The Role of HIV in Serious Diseases

HIV/AIDS is a serious disease that can affect anyone if they are not careful enough to protect themselves. HIV is a virus that attacks the immune system, and without proper attention, it can completely destroy someone’s immune system. This happens when the virus destroys a white blood cell called a CD4 cell, which is essential for fighting off infections. There are two types of these cells: the T4 cell, which helps fight the infection, and the T8 cell, which kills any ongoing infection in the body.

If it continuously spreads, this disease can be harmful to the population and cut lives short. HIV is transmitted through blood, sperm, sex, and even breast milk. However, these aren’t the only ways it can be transmitted. It can also be propagated in surprising ways like sharing needles, tattoo and body piercing parlors, through childbirth (which only affects the baby if the mother has the virus), and organ transplants. With HIV, one can never be too careful. Being cautious is the best way to avoid contracting it because it’s better to be safe than sorry.

One would think that hospitals should be a place of safety, but in Britain, this hasn’t been the case. Four health professionals in England have died due to being exposed to HIV through hospital accidents involving needles. Nine others have contracted the virus through similar injuries while working in hospitals and are still alive.

The statistics form part of a report by the Health Security Agency and has been presented to the Public Records Committee, which has been investigating the issue of needle injuries among NHS staff. This is the first time details of HIV infections resulting from workplace injuries have been published.

The HSA found five distinct cases before 1999 where health professionals had been infected through workplace injuries. Four of the victims had died. The cases include two nurses, one male and one female, who were infected in separate incidents after pricking their fingers on needles used on patients infected with AIDS. Three female healthcare workers were infected in similar ways. Those working in hospitals are even at risk of contracting the virus if they aren’t careful enough.

Anyone not receiving treatment for HIV would find it difficult to fend off infections and diseases. Moreover, HIV progresses through two different stages before it turns into AIDS. The first stage is Acute HIV, usually starting two to four weeks after infection. The virus begins spreading throughout the body, and the affected individual begins to display flu-like symptoms such as headaches, fevers, rashes, and loss of appetite.

Chronic HIV differently impacts a person’s body. The disease progresses slowly, replicating at a much slower rate, and hence takes longer to threaten the immune system. While Chronic HIV might not sound as severe as Acute HIV, it can still infect others. Hence, it’s a sneakier version of HIV, and if a person doesn’t realize they have it, within ten years or less without proper treatment, they will likely develop AIDS.

AIDS, on the other hand, is a set of symptoms that occur when a person has HIV. If a person has a weak immune system incapable of fighting off infections, AIDS becomes stronger and often leads to death. Biotechnology companies are searching for a cure to reduce the spread of infection and increase survival rates.

As depicted below, over thirty-five thousand people died in 2016 since the inception of the virus, a number forecasted to keep rising unless a cure is found. The continued spread of this virus threatens the lives of an increasing number of people.

The following chart demonstrates the areas most impacted by HIV/AIDS. East and Southern Africa, seemingly underdeveloped compared to other regions globally, may be most affected potentially due to their lack of sanitation standards and necessary preventive measures for HIV. The issue might exacerbate if infected individuals from these regions migrate to others seeking help without proper virus identification or awareness. Consequently, many people could be at risk.

Children also suffer from HIV. If a woman with HIV bears a child, the infant will contract the disease. Therefore, potential dosages should primarily be focused on children, who still have a vast life to experience, plus a developing immune system. As shown below, HIV predominates within men, per se, gay communities – an angle influencing dosage distribution. It would be more sensible to prioritize women, particularly pregnant ones, where two lives could be saved instead of one.

Conspiracy theories regarding HIV also circulate. Many posit that HIV is not a natural disease but a man-made contrivance meant for population control. HIV was first discovered in France by a man named Luc Montagnier. Albeit potentially true, HIV created a furore in Africa before reaching the United States in the late 1990s. Some individuals, including Jack Felder – a black germ specialist at the Fifth Army Regiment in Chicago – believe the government created HIV to decimate minority populations.

In 1999, a similar disease called SIV, or Simian Immunodeficiency Virus, was found amongst monkeys. SIV affects monkeys just as HIV affects humans, although neither virus can infect the other species. Research indicates that monkeys have carried SIV for thousands of years, originating in Africa. This could be why HIV is so prevalent and widespread there. Monkeys, the closest mammal to humans, were found after research to carry a strain of HIV linked to SIV. This discovery suggests that SIV somehow transferred to humans, although the ‘how’ and ‘why’ remain undetermined.

