HIV baby cure: One year on

HIV1With over 30 million sufferers worldwide, HIV remains the world’s leading infectious killer. The human immunodeficiency virus attacks the immune system, leaving it unable to fight infections, resulting in AIDS. Improving HIV care is one of the top 10 global health priorities. Therefore, when research published last year suggested a baby had been “cured” of HIV; tabloids quickly began to speculate, with some implying the elusive cure may be closer than we imagined. One year on, with similar cases set to be presented at AIDS 2014, the leading international conference on AIDS, what is the significance of this major breakthrough in terms of tackling the large-scale HIV pandemic?

“Absence of Detectable HIV-1 Viremia after Treatment Cessation in an Infant”

HIV2In 2010, a baby was born prematurely to a mother whose HIV was only discovered during delivery.   With no prenatal care, and therefore a high risk of exposure to the virus, the gutsy call was made to begin aggressive treatment with a combination of three antiretroviral drugs at just 30 hours old.  Infection was confirmed soon after and the child remained receiving therapy.

Surprisingly, within days the level of HIV had rapidly diminished and within a month was non-detectable. However, the successful therapy was unexpectedly ceased after 18 months as the mother stopped taking the child to scheduled appointments. When the child was finally examined again, at 23 months, she remained free from infection despite not being on HIV medication. At the time of the paper the child continued to be in remission, gaining the title “the baby cured of HIV”.

Impact on cases involving babies born with HIV

HIV3The doctors quickly emphasised the therapy proposed was a “functional cure”. With the child recently beginning to shown early signs of infection, it appears the treatment silenced the virus for a substantial period of time rather than eliminating it. In reality, cases involving mother-to-baby transmission are rare. Standard HIV pre-natal treatment can lower the risk to 2%.  Therefore in areas where there are a significantly higher number of cases, such as Sub-Saharan Africa, the main factor is the sub-standard levels of health care rather than the need for new treatment.

Is a new, miraculous treatment now available?

HIV4The therapy itself wasn’t novel as it used readily available antiretroviral drugs; the “novel” aspect of the therapy was the early approach. This is already known to be advantageous as early aggressive treatment is thought to prevent viral reservoirs forming. HIV reservoirs are what hide the virus, making it resistant to the both the immune system and medication, and form within hours of infection.

Can adults now be cured of HIV?

There has been speculation that the immune response of a newborn is more suited to cope with HIV than an adults. Not only are babies immune systems immature, resulting in a milder reaction to the virus, but they lack the memory “defender” cells that are the target of the dangerous viral reservoirs. However, last year several adults were reported to have undergone a similar “functional cure”. Having undergone early antiretroviral treatment, 14 out of 70 patients remained virus free for at least 3 years, following cessation of therapy. This suggests that 5%-15% of HIV patients could eradicate the virus through early treatment.

Early treatment plans would not benefit current sufferers but could help tackle new cases. While treating the virus as soon as possible seems like an obvious idea, it appears it would be difficult to implement. Not only do 1 in 5 sufferers remain unaware they are infected, but the stigma associated with HIV means many people are reluctant to get tested. Therefore, before getting excited over the potential of early treatment regimes, the bigger challenge of identifying the infection promptly needs to be addressed.

The “functional cure” has provided hope and opened new areas for scientists to explore. Importantly, it strengthened the idea that early treatment is vital. However bigger social and development issues, involving improving health care in poorer societies and ensuring early identification, need to be addressed before the findings can be translated into the “HIV cure” that has been widely speculated.

Post by: Claire Wilson

References

Persaud, D., et al., Absence of Detectable HIV-1 Viremia after Treatment Cessation in an Infant. New England Journal of Medicine, 2013. 369(19): p. 1828-1835.

Saez-Cirion, A., et al., Post-Treatment HIV-1 Controllers with a Long-Term Virological Remission after the Interruption of Early Initiated Antiretroviral Therapy ANRS VISCONTI Study. Plos Pathogens, 2013. 9(3).

Pint of Science 3 day festival comes to Manchester!

