Posts tagged HIV treatment
Treatment for HIV depends first on an HIV test. Curbing the growing number of patients with HIV requires the aid of healthcare institutions. The European guidelines for HIV testing are clear and ensure that each patient presenting with certain symptoms and diseases must be offered an HIV test. Patient screening is a good way to test and provide early treatment for those who are HIV positive.
To HIV Test or Not
Willingly most patients offered the test will take it. One study puts the acceptance rate at 99%. That is encouraging to health experts. However, when looking into the number of patients who were offered an HIV exam, European hospitals came up short. It was found that in Europe less than half of the patients who qualify were actually offered the test. Hospitals that had the lowest rates were in Northern Europe. Researchers are concerned that the number of those infected with HIV may be much higher than what is being reported.
Certain areas within the hospitals studied were more prone to recommend HIV testing. These wards are generally the ones regularly dealing with certain communicable ailments (like TB and Hepatitis). Therefore, HIV testing makes sense and is routinely offered. Another group of patients regularly asked are pregnant women, because careful testing can prove vital for the fetus as well. While very few fetuses actually test positive for HIV, the screening is offered and frequently accepted.
Why Is the Test so Frequently Not Offered?
One reason tests are sometimes not offered is medical staff discomfort in the area of HIV. Experts are researching other possible reasons for the sporadic or lack of effort to encourage testing in more patients – especially those in high risk categories. The correlation between the hospital ward and the amount of screening performed provides insight on the matter. Certain cases that present in different wards of the hospital may simply not relate to HIV in the minds of the healthcare providers. Changing this view, and encouraging these European hospitals to step up patient screening, could go a long way in helping to slow the scourge of HIV in Europe.
For many aging adults, certain exams and tests at the doctor’s is a given. Those exams, along with their healthcare providers who pay for them, understand that with age comes certain increased health risks. One area of concern, however, has seemed to skip over this generation of adults. In the world of HIV screening tests, many doctors and other healthcare professionals simply overlook those within the older adult range. In light of this oversight, in 2006, the CDC issued a statement recommending that adults aged 50-64 be screened for HIV.
Research prior to that date had shown that this portion of the population had some living with an infection but not knowing it. Hence, we saw this call to healthcare givers to make a habit of testing older adults for the virus. While the suggestion was heeded, the effort was not sustained. This has caused some concern.
In the years leading up to 2006, the numbers were not high as far as HIV testing for this age group was concerned. Within just a three-year period, the percentage dropped from over 5% to just under 4%, this all taking place prior to the CDC‘s exhortation. In hopes of increasing awareness for these adults and their health care providers, the recommendation for HIV testing to be considered routine for this age group went out in 2006. The numbers did pick up immediately after the suggestion by the CDC was made. However, percentages only increased by one or two points. The news that researchers found most alarming was that this increase was not sustained. The number of older adults tested dropped within a couple years to below the average before the recommendation. Risk factors, however, have remained constant for this age group.
Awareness of these facts will hopefully spark additional efforts to revisit what was recommended nearly a decade ago. Not only should doctors be aware and do what they can for HIV screening tests for these adults, but patients may need to self-advocate in this instance. While no one looks forward to the list of health issues faced as we age, HIV is a big one to have crossed off the list. So check with your doctor and ask about HIV risks and testing at your next visit.
Antiretroviral Therapies have proven to help those who are HIV positive to enjoy a happy and full life. Those receiving treatment can have relatively normal lifespans. Decades of research and testing has made this outcome possible. Yet, there are many worldwide who are infected but who do not receive regular care or treatment. This causes a rise in mortality and poorer quality of life. So, in an effort to reach out and ensure that everyone is tested and treated without some falling through the cracks, a program was instituted in one region that had promising results as a HIV treatment as prevention approach.
A ‘test and treat’ method was applied to one area where HIV care was lacking. Program goals were to make testing and treatment simpler and faster while at the same time reducing the time between testing and therapy. Participants were tested for HIV along with a CD4 count and received results during the same visit. Included in that initial visit were both counseling prior to treatment and eligibility for antiretroviral therapy.
