# Saturday, 25 February 2017
Posted: Saturday, 25 February 2017 | Categories: HIV

For many years after the AIDS crisis of the 80s and 90s, being HIV-positive was considered a death sentence. Many of those who discovered they had the virus – which slowly attacks the immune system – were shunned, unfairly associated with immoral behaviour, and considered too "contagious" to be around.

Today, attitudes towards those who are HIV-positive have changed for the better, in no small part due to the incredible medical advances that have been made.

Currently, an HIV-positive person can expect to live a long and healthy life, provided they are diagnosed early enough, follow a healthy lifestyle and take the recommended antiretroviral medicines. For this reason, it’s now relatively uncommon for an HIV-positive person to develop AIDS, the final stage of infection where the immune system becomes totally compromised.

Of course, while many advances have been made with HIV treatment, a full cure still eludes scientists. However, recent research could play a hugely important role in the development of a working vaccine.

New Antibody Research

According to two new studies published in Science Translational Medicine, antibodies could be the key to the HIV vaccine. Antibodies are proteins created by the immune system and sent out whenever antigens (harmful bacteria or viruses) enter the body. Antibodies identify and bind to a specific type of antigen; this allows the immune system to identify the "intruder" and destroy it. Researchers have long stressed the importance of antibodies in the fight against HIV; these new studies have revealed that antibodies could be even more important than first thought.

One of the studies saw scientists create a special type of antibody that seeks out hidden HIV cells. When cultured together with an "HIV-killer" cell, these antibodies proved effective in destroying previously hidden cells of the virus.

The second study discovered three different antibodies that have a "neutralising" effect on HIV. It's hoped that this means that they can be administered to HIV-positive patients to prevent the virus from progressing.

With studies like this going on all the time, it is possible that we will see an HIV vaccine within the next decade. Currently, however, there are many treatments available to keep HIV infection properly managed and under control. To find out more, read on.

Diagnosing, Treating & Preventing HIV 

The first thing to know about HIV is that it is spread through bodily fluids (semen, vaginal and anal fluid, blood and breast milk). The most common mode of transmission is unprotected vaginal or anal sex.

HIV can also be spread in the following ways:

  • sharing drug needles or other injecting equipment
  • from mother to baby before or during birth
  • from mother to baby when breastfeeding

The instance involving mother and baby can be controlled so the risk is higher where the mother is infected and it is not known.

If you think you might have been exposed to the virus, or if you fall into an at-risk group (men who have sex with men, black African men and women), you should get tested for HIV.

There are different types of HIV test available – normally you will have your blood taken at a clinic and sent away for testing. Order a home test kit through The STI Clinic and you can take a blood sample at home and return it to our lab for testing; our test can detect HIV as early as 10 days after exposure but a negative result is not considered conclusive until 6 weeks after the point of potential infection.

If you think you have been infected in the past 72 hours, you should talk to a doctor about getting post-exposure prophylaxis (PEP); an emergency treatment that can prevent infection from setting in.

For people who are diagnosed with HIV, the treatment programme will involve regular blood tests to monitor the amount of virus in your system, and how healthy your immune system is. At a certain point, you will start treatment with antiretroviral medicines, which work by preventing the virus from multiplying. 

If you’re concerned about contracting HIV, make sure you always use condoms when having sex with someone who may be infected, and never share needles. If your partner is HIV-positive, it is possible to have safe sex – consult the resources available at Terence Higgins Trust to learn more.

 
# Friday, 20 May 2016
Posted: Friday, 20 May 2016 | Categories: HIV

At the 5th Eastern Europe and Central Asia AIDS Conference earlier this year, President of the Red Cross Massimo Barra spoke out about the current state of HIV testing. Barra urged for HIV screening to be "brought out of the hospitals, clinics and centres and onto the streets", thereby accessing particularly high-risk people who might be avoiding medical advice due to the stigma that surrounds the disease.

