Infectious Diseases and Microbiology

Cambridge, United Kingdom

Infectious Diseases and Microbiology

Cambridge, United Kingdom
SEARCH FILTERS
Time filter
Source Type

News Article | May 29, 2017
Site: www.eurekalert.org

PITTSBURGH, May 29, 2017 - The quest to develop a cure for HIV has long been plagued by a seemingly simple question: How do doctors determine if someone is cured? The virus has a knack for lying dormant in immune cells at levels undetectable to all but the most expensive and time-consuming tests. Scientists at the University of Pittsburgh's Graduate School of Public Health announced today in Nature Medicine that they've created a test sensitive enough to detect "hidden" HIV, and yet is faster, less labor-intensive and less expensive than the current "gold standard" test. The new Pitt test also revealed that the amount of virus lurking dormant in people who appear to be nearly cured of HIV is about 70-fold larger than previous estimates. "Globally there are substantial efforts to cure people of HIV by finding ways to eradicate this latent reservoir of virus that stubbornly persists in patients, despite our best therapies," said senior author Phalguni Gupta, Ph.D., professor and vice chair of Pitt Public Health's Department of Infectious Diseases and Microbiology. "But those efforts aren't going to progress if we don't have tests that are sensitive and practical enough to tell doctors if someone is truly cured." HIV spreads by infecting CD4+ T cells, which are a type of white blood cell that plays a major role in protecting the body from infection. Antiretroviral therapies to treat HIV have advanced to the point that people with HIV can have the virus so well-controlled that they could have as little as one infectious virus per million CD4+ T cells. However, the majority of HIV DNA integrated into these cells is defective, meaning it wouldn't cause infection anyway. Once HIV therapy is working, it becomes critical to determine if the HIV DNA being detected by a test could actually create more virus and cause the person to relapse if therapy is stopped. Therefore, the test must be able to show that the virus it detects can replicate--typically by growing the virus from the sample. To date, the best test available to do this is called a "quantitative viral outgrowth assay," or Q-VOA. This test has many drawbacks: It may provide only a minimal estimate of the size of the latent HIV reservoir; requires a large volume of blood; and is labor-intensive, time-consuming and expensive. Gupta's team developed a test that they call TZA. It works by detecting a gene that is turned on only when replicating HIV is present, thereby flagging the virus for technicians to quantify. The TZA test produces results in one week compared to the two weeks needed using the Q-VOA, and at a third of the cost. It also requires a much smaller volume of blood and is less labor-intensive. "Using this test, we demonstrated that asymptomatic patients on antiretroviral therapy carry a much larger HIV reservoir than previous estimates--as much as 70 times what the Q-VOA test was detecting," said Gupta. "Because these tests have different ways to measure HIV that is capable of replicating, it is likely beneficial to have both available as scientists strive toward a cure." Because of its low cell requirement, the TZA also may be useful for quantification of replication-competent HIV-1 in the pediatric population, as well as in the lymph nodes and tissues where the virus persists. Additional authors of this study are lead author Anwesha Sanyal, Ph.D., of Pitt Public Health; Nicolas Sluis-Cremer, Ph.D., Deena Ratner, Ming Ding, Jennifer M. Zerbato, Ph.D., Nicholas Giacobbi, M.S., Narasimhan J. Venkatachari, Ph.D., Yue Chen, Ph.D., Robbie B. Mailliard, Ph.D., and Charles R. Rinaldo, Ph.D., all of Pitt; and Bruce K. Patterson, M.D., and Amanda Chargin, M.B.S., both of IncellDx Inc. This work was supported by National Institutes of Health grants U01-AI35041, R21AI119117 and D43TW010039. This research was made possible by the generous support of the staff and participants of the Pittsburgh site of the Multicenter AIDS Cohort Study (MACS), a research study of the natural history of treated and untreated HIV/AIDS in men who have sex with men. About the University of Pittsburgh Graduate School of Public Health The University of Pittsburgh Graduate School of Public Health, founded in 1948 and now one of the top-ranked schools of public health in the United States, conducts research on public health and medical care that improves the lives of millions of people around the world. Pitt Public Health is a leader in devising new methods to prevent and treat cardiovascular diseases, HIV/AIDS, cancer and other important public health problems. For more information about Pitt Public Health, visit the school's Web site at http://www. .


