Tshedimoso Acute Infection Study (Nov 15)

Impressions

First, frustrations, as today is that kind of day: I spend hours waiting for clients who don’t show up, and when they do, there are only about 1/100 (literally) who qualify for our study. Also, we don’t have a lab director anymore. Our study PI, has become the contact person for any lab related issues. And although he is extremely helpful, he’s not here in person, and there isn’t quite the direction that a high functioning lab should have. Some people in the lab (I won’t say who) joked that we would get a director quickly if we started asking questions like:

”Do we ship samples on dry ice or regular ice?”
“When we pipette, should we press all the way down, or just halfway?”
“What’s a mole?”
“What’s wrong with using distilled water instead of dH₂O?”

I joke about this, but some of these questions are not too far off from ones I’ve asked.

Positives (because what’s life without being a little optimistic): There is an increase in enrollment! People are starting to walk into the research clinic now that we’re distributing posters and business cards. Slow but steady progress is still progress. I’ve also started thinking more about lab projects, which I’m looking forward to, as I feel that I will have more control of things.

I’ve realized that I haven’t described what research I’m doing in Botswana, so I’ve included a little about our acute infection study below. I admit that I cheated a little and cut and paste this from our introduction letter, but it gets to the point.

Tshedimoso: Early and Acute HIV-1C Infection in Botswana/Markers of Viral Set Point in Primary HIV-1C Infection.

Overview

The Tshedimoso study aims to research the body’s immune response and the viral dynamics during primary HIV infection. Primary HIV disease can behave very differently from chronic HIV infection and is likely to be a predictor of time to onset of AIDS. Understanding the body’s response to primary HIV infection could generate interventions to prevent progression to AIDS, such as early treatments and vaccine design.

The Tshedimoso Study screens for two components of primary infection:

(1) Acute HIV infection
(2) Early HIV infection.

Acute HIV Infection

Acute HIV infection, also known as the HIV “window period”, is a period of approximately 2-12 weeks when the patient has HIV but does not have detectable antibodies and tests negative with a regular ELISA rapid test. Using a specialized HIV RT-PCR test, the Tshedimoso Study can detect the HIV virus just a few days after infection. A benefit of this specialized test is that patients do not need to retest for HIV in 3 months to confirm a negative result.

During acute HIV infection patients are 10-20 times more likely to transmit HIV. Some research suggests that the HIV “window period” is responsible for much of the spread of the HIV epidemic. Knowing one’s HIV status during the “window period” empowers patients with knowledge that may alter their risk-taking behaviors, protecting family and the community.

Early HIV Infection

Patients with early infection test positive with the rapid test and have an HIV infection less than 6 months old. Early HIV infection can be detected using the detuned HIV EIA test.