The monkeys who were infected with the SIV virus had eaten two smaller monkeys with two different strains of SIV. With two different strains of SIV it created a new and third strain of SIV called SIVcpz. One theory that scientists have about the transfer of SIV to humans was that a human hunter may have eaten the monkey or had to fight the monkey. Which would ultimately cause the monkeys blood to enter the humans through battle. A human’s body can withstand most diseases that an animal can have but the only problem is that the SIV strain was strong enough to adapt and become stronger.

Protection from a new monkey rendition of HIV has been accomplished with another sort of hereditarily designed counter acting agent. In the event that further examinations demonstrate effective, it could open up another road in the battle against HIV and Aids.

Sound individuals are to be tried with the immune response in a wellbeing trial anticipated that would start in late 2018. Notwithstanding that trial, a different report is being considered to test the immune response in HIV patients.

HIV long back quit being a capital punishment, in any event for the individuals who get the best possible care. Notwithstanding, the infection is for all patients and extremely difficult to wipe out from those contaminated. What’s more, the infection stays dangerous for the untreated, of whom there are numerous in devastated nations.

Antibodies, one of the ways the insusceptible framework battles contaminations, have turned into a promising road of research. Be that as it may, even the most effective normally happening HIV antibodies don’t offer adequate assurance. So in this examination, researchers swung to hereditary designing to enhance nature.

A French Biotech company named Abivax, focuses on the safe framework to cure viral illnesses, their job is to try and develop remedies that can improve the immune system enough to fight off diseases and infections. The organization has declared introductory outcomes from the primary associate of patients in its latest Stage, the IIa trial testing its potential HIV cure, ABX464. Introductory outcomes bolster the medication’s capacity to altogether lessen the HIV repository over a 28-day time frame.

The following partner of patients has initiated dosing for a 3-month period,and it’s scheduled results are set to be expected in mid 2018. The mice that were affected by HIV were dealt with for 50 days with either ABX464 or traditional HAART (Highly Active AntiRetroviral Treatment), ABX464 was not just ready to decrease the viral load over the 50 days treatment period (As seen in the gray area) yet additionally to keep up a low popular load up to a month and a half after treatment capture (As seen inside of the green circle). You can tell by the difference in the figures shown that treated mice had a viral load completely bounce back to pre-treatment levels inside 14 days in the wake of ceasing the treatment ( As seen in the orange circle). This information proposes that ABX464 is changing the harmony between the Infection and its control by the insusceptible framework.

Another major biotechnology company working on finding a cure is GeoVax. GeoVax Labs is a clinical-stage biotechnology organization dedicated to creating human antibodies against difficult-to-fight diseases. Their specialty involves creating VLPs (Virus Like Particles) from the cells of a person receiving an immunization. Creating VLPs within an individual imitates a natural infection, thereby strengthening both the humoral and immune system cells to recognize, prevent, and control the target infection should it appear. Essentially, the company constructs vaccines for individuals seeking to prevent HIV.

GeoVax underway has the most advanced vaccines designed to work against the clade B subtype of the HIV virus, common in America, Australia, Japan, and Western Europe. Their preventive clade B HIV vaccine has successfully completed Stage 2a in human clinical testing and has started a subsequent clinical trial. The vaccine has demonstrated exceptional safety and excellent, highly reproducible immunogenicity. Geography is expanding their HIV vaccine for the most common infection subtype, clade C, affecting those infected the most. They continue to explore the HIV antibodies for their potential to contribute to combined treatments, which could lead to a cure for HIV diseases.

OyaGen is another biotechnology firm, founded on September 5, 2003, designed to discover, develop, and commercialize pharmaceutical treatments that exploit RNA editing and DNA editing enzymes. Over the last decade, a series of studies have identified two families of related enzymes called Editing Compounds.

These compounds are endogenous cell proteins, which chemically modify RNA or DNA molecules, subsequently changing the genetic code. OyaGen believes that there is a significant opportunity to “harness the editing process” to create treatments for various disease states. Their primary therapeutic focus is a novel approach to the treatment of Human Immunodeficiency Virus (HIV). This focus on HIV is driven by a series of significant discoveries, some of which have already been published.

While these treatments are assisting individuals, some people will not be able to be saved due to the drug-resistant strain of HIV. In simple terms, drug-resistant HIV pertains to the ability of disease-causing germs, such as bacteria and viruses, to continue multiplying despite the presence of drugs intended to eradicate them.

Drug resistance in HIV is caused by changes (mutations) in the virus’s genetic structure. These mutations can lead to changes in certain proteins, most commonly enzymes, which enable HIV to replicate. Mutations are widespread in HIV. This is because HIV replicates at an extremely rapid rate and lacks the proteins needed to correct its copying errors.

