January 20, 2017
This week, giving or receiving a viral load test using a special computer chip and a USB stick is possible, according to a proof-of-concept study. We also take a look at the legacy of the President's Emergency Plan for AIDS Relief (PEPFAR) now that Donald Trump has taken office. And could a new microbicide inhibit drug-resistant HIV? To beat HIV, you have to follow the science!
Fast viral load testing without a laboratory is possible, a proof-of-concept study published in Scientific Reports shows.
Researchers developed a special computer chip that is embedded in a USB stick and becomes a disposable viral load test. An assay amplifies the HIV RNA in a small amount of blood and the results are converted into an electrical signal that can be read by a computer or hand-held device. The entire process takes about 30 minutes.
While the chemical reaction of the assay can identify very low levels of HIV, detection levels of 1,000 copies/mL - the sensitivity at which this technology was tested - may be sufficient in low-resource settings, study authors say.
In addition to providing viral load testing for people living with HIV, the chip could also be used to test babies for the presence of HIV, a press release notes. In the future, the device may also be able to test for other viruses, such as hepatitis.
PEPFAR began under President George W. Bush, a Republican. Funding for its HIV/AIDS programs has risen from US$1.6 billion in 2004 to US$5.2 billion in 2016.
Considering President Trump's "America First" agenda and his statements about reducing foreign aid, it is unclear whether funding for PEPFAR will be renewed, according to an editorial in The Lancet HIV.
The journal also points out that funding for the program had been restricted previously to exclude programs that provide certain family planning services, such as abortions.
Additional funding restrictions seem possible considering that Vice President Mike Pence initially opposed needle exchange programs to stem a local HIV outbreak when he was governor of Indiana, the editors write. However, Pence eventually approved of the exchange program. This shows "that evidence and urgency can trump ideology," the editorial concludes, and hopes that this flexibility combined with PEPFAR's Republican origins will let the program survive for the next four years.
A new microbicide, 5-Hydroxytyrosol, is effective against a variety of HIV subtypes in vitro, a group of Spanish researchers reports in AIDS.
The compound also inhibits viral replication in HIV samples that are resistant against most current antiretrovirals. The microbicide was evaluated at inhibitory concentrations of 50% in the micromolar range. While that may be considered high for medications that are taken orally, this drug does not become diluted as it moves through the body since it is applied directly to the relevant tissue (in this case, vaginal mucosae), study authors note.
When tested topically in rabbits, 5-Hydroxytyrosol was also found to be essentially nontoxic, and toxic only in very high concentrations when tested in human peripheral blood mononuclear cells. The compound exhibited synergistic and additive effects when combined with common microbicidal drugs, such as tenofovir (Truvada) or lamivudine (Epivir). These findings show that the microbicide is a "potential component of novel microbicide formulations to prevent heterosexual HIV-1 transmission via the vaginal mucosa," study authors conclude.
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com. Follow Warren on Twitter: @WarrenAtTheBody.
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