Pint-of-Science-logo-with-glasses-528x746What better way to enjoy a sprinkle of scientific banter than down your local pub complete with pint in hand! For three days only, this summer we have enticed some of Manchester’s finest academic researchers out of the lab and into the pub to talk to you about their work. Events are taking place across Manchester on the 19th to the 21st of May and cover a wide range of topics, with enough variety to keep even the pickiest scientific dabbler satisfied. So have a look at our line-up and pick your favourite night, if you’re lucky you may even spot a brainbanker or two, but be quick tickets are selling fast.


Matters of the mind @ The Albert Club in West Didsbury – Click here for tickets

Monday the 19th: Mental health: breaking the stigma

1We’ve all experienced the feeling of being unwell with the accompanying trips to the GP, time off work and medication. Coughs and colds are common and well understood, but what happens when our minds become unwell? One in four of us will be affected by mental illness, the effects of this are no less real than a bout of the flu, but are often much harder to understand. Despite the extent of mental health problems, those affected still experience stigma and discrimination – a burden which can be even worse than the symptoms themselves. This evening, join Dr Rebecca Elliott and mental health experts from the University of Manchester for an evening of discussion where we hope to break down barriers and challenge stigma.

Tuesday the 20th : Understanding stroke.

2With around 152,000 strokes occurring in the UK every year, it’s never been more important for us to understand the ins and outs of this devastating condition. As part of the Stroke Association’s Action on Stroke Month, speakers from the University of Manchester and the Stroke Association will give us a window into the brain and the lives of stroke survivors. Professor Stuart Allan will introduce the workings of the brain, how strokes occur and what makes them so destructive, including how targeting inflammation could offer a brighter future for survivors. A real highlight will be provided by stroke survivor and nurse Christine Halford and her daughter Natalie who will offer moving first-hand accounts of what happens when a carer becomes the cared for. We will have an interactive activity provided by the wonderful artist Amanda McCrann to bring together a fascinating night of information and discovery.

Wednesday the 21st : The ups and downs of sleep and circadian biology (sold out)

3Have you ever wondered why it’s so hard to function when you just wake up or what really drives us to spend almost a third of our lives tucked up in bed? This evening we will address these questions and more as we explore the ups and downs of circadian biology. Join Professor Andrew Loudon and Dr Penny Lewis from the University of Manchester as they take us on a journey through the mysterious landscape of circadian rhythms and sleep. We will explore what makes our biological clocks tick, how our hectic 24-hour lifestyle affects our internal rhythms, how snoozing is vital to our memories and uncover the difference between morning larks, night owls and the indecisive humming bird with a live science experiment!


Understanding our bodies @ Solomon Grundy in Withington – Click here for tickets

Monday the 19th : Unlocking the Sense of Smell – The Scent of A Maggot

4Professor Matt Cobb’s lab studies how the sense of smell works. To do this they use a rather unusual animal – a maggot. You and I have about 4 million smell cells in our noses. A maggot has just 21, and by using genetics they can make a maggot with just a single smell cell. By studying the behaviour of these animals, and the electrical activity of their smell cells, we can understand how smells are processed in the nose and in the brain. Not only does a maggot have a brain, but the bits of its brain that process smells are also wired up just like ours. So by studying something as simple as a maggot we hope to understand how the sense of smell works in all animals, including humans.

Tuesday the 20th : Nanotechnology & the Role of graphene

5Manchester is leading the way in graphene research, with a nobel prize being given to two of its researchers in 2010. The material has some exceptional properties: tougher than diamond, stretchier than rubber, and better able to conduct electricity than anything else. It also has a myriad of possible uses: bendy touchscreens for mobiles, super-light batteries, artificial retinas, more effective drug delivery … and that’s just for starters. Graphene could become as much a part of our daily lives as plastic, and its implications will be huge!

Wednesday the 21st : Personalised medicine and the future of cancer treatment

6This talk will provide a fascinating introduction to personalised medicine, and the future of cancer treatment. No two cancers are the same. So, even patients with the same ‘type’ of cancer will respond differently to treatment. Personalised medicine aims to understand each person’s individual cancer at a molecular level, so doctors can match patients with the treatments that will work best for them. This aim of treating every patient as an individual is still some way off, but Professor Caroline Dive, from the Manchester Cancer Research Centre, will discuss how scientists in Manchester are playing a pivotal role in bringing forward this era of personalised medicine.