News Article | May 29, 2017
Site: www.prweb.com

The quest to develop a cure for HIV has long been plagued by a seemingly simple question: How do doctors determine if someone is cured? The virus has a knack for lying dormant in immune cells at levels undetectable to all but the most expensive and time-consuming tests. Scientists at the University of Pittsburgh’s Graduate School of Public Health announced today in Nature Medicine that they’ve created a test sensitive enough to detect “hidden” HIV, and yet is faster, less labor-intensive and less expensive than the current “gold standard” test. The new Pitt test also revealed that the amount of virus lurking dormant in people who appear to be nearly cured of HIV is about 70-fold larger than previous estimates. “Globally there are substantial efforts to cure people of HIV by finding ways to eradicate this latent reservoir of virus that stubbornly persists in patients, despite our best therapies,” said senior author Phalguni Gupta, Ph.D., professor and vice chair of Pitt Public Health’s Department of Infectious Diseases and Microbiology. “But those efforts aren’t going to progress if we don’t have tests that are sensitive and practical enough to tell doctors if someone is truly cured.” HIV spreads by infecting CD4+ T cells, which are a type of white blood cell that plays a major role in protecting the body from infection. Antiretroviral therapies to treat HIV have advanced to the point that people with HIV can have the virus so well-controlled that they could have as little as one infectious virus per million CD4+ T cells. However, the majority of HIV DNA integrated into these cells is defective, meaning it wouldn’t cause infection anyway. Once HIV therapy is working, it becomes critical to determine if the HIV DNA being detected by a test could actually create more virus and cause the person to relapse if therapy is stopped. Therefore, the test must be able to show that the virus it detects can replicate—typically by growing the virus from the sample. To date, the best test available to do this is called a “quantitative viral outgrowth assay,” or Q-VOA. This test has many drawbacks: It may provide only a minimal estimate of the size of the latent HIV reservoir; requires a large volume of blood; and is labor-intensive, time-consuming and expensive. Gupta’s team developed a test that they call TZA. It works by detecting a gene that is turned on only when replicating HIV is present, thereby flagging the virus for technicians to quantify. The TZA test produces results in one week compared to the two weeks needed using the Q-VOA, and at a third of the cost. It also requires a much smaller volume of blood and is less labor-intensive. “Using this test, we demonstrated that asymptomatic patients on antiretroviral therapy carry a much larger HIV reservoir than previous estimates—as much as 70 times what the Q-VOA test was detecting,” said Gupta. “Because these tests have different ways to measure HIV that is capable of replicating, it is likely beneficial to have both available as scientists strive toward a cure.” Because of its low cell requirement, the TZA also may be useful for quantification of replication-competent HIV-1 in the pediatric population, as well as in the lymph nodes and tissues where the virus persists. Additional authors of this study are lead author Anwesha Sanyal, Ph.D., of Pitt Public Health; Nicolas Sluis-Cremer, Ph.D., Deena Ratner, Ming Ding, Jennifer M. Zerbato, Ph.D., Nicholas Giacobbi, M.S., Narasimhan J. Venkatachari, Ph.D., Yue Chen, Ph.D., Robbie B. Mailliard, Ph.D., and Charles R. Rinaldo, Ph.D., all of Pitt; and Bruce K. Patterson, M.D., and Amanda Chargin, M.B.S., both of IncellDx Inc. This work was supported by National Institutes of Health grants U01-AI35041, R21AI119117 and D43TW010039. This research was made possible by the generous support of the staff and participants of the Pittsburgh site of the Multicenter AIDS Cohort Study (MACS), a research study of the natural history of treated and untreated HIV/AIDS in men who have sex with men.


