orthopaedic Surgery to analyze arthroplasty complications in various subpopulations in support of UTSW’s commitment to the care of marginalized patient populations and equal treatment for every patient.

“These are important findings because they can help alleviate worries among the medical community about treating a group of patients who are often overlooked,” Dr. Sambandam said. “It’s an important quality-of-life issue for many HIV-positive patients.”

Other UTSW researchers who contributed to this study are Varatharaj Mounasamy, M.D., Professor of Orthopaedic Surgery; Ashish R. Chowdary, B.S., medical student; and Jack Beale, M.D., and Jack Martinez, M.D., residents in Orthopaedic Surgery.

About UT Southwestern Medical Center
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 26 members of the National Academy of Sciences, 19 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits a year.

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UT Southwestern Medical Center

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July 26, 2023
Wistar Honors Pediatric HIV Researcher in 27th Annual Jonathan Lax Memorial Award Lecture

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PHILADELPHIA—(June 22, 2023)—The Wistar Institute hosts its 27th Jonathan Lax Memorial Lecture Thursday, June 29th at 5:30 pm EST. For the first time since 2019, the signature event will be hosted in-person at Wistar; it is also being streamed to ensure attendees have access to the memorial lecture. This year, guest speaker Deborah Persaud, M.D., professor of Pediatrics and interim director of Pediatric Infectious Diseases at the Johns Hopkins University School of Medicine, will speak about her research on mother-to-child HIV transmission, pediatric HIV pathogenesis and pediatric cure therapeutics.

Dr. Persaud also serves as the scientific chair of the HIV CURE Scientific Committee of the International Maternal, Pediatric Adolescent AIDS Clinical Trials (IMPACT) group and as a Program Director of the PAVE (Pediatric Adolescent Virus Elimination) Martin Delaney Collaborative. She spoke of being selected to deliver the lecture with gratitude: “It is quite an honor to receive the Jonathan Lax Memorial Award and deliver the 27th annual lecture, which is dedicated to pediatric HIV cure-directed research for the first time. Receiving this tribute to Mr. Lax’s memory, who was such a force in the Philadelphia HIV/AIDS community, is an exceptional distinction.”

“We’re truly excited to host Dr. Persaud this year,” said Wistar’s Luis J. Montaner, D.V.M., D.Phil., the Herbert Kean, M.D., Family Endowed Chair Professor, leader of the HIV Research Program at The Wistar Institute and co-principal investigator of the BEAT-HIV Delaney Collaboratory. “The fight for an HIV/AIDS cure is all-encompassing, and Dr. Persaud’s expertise in pediatric cure-directed HIV research will help the public understand a facet of HIV/AIDS cure research that isn’t often discussed.”

The Wistar Institute and Philadelphia FIGHT established the Jonathan Lax Memorial Award Lecture after Mr. Lax’s death to honor his legacy by bringing distinguished speakers to a lay audience. Previous speakers include luminaries in the HIV/AIDS field such as Nobel Laureate Françoise Barré-Sinoussi, Ph.D., Professor Emeritus at the Institut Pasteur; Mike McCune, M.D., Ph.D., head of the HIV Frontiers Initiative and Biotechnology Accelerator Program of the Bill & Melinda Gates Foundation; and Anthony S. Fauci, M.D., former Director of the National Institute of Allergy and Infectious Diseases.The 2023 lecture is free and open to a global audience. Register here for in-person attendance and register here for virtual attendance.

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The Wistar Institute is the first independent, nonprofit biomedical research institute in the United States, marshals the talents of an international team of outstanding scientists through a culture of biomedical collaboration and innovation. Wistar scientists are focused on solving some of the world’s most challenging and important problems in the field of cancer, infectious disease, and immunology. Wistar has been producing groundbreaking advances in world health for more than a century. Consistent with its legacy of leadership in biomedical research and a track record of life-saving contributions in immunology and cell biology, Wistar scientists’ early-stage discoveries shorten the path from bench to bedside. www.wistar.org

BEAT-HIV Delaney Collaboratory is part of an international consortium of more than 80 top HIV researchers from academia, industry, government, and nonprofit sectors working toward an HIV cure. The Collaboratory is leading three advanced trials to define effective ways to combine immunotherapy regimes towards a cure. www.BEAT-HIV.org

Philadelphia FIGHT is a Federally Qualified Health Center (FQHC) offering HIV treatment and primary care to people living with HIV/AIDS and those at high risk, as well as community education and outreach programs on HIV, Hepatitis, and other topics impacting public health. During the COVID-19 pandemic, FIGHT has provided no barrier, walk-up COVID testing to over 19,000 people in low-income neighborhoods of Philadelphia and partnered with ten community-based organizations to bring COVID vaccines to communities. www.fight.org

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Wistar Institute

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June 22, 2023
Celebrate Juneteenth by promoting Black health, wealth and joy | CNN

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CNN
—

June 19, 2023 is the third annual observance of Juneteenth. The federal holiday commemorates June 19, 1865, when the enslaved people in Galveston, Texas, learned of their emancipation two years after President Lincoln signed the Emancipation Proclamation.