Chemistry and Physics @ The English Lounge in the Northern Quarter – Click here for tickets

Monday the 19th : Ocean circulation – the awkward bits

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The heat capacity of the ocean is around one thousand times that of the atmosphere, and the ocean circulation plays a crucial role in climate change. For long term model simulations one needs to average over space and time to make the computations feasible, but important processes happen over relatively small time and length scales. In this talk, Dr Gregory Lane-Serff will explain some of these processes, including mixed-later deepening, flow over sills and through straits, and flows of dense water into the deep ocean. He will show results from observations, and explain how insights from laboratory models can help our understanding – with some experiments for the audience to do!

Tuesday the 20th : A sonic wonderland

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What are the sonic wonders of the world? Trevor Cox, a renowned professor who engineers concert halls, has made a career out of eradicating bizarre and unwanted sounds. But after an epiphany in the London sewers, Trevor now revels in exotic noises – creaking glaciers, whispering galleries, stalactite organs, musical roads, humming dunes, seals that sound like alien angels, and a Mayan pyramid that chirps like a bird. Join him and discover what insights these remarkable effects give us into how sound is made, altered by the environment and perceived by listeners.

Wednesday the 21st : Waste not, want not – A Radioactive Reality

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Radioactive waste can be one of the most sensitive issues regarding the production of nuclear energy. However, are we too quick to jump to conclusions without considering all the evidence? Matt will talking about the preconceptions that most people have when they hear about radioactive waste and the scale of the problem in the UK. He’ll also talk about what we’re trying to do to solve the problem, while binding all these topics together with some anecdotes about his experiences regarding the topic.


Planet Earth @ Odder bar on Oxford Road – Click here for tickets

Monday the 19th : Unlocking ancient DNA

10Michael is a Royal Society University Research Fellow based in the Faculty of Life Sciences, University of Manchester. His main research interests are in the recovery of genetic information from extinct animals. Due to the age and environmental conditions of the remains of the more poorly understood species, this usually takes the form of cutting-edge techniques in proteomics. In this talk he highlights some of the key areas that ‘palaeoproteomics’ has helped improve our understanding of mammal evolution.

Hunting dinosaurs in the 21st Century…

Dr Philip Manning

Phil is Reader in Palaeobiology and Head of the Palaeontology Research Group at the University of Manchester. He is also an STFC Science in Society Fellow, a Research Associate at the American Museum of Natural History (USA) and a Visiting Scholar at the University of Pennsylvania (USA). In 2014 Phil was elected a Fellow of the Explorer’s Club (New York). His research is both broad and interdisciplinary with active research topics from biomechanics of dinosaurs to the synchrotron-based imaging of both extant and extinct organisms. He and his team have worked extensively in the Hell Creek Formation of South Dakota and Montana, but their field program also includes sites in South America, Europe, Asia, Africa and Australia.

Tuesday the 20th : Taking volcanoes to the IMAX

11Kate Dobson is a geologist who applies the latest cutting edge 3D and 4D imaging techniques across a wide range of geological research, to capture and quantify the spatially and temporally variable processes that control how our planet works. She has been at the University of Manchester since 2011.

From Core to Crust: A journey through the interior of the Earth

Michael Ward Broadley

Michael Ward Broadley is a PhD student at the University of Manchester, and his research revolves around the use of noble gases and halogens as tracers of volatile movement between the Earth’s geological reservoirs. Studying magmas erupted from deep within the Earth’s mantle, by means of analysing their unique geochemical signatures rich in primordial noble gases, it is possible to understand how the Earth obtained its volatiles. The theories that are being put to the test include impacts with primitive meteorites and solar wind influence, among other fascinating mechanisms. Michael is also a regular contributor to his research group’s outreach program.