There’s a good chance that this whole event might have passed you by; in fact, you may not even have been aware that there was currently an HIV/AIDS crisis going on in Eastern Europe and Central Asia. But it’s certainly a cause for concern. In 2013, an estimated 1.1 million people were living with HIV in this region of the world, and that number has been steadily growing ever since.

While the numbers aren’t quite so out of control in the UK, recent years have seen HIV diagnoses creeping up. Coupled with this is that fact that a large proportion of diagnoses (40% in 2014) are made late into the disease, at a point when treatment should have already started. Across the world it seems that people are not only continuing to have unsafe sex, but they’re also failing to get adequate testing and treatment when they require it.

The History of HIV and AIDS

It is not known exactly when HIV originated, but many people think it started in the Democratic Republic of Congo in the 1920s, and was initially contracted from chimpanzees. However, it wasn’t until the 1980s that the virus began to receive widespread attention across the globe. By this point, unfortunately, an epidemic was already under way; it’s believed that by 1980 HIV had spread to five continents.

By 1986, 85 countries had reported almost 40,000 cases of AIDS to the World Health Organisation, with the majority stemming from North, South and Central America. By the end of the decade, it was estimated that this number had gone up to 400,000 worldwide.

A number of high profile celebrity deaths (including Freddie Mercury and Rock Hudson) occurred as a result of AIDS in the 80s and 90s, galvanising government bodies, charity campaigners, and medical research companies to take action. A new era of antiretroviral treatments began in 1995, and over the next few years, prices were reduced for HIV-positive people living in developing countries.

Today, medical advances have made it possible for people with HIV to live a healthy, normal life. Modern-day medications are associated with fewer side effects, and – provided the virus is detected early enough – can often allow the patient to enjoy a normal lifespan.

Contracting HIV

HIV is a virus that attacks the immune system, leaving it weakened and vulnerable to infections. It is spread through infected bodily fluids (semen, vaginal fluid, anal fluid, blood, breast milk) and is normally contracted during unprotected penetrative anal or vaginal sex. According to a study by Public Health England, 95% of people diagnosed with HIV in 2013 contracted it through sexual contact.

You can also contract HIV from sharing needles, or getting infected blood in your eye or an open wound. HIV-positive mothers can also transmit the disease to their baby during birth or breastfeeding.

There are two particularly at-risk groups for HIV in the UK:

    Men who have sex with men

    Heterosexual African men and women 

In a 2015 report, Public Health England recommended that people who fall into these two risk groups should be screened for HIV once a year, and every three months if they are having unprotected sex with new partners. The report also stressed the importance of prompt diagnosis for heterosexuals. Because HIV is often associated with gay or bisexual men, and African men and women, the fear is that many people who do not fall into these groups will not bother to get tested. However, there is still a risk for people outside of these two groups.

Testing for HIV

The good news is that it’s very easy to get tested for HIV. The NHS offers free testing through GP surgeries and sexual health clinics. Private clinics also offer HIV testing, as do trusted online health services such as The STI Clinic.

It is better to know if you have HIV as the treatment interventions have excellent clinical outcomes – especially if the diagnosis is early.

 
# Thursday, 21 November 2013
Posted: Thursday, 21 November 2013 | Categories: HIV

The STI Clinic has launched a testing service for HIV. The test uses the latest detection technology and can provide a reliable result 6 weeks after a risky event. The test looks for antigens and antibodies and is capable of early detection. In some cases the antigens associated with HIV are detectable in the blood after 10 days. We recommend that people get tested as early as possible following exposure to a risky event, but if the result is negative, we will recommend a retest at the 6 weeks mark.

We have also introduced some wider tests with an HIV testing component. These wider screens are aimed at men who have sex with men (MSM) and suit the sexual health risk profile of this population group. The MSM tests incorporate Chlamydia and Gonorrhoea infections and encompass the infection sites of the throat, the rectum and the genitals. These tests also extend to Hepatitis B and C and also Syphilis. The HIV test has a 4 hour turnaround time and the MSM tests are next day results, with the possibility of interim results before all results are available.