Although Juneteenth has recently become more widely recognized, the date has long been a deeply spiritual time of remembrance and celebration for the Black community.

Across the country, African Americans have rejoiced with fireworks and cookouts, sipping red drinks – a nod to ancestors’ bloodshed and endurance.

“We know the horrors that we went through,” explained Kleaver Cruz, writer of the forthcoming book “The Black Joy Project” and creator of a digital initiative of the same name. “It’s always concurrent: the joy and the pain. We use one to get through the other.”

On a particularly joyous note, this June 19, CNN and OWN (both properties of Warner Bros. Discovery) will simulcast Juneteenth: A Global Celebration for Freedom at 8 PM Eastern time. The concert will feature artists across multiple genres including Charlie Wilson, Miguel, Kirk Franklin, Nelly, SWV, Davido, Coi Leray, Jodeci and Mike Phillips. CNN will kick off pre-show coverage at 7 PM Eastern time, highlighting Black advocates, trailblazers, and creators.

“We get to celebrate our freedoms; we get to celebrate the dismantling of things and lean into what we want in the future,” Cruz said of Juneteenth observance. “We want more of that space and less of the one that harms us.”

The Black community still struggles with pain and inequity. Impact Your World has gathered ways you can help reject the pathology of racism and thoughtfully celebrate Juneteenth through non-profits that support Black health, wealth, joy, and overall empowerment. You can donate to those charities here.

For Black Americans, the end of slavery was just the beginning of a 158-year quest for equality. Along the way, the cumulative effect of institutional and systemic racism fomented stark disparities in income, health, education, and opportunity.

“Those that came before us were physically free but were unable to earn livable wages or receive an education without its share of defeating challenges,” said Marsha Barnes, Founder of The Finance Bar.

Data collected by the Board of Governors of the Federal Reserve System shows that in the fourth quarter of 2022, the average Black household’s net worth was about one-fourth that of the average White household.

“Taking the time to address the racial wealth gap highlights many of the roadblocks we as Black Americans currently face,” explained Barnes, a certified financial therapist. She sees the well-documented connection between financial literacy and financial wellness as a key to enhancing wealth in the Black community.

“We still are at a disadvantage, but it’s important we become comfortable with having to learn while playing the game,” Barnes told CNN.

HomeFree-USA is a non-profit aiming to close the racial wealth gap by improving financial education, homeownership, and opportunities. Their Center for Financial Advancement (CFA) recruits, trains, and places Historically Black College and University students into internships and careers with mortgage and real estate companies. The goal is to enhance diversity in the financial sector, expose students to credit and money management and help them become savvy consumers and future homeowners.

The African American Alliance for Homeownership is a non-profit counseling agency that helps families obtain, retain, maintain, and sustain their homes. The organization offers HUD-certified counselors who support first-time homebuyers and foreclosure prevention. The group recently expanded its services to help homeowners with estate plans, resource navigation, home repairs, and energy-efficiency upgrades.

Former NFL Player Warrick Dunn started Warrick Dunn Charities in 1997 to help single parents buy homes by providing $5,000 down payments and home furnishings.

“The more I learned, we wanted to get into the business of giving people the potential to break their cycle of poverty,” Dunn explained in a 2021 interview with CNN.

The non-profit has expanded its priorities to include financial literacy, health and wellness, education attainment, workforce development, and entrepreneurship support.

The National Urban League is committed to the advancement of African Americans through economic empowerment, equality, and social justice. The organization champions education, job training, workforce development, and civic engagement through community and national initiatives.

The legacy of racism in America continues to fuel health and healthcare inequities for Black people.

“We’re seeing diseases that, when I was in medical school, I thought to be diseases that would start to develop in people in their fifties, sixties, and seventies. I’m seeing these diseases sometimes in teenage years,” said Dr. Barbara Joy Jones, an Atlanta-based family medicine physician.

According to the CDC, five health conditions particularly affect the Black community at higher rates: cardiovascular disease, human immunodeficiency virus (HIV), metabolic syndrome, colon cancer, and mental health conditions.

“I consider hypertension, Diabetes, and obesity the triad,” said Jones.

The leading contributor to that triad is what you eat.

