Tuesday, October 24, 2017

Networking a Cure for HIV

    
Fig.1. HIV illustration (left, credit: ©iStock.com/Rost-9D) and receiving treatment (right, credit: WHO).


Editor’s Note: SciColl held our first community workshop on Emerging Infectious Diseases in October 2014. This October, we're posting several pieces that highlight the important work where collections continue to play an integral role.

Editor’s Note: SciColl intern, Eden Absar from the University of Houston, contributed this article as part of her time in the SciColl office during Summer 2017. 

The human immunodeficiency virus (HIV) is an enigma of an infection that has puzzled scientists, doctors, and researchers since the first presented case in the 1980s. Although the modern medical community continues to study it and gather information, a cure for the disease remains elusive. According to the Elizabeth Glaser Pediatric AIDS Foundation, as of 2015, there are nearly 37 million people worldwide who have been infected by HIV. Of that number, 1.8 million are children under the age of 15. In 2015, approximately 150,000 children were newly infected with HIV - a rate of nearly 400 new pediatric HIV patients every day. These numbers present a huge problem that appears to grow threateningly larger in the face of the lack of a cure for the disease.

A scientific collection program in Spain, the Cohort of the Spanish Pediatric HIV Network (CoRISpe), aims to combat these growing numbers through the development of a country-wide biobank network. Currently, the prevention method of choice against vertically transmitted HIV and HIV-infected pregnant mothers is highly active antiretroviral therapy (HAART). Because the effect of HAART on long-term health and survival of HIV-infected children is unclear, one of the main goals of CoRISpe is to track patients’ care across medical providers. They accomplish this through outreach and communication between a network of pediatricians and adult clinicians that works to ensure patients continue to provide samples to the biobank system throughout their lives. The program also aims to use biobank information and collected samples to enable high-quality and low-cost material for research studies. 


Fig.2. The number of HIV-infected children in each region is shown by the colors indicated. The highest number of HIV-infected children can be seen in Catalonia, Madrid Community, and Andalusia. (de Jose et al 2013)


Looking forward, a major goal of the World Health Organization (WHO) is to develop a vaccine that will prevent the vertical transmission of HIV. Vaccine discovery is enhanced by the availability of samples from biobanks, as seen in the vaccine development for polio or measles. However, costs and other logistical concerns are major obstacles toward the creation of more national or regional biobanking facilities, so collaborative biobanking efforts in Europe, the United States, and Africa, as well as the Global Vaccine Enterprise, are working together to find an HIV vaccine. Another significant problem facing researchers is limited sample types in biobanks. This is of particular concern in developing countries where infrastructure, funding, and faith in the medical system hinder the systematic collection of samples. This is seen in national biobanks such as The Gambian National Biobank which has a meager 57,000 samples compared to the U.K. Biobank which has nearly 500,000 samples or the Indian National Biobank which has between 2-3 million samples. However, if a collaborative network effort were implemented, this would diffuse the cost among many hospitals and create a connection to more rural areas that would not otherwise have the appropriate resources.

The development of networks and the leveraging of common resources is of paramount importance in the study of global diseases. Harnessing these resources could enable the discovery of treatment methods for diseases such as Alzheimer’s, Parkinson’s, Lou Gehrig’s and others that remain enigmatic to scholars around the world. The networking methods of CoRISpe can even be extended beyond biological ailments: scientific collections of all types would be enhanced by this style of communication, education, and utilization. The possibilities are endless and because biobanks can maintain samples for an indefinite amount of time, research utilizing these valuable resources can continue potentially forever.

References
de Jose, M.I. et al. 2013. A new tool for the pediatric HIV research: general data from the Cohort of the Spanish Paediatric HIV Network (CoRISpe). BMC Infectious Diseases 13(2). DOI: 10/1186/1471-2334-13-2

De Paoli, P. 2005. Biobanking in microbiology: from sample collection to epidemiology, diagnosis and research. Microbiology Reviews 29(5):897-910. DOI: 10.10116/j.femsre.2005.01.005

Esparza, J. 2005. The Global HIV Vaccine Enterprise. International Microbiology 8(2):93-101.



Glossary

human immunodeficiency virus (HIV)
a virus that can eventually lead to severe immunodeficiency (acquired immunodeficiency syndrome (AIDS), chronic illness, and death; HIV can be transmitted during sexual intercourse, pregnancy, childbirth, breastfeeding and other forms of exposure to bodily fluids that carry the virus
vertically transmitted HIV
also called mother-to-child transmission, this is a form of HIV transmission where a mother is HIV positive and has not received treatment, then the infection is passed to her child through pregnancy, childbirth, or breastfeeding
highly active antiretroviral treatment (HAART)
a combination of antiretroviral drugs to suppress the HIV virus and stop the progression of the HIV disease, the treatment also stops the onward transmission of HIV


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