Chapman A.L.N.,Royal Hallamshire Hospital | Seaton R.A.,Gartnavel General Hospital | Cooper M.A.,New Cross Hospital | Hedderwick S.,Royal Victoria Hospital | And 8 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2012

These good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) are an update to a previous consensus statement on OPAT in the UK published in 1998. They are based on previous national and international guidelines, but have been further developed through an extensive consultation process, and are underpinned by evidence from published literature on OPAT. They provide pragmatic guidance on the development and delivery of OPAT services, looking at all aspects of service design, care delivery, outcome monitoring and quality assurance, with the aim of ensuring that OPAT services provide high-quality, low-risk care, whatever the healthcare setting. They will provide a useful resource for teams developing new services, as well as a practical set of quality indicators for existing services. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.


News Article | February 17, 2017
Site: www.eurekalert.org

The researchers from Imperial College London analysed 20 pharmacies that were available for UK citizens to access online. This is one of the few studies to have examined the online availability of antibiotics and to have explored the potential effects on public health. The research is published in Journal of Antimicrobial Chemotherapy. Antibiotics are classed as prescription only medicines in the UK, meaning they cannot legally be sold to consumers without a valid prescription. In the study, the researchers found that although online versions of UK high street pharmacies were compliant with prescription regulations, 80 per cent of the online pharmacies surveyed let customers choose their dosages, the duration and choice of antibiotic treatments. This can lead to serious side effects in patients and increases the risk of antimicrobial resistance. Antimicrobial resistance is one the biggest threats to global health, food security, and development today, according to the World Health Organization (WHO).The study was carried out by academics from Imperial College London's NIHR Health Protection Research Unit for Healthcare Associated Infections and Antimicrobial Resistance, and Imperial College Healthcare NHS Trust. The team carried out their research by entering the search term 'buy antibiotics online' into Google and Yahoo. The team recognise that the study is a 'snapshot' of the online pharmacy industry, but it does provide insights into how it operates. The 20 pharmacies at the top of the search were analysed by the team. Dr Sara Boyd, a co-author and NIHR Academic Clinical Fellow in Infectious Diseases and Microbiology at Imperial, said: "These findings are a real concern, and raise several important issues regarding antibiotic resistance and patient safety with online pharmacies." All online medicine vendors selling to UK consumers must by law register with both the Medicines and Healthcare products Regulatory Agency (MHRA) and the General Pharmaceutical Council (or the Pharmaceutical Society of Northern Ireland). However, the researchers found that 75 per cent of online pharmacies included in the study lacked evidence of the appropriate registration status required by law. In other findings, the researchers discovered that 45 per cent of the online pharmacies analysed did not require a prescription from the patient. Only 30 per cent of websites in the survey asked consumers to complete a health questionnaire prior to purchase. Seventy per cent of the websites provided information on the safe usage of prescription medications, including potential side effects or adverse reactions when combined with other drugs. Professor Alison Holmes, of Imperial's Department of Medicine, added: "Improper use of antibiotics can mean that infections are not being treated appropriately, or that people are being unnecessarily exposed to antibiotics. This allows bacteria to become resistant to drugs that once killed them. As a result, it is essential that antibiotics are prescribed only when they are needed." Although a small study, the authors say that the research offers insight into the increasing use of the internet for a variety of purposes, including buying antibiotics. Dr Boyd said: "The way patients interact with healthcare is constantly evolving, and shifts in consumer behaviour mean more people are purchasing their goods online. Our study paves the way for larger, more thorough research into this worrying new trend so that we can ensure patient safety and promote the responsible use of antibiotics in all areas of healthcare provision." Martin Astbury, President of the Royal Pharmaceutical Society, said: "Unnecessary antibiotic use can result in serious side effects in individuals and has a major impact on wider public health by increasing antibiotic resistance. We cannot support access to antibiotics through a web form until the standards for prescribing by private providers reflect the standard of face to face consultations in the NHS. Those involved in supplying medicines online should ensure their processes are as robust as possible." All online pharmacies identified as illegally selling antibiotics to patients within the UK were reported to the Medicines and Healthcare products Regulatory Agency (MHRA), who promptly responded. The researchers are working together with numerous stakeholders to improve patient safety and antibiotic stewardship in this area. Anyone with a concern concerns about an online pharmacy should contact the MHRA directly. The study was partially funded by the National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, in partnership with Public Health England and Imperial College Healthcare NHS Trust.

Loading Infectious Diseases and Microbiology collaborators
Loading Infectious Diseases and Microbiology collaborators