“Diet is 80% of health, and just access to quality food and education about food has been very hard,” Jones explained.

“When you go back and look at slavery, the foods we had to eat were the last scraps, so through the passing down of culture, you’re eating foods that are not the healthiest because it was simply for survival,” said Jones.

According to Feeding America, eight of the ten US counties with the highest food insecurity rates are at least 60% Black and one in every four Black American children is affected by hunger.

Addressing food insecurity, nutrition education, and better food access can make a difference.

Feeding America runs a network of food banks in those mostly Black hard-hit counties.

Share Our Strength runs a program called Cooking Matters offering cooking classes, grocery store tours, and digital content to help marginalized families across the country shop and cook with an eye towards health and budget.

The African American Diabetes Association uses targeted outreach projects to help Black people prevent or delay type 2 diabetes.

Despite progress over the years, racism continues to impact the mental health of African American people.

“The stress and microaggressions that happen daily for a person of color in the work environment and everyday life add up, and unmitigated stress can lead to disease,” Jones told CNN.

The Black Mental Health Alliance and the Trevor Project, provide training and networks of mental health providers specifically supportive of the Black and Black LGBTQ communities.

In 2019, the CDC found that Black people comprised 41% of the new HIV infections in the US. The Black AIDS Institute was founded in 1999 to mobilize and educate Black Americans about HIV/AIDS treatment and care. The Black AIDS Institute advances research, support groups, and education and runs a clinic catering to BIPOC and underserved communities.

As recently as the 1990’s, unethical medical research was conducted on Black Americans. The Tuskegee Study is one of the most widely recognized examples of the racist practice that led many Black people to distrust the healthcare system and avoid doctors altogether.

Beyond investing in cultural sensitivity training and prioritizing preventative care, Jones said, “For anti-doctor people, find someone that looks like you; representation matters.”

“Half of the getting to know your part of medicine is to know why psychosocial and economically you are where you are, and having a doctor that looks like you can support that.”

Only about 5.7% of US physicians identify as Black or African American, according to the Association of American Medical Colleges.

The White Coats Black Doctors Foundation is working to increase diversity in the medical profession, supporting educational preparation to become a doctor and helping offset the costs associated with applying and transitioning to residencies.

Black joy has been essential for survival, resistance, and self-development for centuries. But these days, it’s often exploited and misunderstood.

“I see the ways that Black joy at this moment is being commercialized or co-opted to make it feel like it’s Black people smiling,” lamented Cruz. “It’s much, much deeper than that.”

Cruz launched the Black Joy Project as a photo essay on social media in 2015 following the deaths of Michael Brown and Sandra Bland to help the Black community process its collective pain.

“I posted it on Facebook in the stream of consciousness and said, ‘Let us bombard the internet that joy is important too, and as people are sharing these traumatic videos, we have to make space for joy.’ And it was an invitation for anybody else that wanted to do that.”

Enslaved Black people knew they weren’t free but still hoped their future generations would be. That empowering optimism gave them the will to press forward, no matter the circumstance.

“This (joy) is just a continuation of those practices,” Cruz said. “Joy is intrinsic. It’s something that can’t be taken from us because it comes within us; it’s always ours to have.”

Juneteenth is a celebration of freedom, culture, and history, and it’s important to uplift non-profits that positively nourish the arts, music, and all the things that foster Black joy.

The Robey Theatre Company was founded in 1994 by actors Danny Glover and Ben Guillory to tell the complex stories of the Black experience. The theater showcases and develops up-and-coming actors and playwrights to sustain Black theater.

The Debbie Allen Dance Academy uses dance, theater, and performance to enrich, inspire and transform students’ lives.

As some states are moving to block Critical Race Theory and Black history from public education, the Legacy Museum: From Enslavement to Mass Incarceration gives visitors an interactive history lesson on the harsh repercussions of slavery and systemic racism in the US. The immersive exhibition carries visitors through the transatlantic slave trade up to the current mass incarceration of Black people. The museum occupies a site in Montgomery, Alabama where enslaved Black people were historically auctioned off.

“If we’re being serious about Black joy, that means we’re being serious about Black lives, period,” Cruz concluded.

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June 16, 2023
New Research Shows HIV Can Lie Dormant in the Brain

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Newswise — CHAPEL HILL, N.C. – As a part of its life cycle, the human immunodeficiency virus-1 (HIV) inserts a copy of its DNA into human immune cells. Some of these newly infected immune cells can then transition into a dormant, latent state for a long period of time, which is referred to as HIV latency.

