December 1, 2015 – Over the years, some of the work of DCRI’s researchers has been directly related to or touched on the topic of HIV. To recognize World AIDS Day 2015, we are highlighting how our researchers are helping to improve the lives of people around the world living with HIV.
Between 4 and 5 million people around the world are infected with both the hepatitis C virus (HCV) and HIV. These patients have more complications and worse outcomes than those infected with HIV alone, and clearing HCV infection in this population has been shown to reduce the likelihood of death from liver disease. Until now, however, clinicians have had only limited success in eliminating HCV infections with existing drug combinations.
A regimen of ledipasvir/sofosbuvir shows promise for treating patients infected with both HCV and HIV, according to a study led by the DCRI’s Susanna Naggie, MD, MHS. The study showed that 96 percent of HCV patients achieved a sustained virologic response 12 weeks (SVR12) after completing therapy. Patients who reach this benchmark are considered cured of HCV infection.
The DCRI’s Susanna Naggie, MD, and Andrew Muir, MD, MHS, presented some of their latest research at the 22nd Conference on Retroviruses and Opportunistic Infections (CROI), which was held in Seattle.
Naggie presented the results of a phase III trial evaluating a regimen of ledipasvir/sofosbuvir for the treatment of chronic hepatitis C virus (HCV) in patients co-infected with HIV. The results of that study showed that 96 percent of HCV patients achieved a sustained virologic response 12 weeks (SVR12) after completing therapy. Patients who reach this benchmark are considered cured of HCV infection.
“This trial provides strong evidence that people who are co-infected with HIV can achieve very high rates of hepatitis C cure with a combination direct-acting antiviral regimen,” Naggie said. “These high cure rates were observed in most of the historically difficult-to-treat sub-populations, including those who failed previous treatment and those with cirrhosis. We are greatly encouraged by these findings.”
See video of this special research conference, which was held in honor of World AIDS Day 2014.
The researchers found that nations with the highest rates of death due to HIV infection tended to have lower rates of cardiovascular publications, suggesting that competing public health priorities may affect research productivity.
In this study, the researchers used data from the Comprehensive Kidney Disease Assessment for Risk Factors, Epidemiology, Knowledge, and Attitudes (CKD-AFRIKA) to obtain a better picture of how CKD is affecting Northern Tanzania. Between January and June 2014, the CKD-AFRIKA researchers conducted a household survey of randomly selected adults in Northern Tanzania. Trained surveyors and field researchers administered surveys and CKD tests to 481 adults from 346 households. In addition to basic demographic information, participants were asked about any history of diabetes, hypertension, HIV, kidney disease, or heart disease.
The DCRI’s John Perfect, MD, and other Duke researchers are using fish to watch in real time as Cryptococcal meningitis takes over the brain. The resulting images are worthy of a sci-fi movie teaser, but could be valuable in disrupting the real, crippling brain infection that kills more than 600,000 people worldwide each year.
Airborne cells of Cryptococcus make their way into our lungs practically every day — unwelcome guests, but of little consequence for those with healthy immune systems. But for those with compromised immunities, whether by HIV infection or cancer treatment, a resulting Cryptococcal meningitis infection can quickly become deadly.
To be able to target the infection with medications in the future, researchers need to know more about how the organism moves from the lungs into the blood stream and through the blood-brain barrier.