Faster Treatment Saves Lives
The time between HIV infection confirmation and the beginning of a patient’s therapy was greatly reduced – down to around five days – where previously it hovered at almost two months. Due to the efficient manner in which these cases were handled, the numbers showed that more patients received their treatments and followed through. Even better was how drastically the mortality numbers fell. One estimate puts the mortality rate at 13%, where before it was nearly 40%. When the program started little information had been gathered on the HIV positive population. This made it a bit more challenging to determine just how successful the test and treat method was. Undeniably, however, it met with great results that instill confidence in this type of streamlined care.
The success of this program highlights the need to implement HIV treatment as prevention in other areas. Some revision may need to take place so that it fits the needs of the region. Another matter meriting consideration is the cost. Researchers figured that for each patient who survived, the cost was US$235. This basically covered the first year of treatments and intervention. So from a financial standpoint, the cost is minimal compared with the outcome, making the program one that is feasible just about anywhere.
New HIV research has been revealing the workings of the human immune system. The hidden inner workings hold keys to solving some of the most formidable infections facing humankind. One such unlocked mystery is the discovery that one of the immune system’s sensor cells – cGAS – can detect HIV-1.
The cellular molecule, cGAS, is what sounds the alarm when there is an invasion of foreign matter. It has been believed, up until now, that cGAS could not detect retroviruses (such as HIV-1) because of the structural design of its DNA. Human DNA has two strands connected by molecular rungs. Retroviruses have just one strand. Researchers, therefore, concluded that this was one reason the body has trouble ridding itself of the intruder.
The HIV1 can, however, join together. They do this by twisting around each other to form a double strand. While these are more likely to be detected, the strand is often too short and passes through the cGAS radar. Here, however, is where the next piece in this chess game comes into play. The molecular building blocks of these DNA strands, called guanosines, can be detected by cGAS. It does not matter whether the HIV-1 is in its single-strand mode or not. Actually, it hardly mattered at all. What triggered the greatest immune response was the amount of guanosines. When more was added, the cellular defense response increased significantly. This strong reaction declined when the amount was lessened and all but stopped when it was removed altogether.
When HIV-1 infects a body, it imposes its DNA onto the healthy cell’s DNA. The result is a DNA that is curiously lacking in guanosines. It could be a reason as to why HIV-1 is particularly adept at cloaking – being virtually undetected by its host. However, some patients present with such a high number of HIV DNA that the guanosines that do remain still alert the cells, and the defense systems are activated. In these instances, the virus can remain suppressed indefinitely. This strong immune response is believed to be because of the detection of these all-important guanosines and the sensitive radar that detects it, cGAS.
Antibodies, also known as Y-shaped proteins produced by plasma cells, play an important role in keeping us healthy and free from infection. Now, HIV research scientists have identified a protein known as bNAbs. It stands for ‘broadly neutralizing antibodies’ and it may hold the promise of preventing HIV infections. The virus has spikes on it – not unlike many villains – and it uses these to bind and take over healthy cells.
The envelope spike or protein is the preferred target for the bNAbs. They are well equipped to recognize and subdue the virus. However, each type of bNAb is programmed to target specific epitopes or antigens on the spike. Certain bNAbs, therefore, have greater success in suppressing the virus than others. What most known bNAbs do have in common is that they tend to recognize the envelope spike in its closed position.
A virus will attach itself to a healthy cell, but in doing so the spike will open and close – depending on the stage it’s in. One lab has discovered a particular bNAb that can detect the virus when the spike is closed but also when it is partially opened. It was found while the research team was studying the antibodies of those whose bodies successfully control the HIV infection on their own. What is this special antibody called? 8ANC195. Continued efforts to see how 8ANS195 does what it does may lead to big things.
This could prove extremely beneficial in aiding those who are battling with HIV infection. These bNAbs could prove invaluable in identifying and neutralizing HIV that has gone undetected by the immune system. Seeing as most bNAbs target the virus when the envelope spike is closed, the virus with an open spike is free to continue unhindered. Now, with the discovery of antibodies that can detect the virus in its different forms, treatments can be more effective.
For HIV research, the promise of hope offered by these special bNAbs comes with more good news – it could be available in treatments in a short period of time. Clinical trials are already under way. Also, plans to make the antibodies even more effective are in the works. Researchers feel that introducing this bNAb to the cocktail will enhance the treatment therapies currently used.