Although current therapies, such current antiretroviral therapy (ART), can successfully block the virus from replicating further, it cannot eradicate latent HIV. If treatment is ever discontinued, the virus can rebound from latency and reignite the progression of HIV infection to AIDS.

Scientists from the HIV Cure Center at the UNC School of Medicine, University of California San Diego, Emory University, and University of Pennsylvania have been searching for where exactly these latent cells are hiding in the body. New research published in the Journal of Clinical Investigations confirms that microglial cells – which are specialized immune cells with a decade-long lifespan in the brain – can serve as a stable viral reservoir for latent HIV.

“We now know that microglial cells serve as a persistent brain reservoir,” said first author Yuyang Tang, PhD, assistant professor of medicine in the Division of Infectious Diseases and member of the UNC HIV Cure Center. “This had been suspected in the past, but proof in humans was lacking. Our method for isolating viable brain cells provides a new framework for future studies on reservoirs of the central nervous system, and, ultimately, efforts towards the eradication of HIV.”

Latent HIV

HIV is a tricky and unique virus to study. During infection, the virus specifically targets the key coordinators of the immune response, which are called CD4+ lymphocytes. Over time, the virus kills enough CD4+ cells to cause immunodeficiency. .

Past research has shown that latent HIV can hide within a few of the surviving CD4+ T cells throughout the body and the bloodstream. However, other viral reservoirs have been suspected to hide within the central nervous system (CNS) in people with HIV receiving effective ART.

Unlike peripheral blood cells, it is extremely difficult to access and analyze brain tissues for the study of HIV reservoirs. Since these types of cells cannot be safely sampled in people taking ART,he potential viral reservoir in the brain has remained an enigma for many years.

Extracting Pure Brain Tissue

The team first studied the brains of macaques with the simian immunodeficiency virus (SIV), a virus that is closely related to HIV, from the Yerkes National Primate Research Center at Emory University to get a better understanding of how to extract and purify viable cells from primate brain tissue.

Researchers used physical separation techniques and antibodies to selectively remove cells that were expressing microglial surface markers. Then, they isolated and separated the highly pure brain myeloid cells from the CD4+ cells that were passing through the brain tissue.

Using these techniques, researchers then obtained samples that were donated by HIV+ people who were enrolled in “The Last Gift” Study at the University of California San Diego (UCSD). As a part of this unique and important effort, altruistic HIV+ people, who aretaking ART but suffering from other terminal illnesses, will their bodies to further the HIV research project.

“The samples are from people living with HIV, who are on therapy but facing a fatal disease of some kind,” said the co-author David Margolis, MD, the Sarah Kenan Distinguished Professor of Medicine, Microbiology & Immunology, and Epidemiology. “They were willing to not just donate their bodies to science, but also participate in the research program in the months leading up to their death. It’s an extraordinary program that made this critical research possible.”

Now that the researchers know that latent HIV can take refuge in microglial cells in the brain, they are now considering plans to target this type of reservoir. Since latent HIV in the brain is radically different from the virus in the periphery, researchers believe that it has adapted special characteristics to replicate in the brain.

“HIV is very smart,” said senior author Guochun Jiang, PhD, assistant professor in the UNC Department of Biochemistry and Biophysics and member of the UNC HIV Cure Center. “Over time, it has evolved to have epigenetic control of its expression, silencing the virus to hide in the brain from immune clearance. We are starting to unravel the unique mechanism that allows latency of HIV in brain microglia”.”

NF-κB signaling is one of the critical signaling pathways that controls HIV expression elsewhere in the body. When NF-κB signaling is ”turned off”, HIV enters latency in the peripheral blood. However, it seems that latent HIV in the brain is not impacted by the activation of NF-κB signaling. Researchers are unsure why that is, but once an answer is found, they will be one step closer to knowing how to selectively target and eradicate the virus in the brain or peripheral blood.In addition to understanding the inner workings of the brain reservoir, the researchers are also trying to determine the true size of the latent HIV brain reservoir.

“It is very hard to know how big the reservoir is,” said Margolis, who is also the director of the UNC HIV Cure Center. “The problem with trying to eradicate HIV is like trying to eradicate cancer. You want to be able to get it all, so it won’t come back.”

About UNC School of Medicine The UNC School of Medicine (SOM) is the state’s largest medical school, graduating more than 180 new physicians each year. It is consistently ranked among the top medical schools in the US, including 7^th overall for primary care by US News & World Report, and 7^th for research among public universities. More than half of the school’s 1,700 faculty members served as principal investigators on active research awards in 2021. Two UNC SOM faculty members have earned Nobel Prize awards.

