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Update December, 2019


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Health & Wellbeing
 

Study: For babies born with HIV, start treatment right away

 

This undated photo provided by the Centers for Disease Control and Prevention shows a scanning electron micrograph of multiple round bumps of the HIV-1 virus on a cell surface. When newborns are infected with HIV, a new study suggests starting treatment right away is better than waiting just a few weeks to months. (Cynthia Goldsmith/Centers for Disease Control and Prevention via AP)

Lauran Neergaard

Washington (AP) — When babies are born with HIV, starting treatment within hours to days is better than waiting even the few weeks to months that’s the norm in many countries, researchers reported Wednesday.

The findings, from a small but unique study in Botswana, could influence care in Africa and other regions hit hard by the virus. They also might offer a clue in scientists’ quest for a cure.

The Harvard-led team found super early treatment limits how HIV takes root in a newborn’s body, shrinking the “reservoir” of virus that hides out, ready to rebound if those youngsters ever stop their medications.

“We don’t think the current intervention is itself curative, but it sets the stage” for future attempts, said Dr. Daniel Kuritzkes of Boston’s Brigham and Women’s Hospital, who co-authored the study.

Giving pregnant women a cocktail of anti-HIV drugs can prevent them from spreading the virus to their unborn children, a step that has dramatically reduced the number of babies born with the virus worldwide. Still, some 300 to 500 infants are estimated to be infected every day in sub-Saharan Africa.

Doctors have long known that treating babies in the first weeks to months of life is important, because their developing immune systems are especially vulnerable to HIV. But an infant dubbed the “Mississippi baby” raised a critical question: Should treatment start even earlier? The girl received a three-drug combination within 30 hours of her birth in July 2010, highly unusual for the time. Her family quit treatment when she was a toddler — yet her HIV remained in remission for a remarkable 27 months before she relapsed and restarted therapy.

The Botswana study was one of several funded by the U.S. National Institutes of Health after doctors learned of the Mississippi baby, to further explore very early treatment.

The findings are encouraging, said Dr. Deborah Persaud, a pediatric HIV specialist at Johns Hopkins University who wasn’t involved with the Botswana study but helped evaluate the Mississippi baby.

“The study showed what we hypothesized happened in the Mississippi baby, that very early treatment really prevents establishment of these long-lived reservoir cells that currently are the barrier to HIV eradication,” Persaud said.

She cautioned: “Very early treatment is important, but prevention should still be our top priority.”

In Botswana, researchers tested at-risk newborns, enrolling 40 born with HIV, treating them within hours to a few days, and tracking them for two years. On Wednesday, they reported results from the first 10 patients, comparing them with 10 infants getting regular care — treatment beginning when they were a few months old.

Medication brought HIV under control in both groups. But the children treated earliest had a much smaller reservoir of HIV in their blood, starting about six months into treatment, the researchers reported in Science Translational Medicine.

The earliest-treated children also got another benefit: more normal functioning of some key parts of the immune system.

One big question: Did the HIV reservoir shrink enough to make a long-term difference? To find out, next year the researchers will give these children experimental antibodies designed to help keep HIV in check, and test how they fare with a temporary stop to their anti-HIV drugs.

In the U.S., Europe and South Africa, it’s becoming common to test at-risk infants at birth. But in most lower-income countries, babies aren’t tested until they’re 4 to 6 weeks old, said study co-author Dr. Roger Shapiro, a Harvard infectious disease specialist.


Old dogs, new tricks: 10,000 pets needed for science

In this Monday, Nov. 11, 2019 photo, University of Washington School of Medicine researcher Daniel Promislow, the principal investigator of the Dog Aging Project grant, rubs the head of his elderly dog Frisbee at their home in Seattle. (AP Photo/Elaine Thompson)

Carla K. Johnson

Seattle (AP) — Can old dogs teach us new tricks? Scientists are looking for 10,000 pets for the largest-ever study of aging in canines. They hope to shed light on human longevity too.

The project will collect a pile of pooch data: vet records, DNA samples, gut microbes and information on food and walks. Five hundred dogs will test a pill that could slow the aging process.

“What we learn will potentially be good for dogs and has great potential to translate to human health,” said project co-director Daniel Promislow of the University of Washington School of Medicine.

If scientists find a genetic marker for a type of cancer in dogs, for instance, that could be explored in humans.

For the study, the dogs will live at home and follow their usual routine. All ages and sizes, purebreds and mutts are welcome.

Owners will complete periodic online surveys and take their dogs to the vet once a year, with the possibility of extra visits for certain tests. Their welfare will be monitored by a bioethicist and a panel of animal welfare advisers.

To nominate a pet, owners can visit the Dog Aging Project’s website.

The five-year study was formally launched Thursday at a science meeting in Austin, Texas. The National Institute on Aging is paying for the $23 million project because dogs and humans share the same environment, get the same diseases and dogs’ shorter lifespans allow quicker research results, said deputy director, Dr. Marie Bernard. The data collected will be available to all scientists.

Leslie Lambert of Parkville, Maryland, enrolled her 11-year-old rescue dog, Oscar, in an early phase.

“I would selfishly like to have him around forever,” said the 33-year-old veterinarian. “Unfortunately, he ages much, much faster than I do.”

But she’s torn by the prospect of an anti-aging pill because so many abandoned dogs go without care. “Just because we can, should we?”

Compared to farm dogs in the past, today’s pampered pups live longer and get more geriatric diseases, said veterinarian Dr. Kate Creevy of Texas A&M University, the project’s chief scientific officer.

Yet no standard measures exist for frailty or prognosis in sick, aged dogs, Creevy said. The project will develop those tools.

One dog year is roughly equal to seven human years, Creevy said, but that varies by breed. Large dogs have shorter lifespans than smaller dogs. A Great Dane’s lifespan is about half that of a toy poodle’s.

That makes large dogs better test subjects for the pill. Dogs weighing at least 40 pounds will be eligible for an experiment with rapamycin, now taken by humans to prevent rejection of transplanted kidneys. The drug has extended lifespan in mice. A small safety study in dogs found no dangerous side effects, said project co-director Matt Kaeberlein of the University of Washington.

Human devotion to dogs drives projects like this, the scientists said. Owners will gladly fill out surveys, send records and submit a pup’s poop for analysis if they think it will help all dogs live longer, even if it won’t help their pet.

“People love dogs,” said Promislow, who normally studies aging in fruit flies. “No one has ever come up to me and said, ‘Oh my goodness, I just love fruit flies.’”

Promislow’s mixed breed, 14-year-old Frisbee, will not participate to prevent a conflict of interest.

“It’s too bad because she’s a terrific example of a really healthy ager,” he said.

  


HEADLINES [click on headline to view story]

Study: For babies born with HIV, start treatment right away


Old dogs, new tricks: 10,000 pets needed for science