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3 recent developments on HIV research

Leon Kan, 06 Jul 2017
The human immunodeficiency virus (HIV) has been around for the better part of three decades. In that time, it has spread all over the world and become one of the worst public health nightmares in modern medical history.

These days, HIV is more than just treatment with ample amounts of resources going into prevention as well as education.

While a definite cure has yet to be discovered, the condition has improved drastically as each new research outcome brings us one step closer to finding a cure. The following are three of the latest discoveries in HIV research.

1. New test to detect hidden HIV

Diagnosis tests for HIV have existed for several decades now. However, the challenge has always been in detecting sufficiently low viral counts which are seemingly “hidden” in HIV positive patients undergoing treatment in the early phases of the infection.

Now, a team from the University of Pittsburgh has discovered a new test that is able to detect these “hidden” HIV much faster, more easily and at a more affordable price than the current crop of tests.

Known as the TZA test, the new test works by detecting a gene that is turned on only when there is replication of HIV, where it then subsequently flags the virus out. The new TZA test proposes to cut the process time by half and cost by one third respectively while being able to detect HIV volumes 70 times less than the previous minimum of the Q-VOA test.

“Globally there are substantial efforts to cure people of HIV by finding ways to eradicate this latent reservoir of virus that stubbornly persists in patients, despite our best therapies,” said senior author Phalguni Gupta.

“But those efforts aren’t going to progress if we don’t have tests that are sensitive and practical enough to tell doctors if someone is truly cured.”

This new test will be targeted towards patients already undergoing anti-retroviral treatment and patients in the paediatric age group. Alongside it, the results from low HIV reservoir studies can help the development of even more effective anti-retroviral therapies.

2. Anti-HIV vaginal gel

Meanwhile, a surprising discovery has led to researchers gaining a better understanding of the gender discrepancy of HIV treatment when it comes to efficacy.

By attempting to develop an antiviral vaginal gel to protect women from contracting HIV infection during unprotected sex, a team instead discovered that the bacterial ecosystem of the vagina actually modifies the effectiveness of the delivered medication.

Tenofovir, an anti-retroviral drug, has long been approved for treatment of HIV infections. However, during clinical trials, tenofovir was often found to be more effective in women than men.

Even when applied directly as a vaginal gel, the drugs are only partially protective. As it turns out, it was the vaginal bacterial ecosystem which made all the difference, more specifically, the bacteria from the lactobacillus family.

Women who harboured more lactobacillus bacteria in their vaginal ecosystem were able to prevent HIV infection by 61% as compared to women with less lactobacillus at 43%. While the lactobacillus bacteria did not confer any positive culture benefits when mixed together with tenofovir, it is the “bad” bacteria such as Gardnerella vaginalis which causes the drug to break down even before it can be rendered effective.

“We have to look at biological variability in each person,” said microbiologist Nichole Klatt of the University of Washington, who led the research with a team of U.S. and Canadian scientists.

All of these findings have extensive ramifications in poorer income nations where prevention has become an increasingly targeted method. With several other manufacturers and researchers working on anti-HIV vaginal applications, these newer drugs would probably have to undergo similar tests as well.

3. One step closer to a HIV vaccine

The ultimate goal for HIV research often remains to be finding a cure or vaccine against the virus. Nevertheless, this has been easier said than done as HIV remains to be both a highly resilient and adaptive virus.

Fortunately, we are now one step closer to realising a HIV vaccine thanks to a team of scientists at the Scripps Research Institute (TSRI).

Referencing previous studies on the structural protein on a HIV’s surface, the team was able to create a mimic of the HIV, subtype C, which is largely responsible for many of the infections worldwide. The surface protein, known as envelope glycoprotein, allows researchers to have an accurate physical representation of HIV which can be used in combination in a vaccine to target various strains of HIV.

The most common HIV strains are called clades A, B and C. Prior to this, only the structure of clade A HIV was known and now, TSRI has added clades C into the mix.

Nevertheless, identifying and replication of the virus’ surface protein was no simple task as it was often unstable and prone to breaking down. As such, the team’s ability to successfully replicate clades C is a remarkable achievement.

All of these are in line with TSRI’s various concurrent research on HIV, in hopes of one day developing a successful vaccine against HIV.

"All of this research is going toward finding combinations of immunogens to aid in protecting people against HIV infection," said Professor Ian Wilson, chair of the Department of Integrative Structural and Computational Biology. MIMS

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