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University of North Carolina School of Medicine

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June 16, 2023
Uganda’s Anti-Gay Bill Imperils HIV Fight

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Newswise — [KAMPALA] Uganda’s anti-homosexuality bill, if signed into law, could lead to the withdrawal of foreign aid and threaten goals to end HIV/AIDS by 2030, advocates warn.

Uganda’s parliament passed the revised Anti-Homosexuality Act (AHA), which criminalises homosexual conduct, with minimal amendments this week (2 May).

The legislation was first passed at the end of March but revised in April after President Yoweri Museveni returned it to parliament for amendments.

“If it becomes law, it will increase stigma and discrimination against LGBTQ people and men who have sex with men, further limiting prevention and treatment services.” – Richard Lusimbo, director-general, Uganda Key Populations Consortium

The bill includes a punishment of life imprisonment for same-sex sexual conduct and up to ten years behind bars for attempted same-sex sexual acts. It also imposes the death penalty for “aggravated homosexuality” and criminalises the “promotion” of homosexuality, which many people fear will encourage homophobia.

UNAIDS had warned that passing the bill into law would jeopardise progress in the fight against HIV/AIDS and undermine fundamental human rights including the right to health and the right to life. 

“Uganda’s new Anti-Homosexuality bill is an outrage,” said Winnie Byanyima, executive director of UNAIDS.

“Access to timely and quality health care is a human right – sexual orientation should not determine one’s rights.”

Anne Githuku-Shongwe, director of the UNAIDS support team for eastern and southern Africa, said Uganda had made “excellent progress” in tackling the AIDS pandemic. “This new bill, if passed into law, would undercut that progress,” she warned.

Human rights ‘disaster’

According to a study published in The Lancet, HIV prevalence is significantly higher among men who have sex with men (MSM) and in African countries with laws that criminalise same sex relationships.

“If it becomes law, it will increase stigma and discrimination against LGBTQ [lesbian, gay, bisexual, transgender, and queer] people and men who have sex with men, further limiting prevention and treatment services,” said Richard Lusimbo, director-general of Uganda Key Populations Consortium, a human rights organisation.

Lusimbo explained that the bill, if passed into law, would be a disaster to the human rights of LGBTQ people, to public health and the fight against HIV/AIDS.

The US government has threatened to withdraw funding for Uganda through its President’s Emergency Plan For AIDS Relief (PEPFAR) if the law is passed.

“At this time, we are reviewing the possibility that the AHA, if signed, might prevent us from providing lifesaving prevention, care and treatment services equitably to all Ugandans receiving PEPFAR support,” said a US State Department spokesperson.

PEPFAR’s annual HIV/AIDS response investment in Uganda is about US$400 million.

Despite the pressure from the US and other governments, there is speculation that President Museveni will most likely sign the bill into law. However, the power of ascension of a bill does not lay primarily with the president.

The Ugandan parliament can also pass the bill into law if the president does not assent to or veto a bill after it is passed by parliament within 30 days or if the bill is returned to parliament twice.

In his speech on April 22, at conference themed ‘Protecting African culture and family values’, President Museveni thanked members of the Ugandan parliament for passing the bill.

“It is good that you rejected the pressure from the imperialists,” he said, reflecting his support for what has been described by activists and advocates as a draconian law.

The bill is setting the pace for other African nations as countries like Kenya, Tanzania, Ghana and others indicate readiness to introduce similar bills in solidarity with Uganda.

Charles Brown, executive director of Preventive Care International (PCI), a Ugandan non-governmental organisation that focuses on HIV, says the bill is harsh and not well thought through. He fears it will further entrench inaccessibility of health services for people in same sex relationships.

“Already, the landlady of one of my offices in western Uganda called me saying that she was told that our organisation promotes homosexuality and she is scared of being arrested,” Brown told SciDev.Net, fearing eviction.

“We hope that the president doesn’t sign it into law,” he added.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.

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May 5, 2023
Antibiotic resistance is an increasing problem. Learn all about it in the Drug Resistance channel.

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Staphylococcus aureus, Clostridioides difficile, Candida auris, Drug-resistant Shigella. These bacteria not only have difficult names to pronounce, but they are also difficult to fight off. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria. Antimicrobial resistance is an urgent global public health threat. According to the World Health Organization, antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality. It kills at least 1.27 million people worldwide and they are associated with nearly 5 million deaths in 2019, according to the CDC. In the U.S., more than 2.8 million antimicrobial-resistant infections occur each year. Careful prescribing of antibiotics will minimize the development of more antibiotic-resistant strains of bacteria. Staying informed is another way to fight these dangerous “superbugs.” Below are some of the latest news updates on the topic of Drug Resistance.

