April 20, 2007

HIV Detection Research Aids Int'l Relief Efforts

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“I have seen how horrendous the current testing situations are,” said Prof. Antje Baeumner, biological and environmental engineering, referring to a harsh reality faced by many underdeveloped countries with high rates of HIV/AIDS. For the last decade, Baeumner and her colleagues have been working on technology that enables easy pathogen detection, from dengue to anthrax and E. coli.
Most recently, however, they have been applying their research to a worldwide HIV/AIDS study in an attempt to produce an efficient and inexpensive method of detecting the virus’s spread in HIV/AIDS patients. This project, called the CD4 Initiative, is an international endeavor calling for research teams to develop a simple, affordable and rapid test to measure the health of the immune system in HIV/AIDS patients in developing countries.
The CD4 Initiative, spearheaded by Imperial College in London and funded by an $8.6 million grant from the Bill and Melinda Gates Foundation, has spread to five groups, each of which has taken on a different role in the project.
The Cornell team has been awarded an initial $386,000, subject to annual renewal over four years.
The role of Baeumner and her colleagues in this initiative has been to investigate prototypes that would indicate the severity of the disease’s progression by measuring the number of CD4+ cells in the blood. CD4+ cells are a type of white blood cell that, at their normal levels, protect the body from potential infection. These cells are some of the first attacked by HIV once the virus enters a person’s body.
“When a person’s immune system is attacked by HIV, CD4+ count drops below a certain level,” Baeumner said. “Depending on the number [of cells], a patient can be treated, for example, with vaccination, or if more serious, with antiretroviral treatments.” The technique determines the best possible treatment for patients.
In the United States and other developed nations, methods similar to the type being investigated by the Cornell team are commonly used in HIV/AIDS treatment. However, in underdeveloped nations, these treatments are too expensive to be distributed in large numbers to be effective. The prototype under consideration would “match the needs of resource-limited countries,” Baeumner said, and would “consist of a test similar to a pregnancy test.”
In addition, the material used to construct this test would have to withstand the high temperatures found in many of the countries targeted for its distribution, in order to protect the patient’s blood sample against the heat.
“[This] is where the engineering part of this comes in,” Baeumner said.
Underdeveloped nations are not the only areas affected by HIV/AIDS. According to the Center for Disease Control website, in the 90s, three out of every thousand U.S. college students suffered from HIV/AIDS.
“SAT scores don’t correlate to protection, “said Sharon Dittman, associate director of community relations at Gannett Health Services when asked about the prevalence of HIV/AIDS at Cornell. “Having information and awareness alone is not protective … these must translate into one’s own behavior.”
Gannett currently offers two methods of HIV detection, one using an oral swab, and the other using a blood sample.
“We had approximately 600 Cornell students come in for HIV testing in the 2005 – 2006 school year,” said Gannett Clinical Counselor and Health Educator Barbara Jastran. “About one or two Cornell students per year test positive for HIV.”
When asked if Gannett would offer the CD4 test currently under investigation if it were to prove successful, Dittman and Jastran agreed that Gannet would likely refer students who had tested positive to a specialist who could conduct such a test. Dittman added, “We’ll talk to them about the next step and what they should expect.”
“It’s very exciting to be part of a community researching this pandemic … when just a few decades ago ‘positive’ meant a death sentence,” Dittman said, adding that Baeumner’s research is helping people “who would otherwise have a very hard time finding treatment.”
While there is still no date slated for completion of her team’s research, Baeumner explained that in the later phases of the project, a manufacturing company would take over. Its responsibilities would include disseminating the product and educating local specialists in target countries on how to implement treatment. On whether such a technique could eventually be used in the United States, she said, “I don’t see why not.”
Several other organizations, including Beckman Coulter Inc., Zyomyx Inc., the Macfarlane Burnet Institute of Australia, and the Program for Appropriate Technology in Health (PATH) are working on similar product development re-affirm that the best method for HIV/AIDS identification is developed as quickly as possible.
PATH, an international, non-profit organization based in Seattle, was founded in 1977 “to improve the health of people around the world by advancing technologies, strengthening systems, and encouraging healthy behaviors,” according to the group’s website. Named one of the 200 largest U.S. charities by Forbes in 2005, the group has been involved in several projects similar to the CD4 Initiative, such as developing cheap, comfortable condoms for women in Africa, designing a heat-detection sticker for vials of Polio vaccinations, and offering an alternative to clitoral removal, a “coming of age” ceremony, to young women in Africa.
Esther Butler, communications assistant at PATH, stated in an e-mail about PATH” involvement in the initiative, “PATH is developing a rapid CD4+ cell purification method along with a reagent stabilization system for use in resource limited areas without refrigeration … Additionally, reagents will be stabilized in this system for long term storage at high ambient temperatures.”
In other words, PATH’s work will focus on, among other things, the storage and maintenance of CD4+ cells after their collection from patients.
“We work where there’s much need … Every country has a different cultural and economic history,” PATH’s Senior Communications Associate Teresa Guillien said.
Regarding how the CD4 Initiative differs from other projects PATH has contributed to, she said, “CD4 is in line with a lot of work we’ve done. We’re building on many years of experience in different environments, technologies, and for different health needs.”
As for Baeumner’s research at Cornell, once a suitable prototype is chosen, one-year clinical trials will be conducted to determine its potential success.
Baeumner’s ultimate goal, she said, is “to help [HIV/AIDS patients] lead a healthy life.”