This Week in HIV Research: Getting Smart(Phone) About HIV Detection

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It's time for our latest weekly romp through the lush fields of recently published HIV-related research. In our latest perusal of peer-reviewed journals, we spotted these intriguing items:

  • Early promise for a cellphone attachment that could be used in resource-limited settings to help identify acute HIV infections or potential HIV treatment failures.
  • New signs HIV-2 does ultimately lead to serious disease progression if left untreated, just at a slower rate than HIV-1.
  • A possible correlation between transient CD4 count declines and incident hepatitis C coinfection.
  • A deep dive into the global demographics of non-Hodgkin lymphoma in the combination HIV treatment era.

Come along for a more detailed look at each of these newly printed study results. To beat HIV, you have to follow the science!

Barbara Jungwirth is a freelance writer and translator based in New York. Follow Barbara on Twitter: @reliabletran.

Myles Helfand is the executive editor and general manager of TheBody and TheBodyPRO. Follow Myles on Twitter: @MylesatTheBody.

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Novel Cellphone-Based Platform for HIV Detection

An experimental mobile-phone based platform may facilitate rapid detection of acute HIV infection or early treatment failure in resource-poor areas, the platform’s developers reported in Nature Communications.

Based on nanotechnology, the system uses a 3D-printed cellphone attachment, a microchip, and reagents, all of which cost less than US$ 5 per test. It amplifies HIV’s nucleic acid, generates optical signals using micromotors, and uses the cellphone’s own optical sensing capabilities to detect the presence of HIV molecules. The amplicons generated are comparatively large and change the motion of the micromotors. That change can then be measured by the cellphone. Small-scale testing has shown the system to be 99.1% specific and 94.6% sensitive, with a threshold of 1,000 virus particles/ml, the study found.

The platform will require additional modifications before it can be used more widely, report authors cautioned. Any positive test result would still need to be confirmed by standard laboratory tests, they said. The technology could be used for other viruses or bacteria, as well, a related press release noted.

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Untreated HIV-2 Does Lead to AIDS, Just More Slowly Than Untreated HIV-1

The survival curve of people living with HIV-2 is similar to that of people living with HIV-1, but is spread out over a longer period of time, a long-term open cohort study published in The Lancet HIV showed.

The HIV-2 variant of the virus occurs mainly in West Africa, while HIV-1 is distributed across the globe. HIV-2 had been thought to rarely progress to the clinical definition of AIDS or death, even in the absence of treatment. However, the current study shows that not to be the case.

Researchers analyzed data on nearly all of Guinea-Bissau’s police force over the course of 23 years. Of the 4,817 total participants, 919 were either found to be HIV positive at study entry or were diagnosed after enrollment, and 464 of those 919 had HIV-2. While it took participants living with HIV-2 longer to progress to AIDS, 43% of them did so (in a median 14.3 years). Among those with HIV-1, 54% developed AIDS after a median of 6.2 years.

In a related press release, Fredrik Månsson, one of the study’s authors, noted the lack of commercial interest in HIV-2 research, in part because of West Africa’s poverty and consequently low investment levels. He and his colleagues called for a long-term treatment study to determine the usefulness of early antiretroviral treatment for those living with HIV-2.

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CD4 Count Dip May Signal Incident Hepatitis C Coinfection

The CD4 cell counts of people living with HIV dropped temporarily when they acquired hepatitis C (HCV), independent of how long they had been living with HIV and of whether they were on antiretroviral treatment, a study published in AIDS found.

Researchers matched 214 treatment-naive and 147 on-treatment men who have sex with men (MSM) who were co-infected with HCV to controls living with HIV only (5,384 not on antiretrovirals, 3,954 on antiretrovirals). For the first two to three years after acquiring HCV, CD4 cell counts in both coinfected groups were lower than in the controls, but later returned to control group levels.

It is unclear whether such a drop could influence the effectiveness of HCV treatment or contribute to faster HIV disease progression, study authors noted. However, they recommended that health care providers test for HCV if their patient’s CD4 cell count drops despite antiretroviral treatment. Further clinical implications of the study results have yet to be determined, they conceded.

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MSM, South African Women at Elevated Risk of Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma (NHL) rates were higher in MSM than in heterosexuals and in South African women than in European women, a data analysis published in AIDS showed.

All 210,898 study participants had started antiretroviral therapy, but not all had continued treatment. Overall NHL incidence was 142/100,000 person-years (pys), compared to 10/100,000 pys in the general population. People with low CD4 cell counts are at higher risk of contracting AIDS-defining conditions, such as NHL. This was reflected in NHL rates of > 1,000/100,000 pys among people in Europe and North America who had CD4 cell counts < 50 cells/µl. However, the corresponding rate in South Africa was 150/100,000 pys. It is possible that people in low-resource settings who have very low CD4 counts die before they are diagnosed with NHL, study authors reasoned.

The researchers called for dedicated studies to determine the effect of coinfection on NHL risk and to develop preventive measures against this cancer. “In the meantime, early access to [antiretrovirals] and regular patient monitoring to avert low current CD4 cell counts remain key for NHL prevention,” they concluded.