Scientists make critical progress toward preventing C. diff infections (embargoed until 26-Mar-2023 5:00 PM EDT)

Resistant bacteria are a global problem. Now researchers may have found the solution

Potential Treatment Target for Drug-Resistant Epilepsy Identified

Brazilian researchers investigate diversity of E. coli bacteria in hospitalized patients

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Newswise

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March 20, 2023
Commonly used antiretroviral drugs used to treat HIV and hepatitis B reduce immune cells’ energy production

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FINDINGS

New UCLA-led research suggests that antiretroviral drugs called TAF and TDF directly reduce energy production by mitochondria, structures inside cells that generate the power that cells use to function. Both drugs led to reduced cellular oxygen consumption rates, a measure of the ability of the mitochondria to produce energy, compared with controls. But in combination with other antiretrovirals, TAF appeared to result in a larger energy reduction than TDF did. Whether this is a cause for concern is not known at this point.

BACKGROUND

The antiretroviral drugs tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) are used to treat HIV and hepatitis B infection in millions of people around the world. These drugs are also used as pre-exposure prophylaxis (PrEP) against HIV in uninfected people.

METHOD

Using both a human clinical trial and experimental lab studies, the researchers assessed the impact of TAF and TDF in combination with other antiretrovirals on the ability of blood immune cells to make energy. In the clinical trial, 26 people with HIV switched antiretrovirals over nine months and the researchers assessed how the drugs affected their cells’ energy production. The investigators confirmed these findings experimentally in the lab by directly adding the drugs to healthy immune cells and analyzing their impact on the cells’ metabolism.

IMPACT

The clinical implications of the findings are unclear at this point, a question that requires more research. These drugs are well tolerated by millions of people worldwide, but the long-term clinical implications of these drugs on the ability of human cells to make energy is unclear.

COMMENT

“Mitochondria are key structures inside the cells. This is the among the first demonstrations that antiretrovirals used in humans in HIV and hepatitis B directly change the function of mitochondria to make energy,” said senior author Dr. Theodoros Kelesidis, associate professor-in-residence of medicine in the division of infectious diseases at the David Geffen School of Medicine at UCLA. “We utilized independent research methods to confirm our findings. This is an important message, given that millions of people are on these antiretrovirals. It remains to be shown whether the effects of these antiretrovirals on mitochondria are mechanistically linked to certain metabolic changes that may be seen with the use of these antiretrovirals such as weight gain.”

AUTHORS

Study co-authors are Eleni Ritou, Sandro Satta, Anton Petcherski, Maria Daskou, Madhav Sharma, Hariclea Vasilopoulos, and Dr. Orian Shirihai of UCLA, and Eisuke Murakami of Gilead Sciences.

JOURNAL

The study is published in the peer-reviewed journal Metabolism.

FUNDING

The study was supported by Gilead Sciences, Inc. (CO-US-311-4393) and the National Institutes of Health (R01AG059501).

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University of California, Los Angeles (UCLA), Health Sciences

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January 18, 2023
Paving the way toward a cure? Study reports new insights into role of proteins in HIV latency

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Newswise — Understanding HIV latency at the molecular level is crucial for efforts to eliminate the viral scourge that causes AIDS. Latent infected cell reservoirs—where the human immunodeficiency virus (HIV) hides and persists in the bodies of infected patients in a kind of silent standby mode—are the reason why antiretroviral treatments never wipe out the virus.

In a nutshell, these latent reservoirs of HIV act as the biggest obstacle to curing the disease.

Now, in a rigorous new study led by uOttawa Faculty of Medicine virologist Dr. Marc-André Langlois, researchers are describing an against-the-grain discovery that is a potential game changer in the field. It has the potential to show the way forward for HIV cure research.

Published today in Nature Communications, the findings demonstrate that a family of host proteins long thought of as purely antiviral are sometimes also helping latent HIV find safe harbor in patients’ bodies.

Using cutting-edge technology and methodical assays in this project started in 2016, Dr. Langlois and his collaborators describe the impact of host-encoded proteins called APOBEC3 (A3). These proteins possess the ability to potently mutate viral DNA and restrict retroviruses like HIV as well as other types of viruses. But his team’s latest findings suggest that these proteins can also play another role outside of their traditional evolutionary one – and it’s not always in a patient’s favor.

“We’re showcasing a new mechanism by which HIV can become latent – and it can become latent through the action of our host proteins that are there to protect us. But in fact, these proteins can end up helping the virus maintain its stealthiness in the body,” says Dr. Langlois, a full professor at the uOttawa Faculty of Medicine and Chair in Pandemic Viruses and Preparedness Research.

