AIDS Research Interview

AIDS Interview 

This week we have had the opportunity to interview two amazing women who have first hand experience in helping deal with the current struggle against HIV and AIDS.  Both Dr. Maithe Enriquez and Dr. Carole McArthur are associated with UMKC and shared incredible insight with us on what the disease is, how it is affecting the world around us, and how we are looking to find a cure.   

Dr. Maithe Enriquez currently has a clinical appointment at the UMKC School of Medicine and provides primary care to adults living with HIV disease in the Infectious Disease clinic.  She has a rich background in dealing with HIV as she is currently a principal investigator for an NIH funded study focused on addressing non-adherence to HIV treatment in the community.  HIV or Human Immunodeficiency virus is a retrovirus that selectively infects CD4 cells, a white blood cell, and T-cells that are critical for cell-mediated immunity. Overtime untreated HIV progresses and destroys the immune system causing Acquired Immune Deficiency Syndrome also known as AIDS.  AIDS compromises the immune system making the affected person susceptible to infections and other diseases that they can’t fight off.  

HIV is a virus passed from person to person through sexual fluids and blood.  20 years ago, blood transfusions were the main means of transportation of HIV and knowing how HIV is transferred has since helped us attempt to maintain the virus.  Making sure the public is aware of how to stay safe from contracting this virus is an important job.  Not sharing hypodermic needles, blood, or bodily fluids with someone who is HIV positive is a prime way to avoid contracting the virus.  “No one has to get AIDS anymore,” Dr. Enriquez tells us, “given the availability of efficacious treatment.”  Early detection of HIV can help prevent the disease from progressing into AIDS.  If someone does test positive for HIV, treatment has advanced to the availability of regimens that are one pill a day (3 medications combined in 1 pill).  This one pill regimen could help prevent million of people from advancing the HIV disease into AIDS.  According to the AIDS web site, AIDS.gov, 3.4 million people are currently living with HIV/AIDS worldwide and 97% of these people live in low to middle-income countries where treatment is difficult to find and afford.  This epidemic has caused more than 25 million deaths since it was first discovered in 1981 and more than 1.4 million people in the United States are living with the HIV infection putting them at risk for AIDS.  

A world map showing how many people are infected with HIV (Global Statistics).

So what does this mean for these 34 million people?  HIV/AIDS research has been working on finding a cure for more than 30 years and Dr. Enriquez is optimistic.  Though HIV is a difficult disease to pinpoint a cure for due to its ability to multiply rapidly and to adapt over time, researchers are making strides in attempting to find a cure and to keep up with its ever changing nature.  We asked Dr. Enriquez if she thought finding a cure to HIV/AIDS is in the near future to which she responded “I think yes, an effective cure will be developed.”  This is good news for the the 34 million people around the world who are suffering from HIV/AIDS and for the projected (on average) 2 million people who contract the disease for the first time each year according to AIDS.gov.  “It’s amazing to me to have witnessed how much HIV treatment has advanced!” says Dr. Enriquez who has played an important role in the advancement of HIV/AIDS knowledge in communities as well as in the discovery of treatments for the disease.  Dr. Enriquez also encouraged us to watch the critically acclaimed documentary “How to Survive a Plague” about the AIDS epidemic.  The official trailer to the documentary is included below.

The official trailer for the documentary "How to Survive a Plague", which has received outstanding reviews and is highly recommended for anyone looking to learn more about the spread of HIV/AIDS in America. The film is available on Netflix.

We also had the pleasure of meeting with Dr. Carole McArthur last week at Michael Forbes restaurant in Brookside.  Dr. McArthur is very knowledgeable in how to take care of people who are suffering from HIV or AIDS and also the process that is being observed in order to find an effective cure.  Dr. McArthur shared with us a little bit about her background and how she came to know so much about the disease.  Dr. McArthur received her P.h. D. from Otago University in the South Island of New Zealand and then performed her post-doctoral work at the University of Florida, where she also ran track at the University of Florida for the Florida Track club team. By this time, Dr. McArthur had become an expert in genetic monoclonal antibody research, a fairly new field at that time, and was recruited by a researcher at Scripps Research Institute to do more post-doctoral work, immediatley  moving to Michigan to do research at Michigan State University. At Michigan State she was spear-heading the collaboration of industry and science in academia, one of the first experiments  in American history, creating create many new medical devices and advances that we still use today.  She then progressed to work for Abbott Laboratories in Chicago, focusing on genetic engineering, working amongst an R and D department with 22,000 scientists who were “very brilliant people!” she exclaimed. After all these years of research Dr. McArthur then decided to attend UMKC to get her M.D. in pathology and became a doctor.  Dr. McArthur now works at Truman Medical Center helping patients with HIV and also teaches immunopathology in school of dentistry at UMKC, which led us to meeting her for this interview.  She has an extensive background in researching HIV and similar diseases and also handling and controlling diseases in the community.  Dr. McArthur has also been to Cameroon, Africa, taking along medical supplies and equipment to set up a lab where she helps educate and treat people in Africa with HIV.  Dr. McArthur has an extensive background in HIV/AIDS treatment and was a perfect match for us to interview. 