Wednesday the 21st : Secrets of the Moon

13Katherine Joy is a senior research fellow at the University of Manchester SEAES. Her research focuses on studying the geological history of the Moon throughout lunar samples returned by the Apollo astronauts, and lunar meteorites that are found here on Earth. She analyses these samples in the laboratory to investigate their chemistry, mineralogy and age. With the contribution of data collected by satellites orbiting the Moon it’s possible to reveal its fascinating geological evolution, as well as explore the wider history of the Solar System. Her work may one day help guide people planning to send astronauts back to the lunar surface.

Cooking Up A Comet – Francesca McDonald

Francesca is a first year PhD student and her research concerns determining and comparing the volatile budgets of the lunar and terrestrial mantles. This will make us understand the volatile behaviour during the formation and evolution of Earth-Moon system. The rock samples she studies are Apollo lunar basalts and terrestrial komatiites. She also partakes in outreach work where she talk about comets whilst having her glamorous assistant Alex Clarke cook her up a comet.

Hope you see you there!

the Brain Bank Team.

Hope for new MS drug which could repair damaged cells.

Researchers from the private biotech firm ENDECE Neural have just announced the development of a new compound they believe may have the potential to repair damage caused by multiple sclerosis (MS).

MS is the most common neurological disorder affecting young adults in the western hemisphere. Although scientists are still unsure of what causes the disorder, it is known that symptoms stem from damage to the fatty covering surrounding nerve cells, known as the myelin sheath. It is believed that in the early stages of the disease the body’s own immune cells (cells usually primed to seek out and destroy foreign agents within the body, such as viruses and parasites) mistake myelin for a foreign body and launch an attack. Since myelin is essential for fast neural communication and cell protection, the symptoms of MS stem from a slowing of neural communication and ultimately nerve cell damage.

oligoThe myelin surrounding cells in the brain and spinal cord is provided by cells called oligodendrocytes. These cells reach out a number of branching arms which wrap around segments of surrounding neurons, forming the myelin sheath. The majority of drugs available for treatment of MS aim to reduce initial damage to this sheath. However, researchers from ENDECE are now investigating treatments which can increase the number of oligodentrocytes in the central nervous system, thus leading to remyelination of damaged cells. Dr. James G. Yarger, CEO and co-founder of ENDECE notes, “For decades, researchers have been seeking ways to induce remyelination in diseases such as MS that are characterized by demyelination,”. And now this dream may be becoming a reality.

ENDECE’s work revolves around their pipeline drug NDC-1308. Although the name isn’t likely to turn any heads, its properties just might. Following the observation that pregnant women typically do not experience the symptoms of MS during their third trimester, a number of researchers have been exploring a possible role for estrogen in the treatment of MS. ENDECE researchers created 40 separate estradiol analogues (substances similar in structure to estradiol but with a range of key modifications) and assessed their biological effects. From this work they found that one analogue (NDC-1308) had a particularly potent effect on oligodentrocyte precursor cells (OPCs – cells with the ability to become mature oligodentrocytes), causing them to differentiate into mature oligodendrocytes. In follow-up studies researchers found that treatment with NDC-1308 led to remyelination in a mouse model of MS, specifically showing a 20% increase in myelination in the hippocampus (a region of the brain known to experience demyelination in this model). NDC-1308 was also found to cause remyelination in the rat and to induce cultured OPC cells to differentiate into mature oligodendrocytes. Taken together, these findings suggest that NDC-1308 may prove effective in restoring the lost myelin sheath on damaged axons in patients with MS.

Dr. Yarger states, “We envision NDC-1308 being administered either alone or in combination with current therapeutics that target the immune response and/or inflammation associated with MS. By inducing remyelination, it may be possible to restore muscle control, mobility, and cognition in patients with MS. Therefore, a drug that induces remyelination, such as NDC-1308, can potentially double the size of the current market for MS therapeutics.”

NDC-1308 is still in late preclinical development, and has yet to go through rigorous safety screening and clinical trials. However, as a drug that potentially stimulates remyelination, it represents a whole new strategy for the pharmaceutical treatment of MS patients in the future.

Post by: Sarah Fox