“This is an important finding because these proteins were always perceived of as protectors that were on our side. But our work shows there are instances where they appear to have unintended consequences, and one of these unintended consequences is helping HIV become latent. And HIV latency is the biggest hurdle to a cure,” he says.

This raises major questions: Is the action of these proteins ultimately more beneficial or more counterproductive in the case of HIV, a virus that favors a latency phenotype? Can a drug be developed down the line to prevent the action of A3 proteins so the cellular and anatomical reservoir of latently infected cells is reduced?

These are the kind of explorations that Dr. Langlois and his team will be examining moving forward.

“Yes, we can keep HIV under tight control with antiretroviral drugs – and those drugs work wonderfully. But they’re not a cure. We are striving for a cure, and we think part of the countermeasures following an exposure will be to block the activity of A3 proteins to inhibit HIV latency,” says Dr. Langlois, who is also executive director of CoVaRR-Net, a network of interdisciplinary researchersnorth_eastexternal link created to assist the Canadian government’s strategy to address the threat of emerging SARS-CoV-2 variants.

“We’ve done the first demonstration that this mechanism—something that wasn’t on the radar and goes against mainstream thought—is really happening. So this is the first layer of evidence, and we’ll be building on it with follow-up studies.”

For this study, Dr. Langlois and his uOttawa Faculty of Medicine team focused on infection experiments. They provided samples to collaborators at the University of Western Ontario, who provided the “viral deep sequencing” expertise mapping where the virus inserts itself in the human genome after infection. The research was supported by a Canadian Institutes of Health Research (CIHR) grant.

Now demonstrated in vitro in the lab, and to some extent in patient samples, Dr. Langlois wants to take it to the next level with animal models. And while the overarching impact of the A3 proteins’ influence on HIV integration site profiles is unclear at this stage, his research team is committed to exploring potential answers.

The stakes of this research are high. Since its emergence as a new immunodeficiency syndrome in the early 1980s, HIV-AIDs has been one of the globe’s most serious health challenges. There’s been remarkable progress battling the virus, yet there are over 38 million people living with HIV worldwide, and tens of millions of people have died of HIV-related illnesses since the epidemic began.

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University of Ottawa

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January 10, 2023
It started as a one-time volunteer opportunity. 50,000 meals later, one volunteer is still making a difference | CNN

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CNN
—

‘Tis the season for spreading cheer and joy, two holiday ingredients Lavon Lacey likes to deliver year-round. For the past 26 years, Lacey has volunteered with Open Hand Atlanta, a nonprofit delivering nutritious and healthy meals to Georgia’s chronically ill, disabled and homebound citizens.

On his recent delivery rounds, Lacey was greeted at most of the apartment buildings like he lives there. That’s typical; he’s been delivering to some of these places for over 20 years. After exchanging pleasantries with various building employees who have became friendly acquaintances, Lacey continued his journey with a box of prepared meals tucked under his arm.

It ended with a knock on one of the apartment doors, “Open Hand, I have your food.”

His routes usually consist of 10 to 12 different stops around town. Some of the people he visits are new, some he’s been delivering to for years. On this particular route, one gentleman uses a wheelchair, so Lacey offered to bring the boxes of meals inside for him.

“There are circumstances where they are too old to handle a box, so I take it in for them and put it in their kitchen. But usually, we hand it to them at the door.”

It may seem like a small gesture, but for the people he’s helping, it makes a big difference. And all these small gestures add up. Lacey estimates he’s delivered over 50,000 meals to around 7,500 people and he’s done it all for just one organization – Open Hand Atlanta.

“Open Hand Atlanta brings more than just food, it brings nutritious food to people who may not otherwise get to eat.”

Open Hand got started in Atlanta in 1988 when a group of friends began cooking meals for people in their community with HIV/AIDS.

Lacey got involved in the mid ’90s when the theater group he was working with decided to volunteer for a community service project.

“We came and packed meals and I went, ‘I like this organization. I think I’ll start delivering meals.’”

Once he began delivering meals, however, he felt compelled to continue after seeing the dire needs of those being served. He would revisit homes frequently, making friends along the way which made the work more personal, but sometimes heartbreaking.

“Back when I first started, most of the clients had HIV/AIDS. You developed relationships with people as you delivered the meals,” Lacey said. “You got used to their names and saying hello and making their days a little brighter. Then suddenly their name would not be on the list anymore. You’d know at that point they’d either passed away or moved to a different level of care. That was hard to get accustomed to.”

Over the years, the Open Hand clientele has changed. Seniors now make up a large portion. Open Hand Atlanta also delivers meals to families, those with disabilities or illness and any “at-risk individuals from all walks of life,” according to the organization.