Transformations happen arbitrarily, once a day, however, numerous are safe. In fact, most transformations actually put HIV at a disadvantage since they decrease the virus’s “fitness” and slow down its ability to infect CD4 cells in the body. However, several changes can actually provide HIV with a survival advantage when HIV medications are used because these mutations can block drugs from acting against the HIV enzymes they are designed to target. These are the mutations we are concerned about when we discuss drug resistance.

HIV relies on many proteins to reproduce within a human cell. It also depends on proteins, including gp41, to latch on to CD4 cells and infect them.

Unlike genotypic testing, which searches for specific genetic mutations causing drug resistance, phenotypic testing directly measures the behavior or phenotype of a person’s HIV in response to specific antiretrovirals. Given the way phenotypic tests work and the results they provide, many doctors believe that these tests are more comprehensive and reliable than genotypic tests, especially when testing samples from people who have tried and failed numerous HIV drugs in the past.

Using the simplest terms, phenotypic testing is performed by placing samples of a person’s HIV in test tubes with each HIV drug to observe how the virus reacts. The ability of the virus to grow (or not grow) in the presence of each drug is evaluated. The virus is exposed to varying quantities, or concentrations, of each drug. The ability of the person’s virus to grow in the presence of the drugs is compared with some wild-type virus that is known to be 100 percent susceptible to all HIV drugs. The comparison between the person’s virus and the wild-type virus provides the phenotyping results.

These results inform doctors about the amount of a particular drug needed to decrease HIV replication. In other words, the laboratory conducting a phenotypic test is trying to determine the quantity or concentration of a drug required to stop HIV from replicating.

For instance, if four times the amount of the NRTI Ziagen (abacavir) is needed to control HIV replication, the virus is said to exhibit “fourfold resistance” to the drug. If seven times the amount of Ziagen is required, the virus is sevenfold resistant to the drug.

When phenotypic tests initially became available, interpreting these changes was difficult. It wasn’t clear what a change implied in terms of the virus being fully sensitive, less sensitive, or not sensitive to a specific HIV drug. As a result, companies conducting phenotypic tests began working closely with researchers to better understand these changes and what they truly mean regarding resistance to available drugs. After several years of extensive research, these companies have developed “clinical cutoffs”, a critical component of phenotypic testing that allows for significantly easier interpretation of changes as they relate to the sensitivity of HIV to many of the available drugs.

Coming back to the case of Ziagen utilizing Monogram Bioscience’s PhenoSense HIV test, the lower clinical cutoff is 4.5-fold protection and the upper clinical cutoff is 6.5-fold protection. As such, HIV that is fourfold resistant to Ziagen is still technically sensitive to the drug. However, HIV that is sevenfold resistant to Ziagen implies that the virus is considerably less sensitive to the drug and, therefore, not a good treatment choice.

As for resistance levels that fall between the lower and upper cutoffs, this implies partial resistance (the higher the fold change, the less sensitive HIV is to the drug being used). While it is always best to use antiretrovirals that your virus is fully sensitive to, it is sometimes necessary to use (or reuse) drugs your HIV is partially resistant to.

Every HIV drug has different clinical cutoffs, which can be confusing. To help understand these cutoffs and make it easier for healthcare providers to interpret the results, labs conducting these tests provide detailed reports for each test conducted.

There are two “standard” phenotypic tests available: Monogram Bioscience’s PhenoSense assay and Virco Lab’s Antivirogram. Both tests evaluate the fold changes for all of the available NRTIs, Protease Inhibitors and NNRTIs. Monogram Biosciences has a separate phenotypic measure, called PhenoSense Entry, which tests HIV’s sensitivity to the entry inhibitor Fuzeon.

Another test is Virco Lab’s vircoTYPE HIV-1 assay. This is actually a “predictive” phenotypic test, using genotypic testing results to ascertain the virus’s phenotype without actually performing a phenotypic test. To do this, labs use genotyping testing to determine whether an HIV sample has mutations known to cause drug resistance. Once the genotype has been determined, the laboratory queries a database maintained by Virco containing the genotypes of several thousand HIV samples collected from other people. It then retrieves the phenotypes, the fold changes that correspond to these examples, averages the data together, and predicts the drugs that the current sample will be more or less sensitive to.

Note that Monogram Biosciences and Virco calculate their cutoffs in different ways. Therefore, the cutoffs determined for one company’s test (e.g., PhenoSense) do not apply to the cutoffs determined for the other company’s test (e.g., vircoTYPE).

The key to avoiding HIV and staying protected is to watch out for specific cures that are being distributed by the many biotechnology companies who are trying to develop them. The best way to prevent HIV from spreading is by encouraging an HIV test whenever you schedule a hospital visit. It would also be in everyone’s best interest to encourage their partners to get tested as well. HIV and AIDS are easily spread, so when it comes to any type of protection or precaution, it’s better to be safe than sorry.

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