Dr. McArthur (center) educating the local people in Africa on HIV.

When asked to describe AIDS in her own words Dr. McArthur used a house of cards metaphor; the HIV virus completely attacks the immune system similar to the removal of a bottom card in a house of cards, just as the house of cards would collapse upon itself, so does the immune system and body when infected with HIV.  This collapse of the immune system leaves the person open to contracting other infections such as Tuberculosis.  Dr. McArthur said that almost all the patients who had hemophilia and received blood transfusions contracted HIV and died from AIDS and other complications during the 1980s when testing was less robust than today.  A high percentage of hemophiliacs suffered from not only HIV-1 but also the hepatitis C virus that was transmitted through blood  also (White).  According to Dr. McArthur, there are several common misconceptions about HIV and AIDS in the general population. One such misconception is the virus’s ability to live outside of a human host, which it is not able to do for very long at all.  The HIV virus needs a host cell to live off of in order to survive.  Another, more prevalent misconception has to do with the pathogenicity of the virus.  HIV must be introduced directly to an open wound, or through various body fluids, and therefore in comparative terms, is really not as infectious as some other common diseases. Dr. McArthur used the following image to demonstrate the potency of the infectious capabilities of HIV in contrast to those of Hepatitis B. Imagine there is a spoonful of HIV (for all intents and purposes) in a pool, no one would get it unless they had an open wound, but if there is a spoonful of Hepatitis B, then every swimmer would be infected. Research has made huge advances in the last several years, trying to find a cure and ways to confine the HIV virus and limit the number of people who have to live with AIDS.  HIV is also not as lethal as it once was, as now there are many more medications out there to postpone symptoms.  

Many different strains of HIV can be localized all over the world.

Dr. McArthur believes the search for a cure for HIV to be critical, and believes it is completely obtainable. The difficulty in finding a cure arises in the virology of HIV, with its fast mutation rate, numerous different strains and issues of drug resistance, as well as the more often deadly, opportunistic infections and diseases, such as Tuberculosis, that prey on the weakened immune system.  Several different strains of HIV can be seen in the image below and researchers are attempting to document the changes and movement of different strains across the globe to better understand the virus.  Dr. McArthur has also helped begin trials in Africa on different types of drugs that can be used to prevent or cure HIV.  However, finding a drug that will cover the vast array of strains and quick mutations of HIV is a work in progress.  Above all else, Dr. McArthur believes the main obstacle to developing a cure to HIV/AIDS lies in the money. “It’s just money, that’s what it is. If we solve this problem, we’ll solve so many other diseases. It is just a matter of time. Look at cancer—no one said we would find a cure and now there are so many cancers that are curable.”  It is true that with several cures for common cancers we can see a light of hope at the end of the battle against the HIV/AIDS pandemic.

Acknowledgments:
We would like to extend a generous thank you to both Dr. Maithe Enriquez and Dr. Carole McArthur for helping us with this project and for sharing so many great stories with us! They are truly experts on HIV and AIDS and helped us understand the magnitude of this disease and how important it is to help find a cure.

References:

"Global Statistics." AIDS.gov. U.S. Department of Health & Human Services, n.d. Web. 6 Feb. 2014. <http://aids.gov/hiv-aids-basics/hiv-aids-101/global-statistics/index.html>.

"HIV/AIDS." National Hemophilia Foundation. N.p., n.d. Web. 14 Feb. 2014. <http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=43&contentid=39>.

Picture References:
 
http://dentistry.umkc.edu/oralbio/faculty/mcarthur_cameroon.shtml
http://aids.gov/hiv-aids-basics/hiv-aids-101/statistics/
http://www.pbs.org/wgbh/pages/frontline/aids/atlas/clade.html
http://aids.gov/hiv-aids-basics/hiv-aids-101/what-is-hiv-aids/