And demand is growing. In 2021, Open Hand Atlanta cooked and served around 1.5 million meals and now prepares and delivers an estimated 5,000 meals a day. It’s one of the largest community-based providers of home-delivered meals in the US and relies on staff and volunteers to package and deliver meals throughout the state of Georgia.

With his 27th year coming up next summer, Lacey doesn’t see himself stopping anytime soon and says he’ll probably do it until he “can’t walk anymore.”

“Volunteerism was just something I grew up with.”

Lacey says volunteering broadens his horizons and makes him feel healthier and happier. He hopes his story will inspire others to volunteer, especially during the holiday season.

“What better time to find an organization that you’re passionate about and volunteer your time. And then maybe you’ll just keep doing it through the New Year…or 26 years.”

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December 20, 2022
Another monkey virus could be poised for spillover to humans

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Newswise — An obscure family of viruses, already endemic in wild African primates and known to cause fatal Ebola-like symptoms in some monkeys, is “poised for spillover” to humans, according to new University of Colorado Boulder research published online Sept. 30 in the journal Cell.

While such arteriviruses are already considered a critical threat to macaque monkeys, no human infections have been reported to date. And it is uncertain what impact the virus would have on people should it jump species.

But the authors, evoking parallels to HIV (the precursor of which originated in African monkeys), are calling for vigilance nonetheless: By watching for arteriviruses now, in both animals and humans, the global health community could potentially avoid another pandemic, they said.

“This animal virus has figured out how to gain access to human cells, multiply itself, and escape some of the important immune mechanisms we would expect to protect us from an animal virus. That’s pretty rare,” said senior author Sara Sawyer, a professor of molecular, cellular and developmental biology at CU Boulder. “We should be paying attention to it.”

There are thousands of unique viruses circulating among animals around the globe, most of them causing no symptoms. In recent decades, increasing numbers have jumped to humans, wreaking havoc on naïve immune systems with no experience fighting them off: That includes Middle Eastern Respiratory Syndrome (MERS) in 2012, Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) in 2003, and SARS-CoV-2 (the virus that causes COVID-19) in 2020.

For 15 years, Sawyer’s lab has used laboratory techniques and tissue samples from wildlife from around the globe to explore which animal viruses may be prone to jump to humans.

For the latest study, she and first author Cody Warren, then a postdoctoral fellow at the BioFrontiers Institute at CU, zeroed in on arteriviruses, which are common among pigs and horses but understudied among nonhuman primates. They looked specifically at simian hemorrhagic fever virus (SHFV), which causes a lethal disease similar to Ebola virus disease and has caused deadly outbreaks in captive macaque colonies dating back to the 1960s.

The study demonstrates that a molecule, or receptor, called CD163, plays a key role in the biology of simian arteriviruses, enabling the virus to invade and cause infection of target cells. Through a series of laboratory experiments, the researchers discovered, to their surprise, that the virus was also remarkably adept at latching on to the human version of CD163, getting inside human cells and swiftly making copies of itself.

Like human immunodeficiency virus (HIV) and its precursor simian immunodeficiency virus (SIV), simian arteriviruses also appear to attack immune cells, disabling key defense mechanisms and taking hold in the body long-term.

“The similarities are profound between this virus and the simian viruses that gave rise to the HIV pandemic,” said Warren, now an assistant professor in the College of Veterinary Medicine at The Ohio State University.

The authors stress that another pandemic is not imminent, and the public need not be alarmed.

But they do suggest that the global health community prioritize further study of simian arteriviruses, develop blood antibody tests for them, and consider surveillance of human populations with close contact to animal carriers.

A broad range of African monkeys already carries high viral loads of diverse arteriviruses, often without symptoms, and some species interact frequently with humans and are known to bite and scratch people.

“Just because we haven’t diagnosed a human arterivirus infection yet doesn’t mean that no human has been exposed. We haven’t been looking,” said Warren.

Warren and Sawyer note that in the 1970s, no one had heard of HIV either.

Researchers now know that HIV likely originated from SIVs infecting nonhuman primates in Africa, likely jumping to humans sometime in the early 1900s.

When it began killing young men in the 1980s in the United States, no serology test existed, and no treatments were in the works.

Sawyer said there is no guarantee that these simian arteriviruses will jump to humans. But one thing is for sure: More viruses will jump to humans, and they will cause disease.

“COVID is just the latest in a long string of spillover events from animals to humans, some of which have erupted into global catastrophes,” Sawyer said. “Our hope is that by raising awareness of the viruses that we should be looking out for, we can get ahead of this so that if human infections begin to occur, we’re on it quickly.”

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University of Colorado Boulder

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September 30, 2022