Further details about these tests are located here and here.
 
# Wednesday, 24 July 2013
Posted: Wednesday, 24 July 2013 | Categories: HIV

Although HIV is manageable, the cure for the disease remains a medical enigma. Every so often unique cases relating HIV being functionally cured crop up in the media. The most recent case comes from two men that appear to have been cured of HIV following a bone marrow transplant. Here we consider the implications of those findings.

 

The outcome of these cases was reported at the International Aids Society Conference in Kuala Lumpur. According to the medical team, two men who had lived with the virus for over 30 years received a bone marrow transplant as a part of their cancer treatment. In order for the treatment to be successful, the men kept taking their HIV medications.

 

As a consequence of the bone marrow transplant, the stem cells in each of the men were replaced. This of course is important; as the clinicians involved hypothesised that their recovery could have been a result of new stem cells creating immune cells to fight the disease. At the time of reporting, the men had been off their HIV treatment for 7 and 15 weeks respectively, and were still being monitored.

 

Although this report could be seen as a cause for optimism, the medical team that had worked on the cases urged for a cautious optimism and noted that it was too early to tell what the implications of the current findings would be in the long run. Similarly, it was noted that there was still a possibility that the virus remained dormant in other areas, such as the brain or the gastrointestinal region.

 

We feel inclined to agree with the medical team, as it is too early to tell where this finding could lead. From a clinical point of view, a bone marrow transplant for every patient with HIV is not feasible nor is it desirable, given that it is a costly, high risk treatment. Similarly, it is important to note that the men had a co-morbidity of lymphoma that required treatment and as such it is worth asking how much of that is applicable to individuals who “only” have HIV. As it is too early to tell whether the two men have been cured, it is also too early to see whether there are any side effects that will occur as a result of the bone marrow transplant.

 

What comes next is for the research community to consider the potential mechanisms that may have played a role in the recovery of these patients, and to study if it is possible to exploit these mechanisms to develop a safe and lasting treatment of HIV.

 
# Monday, 29 April 2013
Posted: Monday, 29 April 2013 | Categories: HIV

Since we first became aware of HIV, various attempts were made to within research to develop treatments and vaccinations. Sadly, with the exception of one trial, there was little success in developing an efficacious vaccine. So we were not surprised when we recently heard about the reports of another trial being interrupted.

 

The trial, which was conducted in the US, was rather large scale and had enrolled 2504 volunteers to date. In total, 19 cities took part, and all the participants were either gay males or transgender males having sexual relationships with gay men. All the participants were offered condoms and took part in extensive counselling about the risks of HIV. The entire sample was randomly split into two groups. One group received a placebo, whereas the other one was given two different types of injections. Firstly they were given a vaccine that had genetically engineered HIV material. This was done in order to prime the immune system to attack the virus. The second injection was a booster, which was meant to enhance and strengthen the immune response. Neither of these vaccines was capable of causing HIV.

 

However, an independent review board concluded that the vaccine was not reducing the amount of HIV in the blood or preventing HIV infection. In addition to that, a marginal difference was noted between the groups in that a few more participants in the vaccination group had been infected with HIV. However, this was not statistically significant and was likely to be due to chance. Due to the risk to the participants’ health, the study was stopped by the National Institute of Health. Nevertheless, the researchers stated that they would continue to monitor the participants’ health.

 

Despite that, it is worth noting that here are several other ongoing trials within this field. The most notable of those is a follow up of a Thai trial, which was the most successful HIV trial to date. The initial trial, which occurred in 2009 indicated that their vaccine reduced HIV infections by 31.2%. Therefore, it is unlikely that the idea of developing an HIV vaccine will be abandoned any time soon.

 

Although it is unfortunate that the current trial was unsuccessful, the data from the research could still hold valuable and useful information. In the world of research, where it is often a case of publish or perish, it is interesting to note that a study which failed to produce the desired results is given its due attention. Nevertheless, until vaccinations are developed, the best interventions appear to be condoms and early detection.

 
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