Growing up, Linos Vandekerckhove loved biology, so it seemed an obvious choice to go to medical school. After two years of practising internal medicine, in 2001 he had a chance to spend a year in South Africa.

“Here I was, in the eye of the storm, where most days one person would come to the clinic and die within 48 hours from an AIDS-related illness,” he said.

He returned to his native Belgium shaken. “It was really shocking to me, because in Europe treatment was readily available, so suddenly I felt like some people pay a very high price.”

Not wanting to plunge back into a hospital setting, he opted to work for a few days a week in an HIV virology laboratory. After getting his PhD, he wanted to continue researching HIV, so he joined the Ghent University Hospital in Belgium. After a few years of working with patients, he finally had more time to spend on research. In 2009, he started his own laboratory, the HIV Cure Research Center Ghent, and a year later he spent five months in San Francisco, United States of America, to familiarize himself with research on a cure.

“The sabbatical helped me gain momentum,” he explained. His research laboratory now employs 20 people.

Recently, his team completed a study with 11 people living with HIV. It involved pausing antiretroviral therapy so that scientists could observe viral rebound.

“An ethics committee had to validate the study and, of course, we held a patient forum to analyse the stress factors associated with taking people off treatment and the subsequent tests on them,” Mr Vandekerckhove said. His team made sure that the eight to nine procedures would be minimally invasive and carried out in a day, so that the volunteers could return to work after two days. To minimize any further disruption, technical assistants went to each person’s home to regularly gather blood samples.

“We wanted to involve the volunteers as much as possible and show our support from A to Z,” he said.

Two patterns surfaced from the study. Viral rebound, which took 15–36 days, occurs randomly. The team found more than 200 independent rebound events, from the gut to the lymph nodes to “just about everywhere where immune cells are present.”

Mr Vandekerckhove’s team also found that, depending on where the virus rebounded in a part of the body, the virus had evolved with its own individual make-up, like a barcode or a fingerprint. The researchers found different viruses, showing that they are not all the same single virus that has emerged from a reservoir, but rather multiple re-emergent events.

“We analysed 30 barcodes per cell type and about 400 barcodes per person,” he said.

That’s when they asked for help from virologists and statisticians.

“Our study revealed that having a medicine that would only target the lymph nodes is wrong. What this shows is that you need to focus on many organs, not just one,” Mr Vandekerckhove said.

UNAIDS Science Adviser Peter Godfrey-Faussett congratulated the HIV Cure Research Center Ghent. “Such detailed work advances our understanding of reservoirs where HIV “hides” while treatment suppresses the virus in the blood,” he said.

In his opinion, the research highlights the many challenges of the virus, since HIV can rebound from a wide range of reservoirs. “This is why a clear understanding of the nature of the reservoirs is so important to find a cure.”

Mr Vandekerckhove remains very positive, pointing to how gene therapy used to be science fiction but is now a reality.

“We need to bring the world of research to the world of patients,” he said. In his mind, a cure is one of the many facets of HIV that we cannot overlook.

Fellow Belgian Jonathan Bossaer couldn’t agree more. Ten years ago, he became very ill in South Africa and soon found out he had contracted HIV. After many years of feeling lost, a friend’s death made him realize he had to change.

“I was able to free myself of the frustration and shame that I had been living with for almost eight years and let go,” Mr Bossaer said. He founded a charity to raise awareness about HIV stigma. “Positively Alive has three main objectives: educate people about HIV, normalize HIV and help end HIV by raising funds,” he explained.

Half the funds go to a South African orphanage and the other half to Mr Vandekerckhove’s research centre. “Ending the HIV and AIDS epidemic is an enormous challenge and research for a cure and a vaccine needs our full support,” he said.

Pausing a bit, Mr Bossaer said, “The fight is far from over, but we are on the right path.”

The post Desperately seeking an HIV cure: Belgian research centre studies viral rebound appeared first on MyMedicPlus.

New Delhi: Findings of India Heart Study (I.H.S) show that 21.10% of the respondents were white-coat hypertensive while 18.90% were found to have masked hypertensionthereby putting 40% people at the risk of misdiagnosis and ‘missed’ diagnosis. There were 1228 participants from Delhi with 804 males and 424 females.

Masked hypertension is a phenomenon when an individual’s blood pressure reading is normal at the doctor’s office but high at home; white-coat hypertension is defined as a condition in which people exhibit a blood pressure level above the normal range in a clinical setting only. White-coat hypertensives who are misdiagnosed and put on anti-hypertension drugs have to take unnecessary medication.

India Heart Study (I.H.S) findings highlight a high prevalence of masked hypertension and white-coat hypertension in Indians at 42% on the first office visit (doctor’s clinic). It was also found that Indians have a higher average resting heart rate of 80 beats per minute, higher than the desired rate of 72 beats per minute. Another striking finding of the study is that unlike other countries, Indians have higher blood pressure in the evenings than in mornings which should guide doctors to rethink the timing of advising anti-hypertensive drug dosage. “India Heart Study points to a need for better clinical management of hypertension in India. This is India-specific data and should help shape the best practices for the diagnosis of high blood pressure among Indians. 

The study presents exhaustive data on the various aspects of hypertension,” said Dr. Upendra Kaul, Cardiologist, Chairman and Dean Academics and Research of Batra Hospital & Medical Research Centre, who was the Principal Investigator of I.H.S.

Throwing light on the study, Dr. Willem Verberk, PhD., Cardiovascular Research Institute Maastricht (CARIM), and a key investigator, said, “For the ‘correct’ detection of hypertension, home blood pressure monitoring is advised. However, different patients may have different co-morbidities, like diabetes, which makes the use of validated devices for home blood pressure monitoring important. Home blood pressure monitors for pregnant women, adolescents and people with kidney disorders needs to be validated separately.” 

What sets this study apart is that it was conducted on ‘drug-naive’ set (people not on any hypertension drug) of participants using a comprehensive process of taking blood pressure readings. The investigators examined the blood pressure of 18,918 participants (male and female) through 1233 doctors across 15 states over a period of nine months. The participants’ blood pressure was monitored at home four times in a day for 7 consecutive days.

Eris Lifesciences commissioned the India Heart Study that was conducted under the aegis of Batra Hospital & Medical Research Centre.

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