HIV

Here is a picture of zebrafish tail regeneration. As part of our ongoing research on wound healing, I put the fish to sleep, chopped one part of his tail fin off (the right half in this photo), and am photographing its regeneration. This has nothing to do with HIV research, although our lab does investigate protease inhibitors, with HIV as a potential target.

Recently the HIV situation in Vietnam came to my attention. Although the fact that HIV+ children are virtually unadoptable is not news to me, it very much surprised and angered me that roughly 75% of infants that test positive for HIV are not actually carrying the virus. The problem is the testing methods: an ELISA antibody test is cheap and widely used. This test measures antibodies to HIV, not HIV itself (PCR is used for this and is very accurate, read on). A negative result is fairly reliable, but since maternal antibodies cross the placenta, there is a 75% false positive rate. Children that test positive get retested at 18 months, after the mother's antibodies have left the child's system. But at that point, they have been in the orphanage for 18 months labeled "HIV+". Although PCR can be used to test for viral DNA in infants as young as 1 day old, this test is expensive and not widely available in Vietnam. Its my dream that some day infants in Vietnam and all over the world have access to fast and accurate HIV testing. This will not only help the 75% false positive children from being labeled HIV+, but will allow for early intervention of antiretrovirals in the 25% that are actually infected. Herein lies another problem, access to drugs. Antiretroviral intervention at a young age has a high success rate! Two-thirds achieve viral suppression but have to take the drugs for a long time (rest of their life?). But the remaining third achieve permanent viral suppression without the need for constant antiviral treatment--a "cure". And thanks to scientists like us, new drugs with fewer side effects and more effective viral suppression are being discovered and tested as we speak. With better viral suppression, the rate of transmission drops considerably. Even now, HIV is no longer considered a mortal disease, but a survivable disease that requires life-long management. Think you don't know anyone that is HIV positive? You probably do!