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Durban - Hope for an Aids vaccine has been renewed by the revelation in scientific journal Nature this week of CAP 256, an HIV-positive woman’s “killer” blood and disease-neutralising capacity.
In KwaZulu-Natal a place called Vulindlela on the edge of Mooi River, home to 400 000 living on the verge of poverty, has provided University of KwaZulu-Natal scientists with life-changing data on HIV and TB treatment.
The KZN scientific team – including Salim and Quarraisha Abdool Karim from the Centre for the Aids Programme of Research in South Africa (Caprisa) – has found the same “neutralising” blood.
And they say this could have enormous ramifications.
“We don't know all the answers,” says Salim Karim, “But what we have learnt from this blood sample is that things we thought impossible are now doable.
“We have been able to clone cells from blood that make potent antibodies, which means large-scale experimental work can go ahead. These are small but important steps on the path to an Aids vaccine.”
The people who live in traditional rural communities like Vulindlela, a two-hour drive from Durban, lead simple lives.
While some have electricity, few have plumbing, sanitation or running water. Life for them is hard.
There are few local job opportunities. Men work in the cities, women and children predominate and sexually transmitted diseases are pravelent.
In the centre of the township you’ll find an ordinary white-walled building where uniformed staff go about their daily duties, sometimes with stethoscopes around their necks, talking to patients.
Here you will meet people like Gethwane Mahlase, a pivotal local activist for Aids treatment and prevention in Vulindlela who doesn’t mince her words in her quest to encourage young women to be tested.
“Aids is about who’s on top,” she says bluntly. “A woman might insist on a condom, but that doesn’t mean that the man will want to use one. If we want to succeed in the fight against Aids, we have to change men’s behaviour.”
Mahlase recently won the Business Women of the Year Award for her NGO work on HIV prevention in Vulindlela.
Whether her persuasiveness or changing perspectives in the communities is having an impact is hard to say.
But what is extraordinary is that this far-flung community with no hospital and just a few clinics is leading the international race in vaccine research and HIV/TB treatment.
“People genuinely want to help,” says Mahlase. “They want us to find the answers to the diseases that are killing their relatives, leaving the elderly to take on enormous burdens of responsibility in their old age. If we ask for volunteers, they will come forward.”
One member of a research volunteer group, an HIV-positive mother, is one of the most important people on Earth. She naturally exhibits an artillery of powerful broadly neutralising antibodies which, harnessed and understood, have the potential to eliminate most of the global HIV strains.
She is on antiretrovirals and has an undetectable viral load and a high CD4 immune cell count.
The scientific community is well aware CAP 256 (the anonymous research volunteer number abbreviated from Caprisa participant) has an immune system able to mount a potent response to the HIV that infects her body.
In other words, she is a rare jewel whose cellular components could potentially halt the HIV pandemic.
We should laud her for what she is doing for humanity, but chances are we will never know her name, get to speak to her or meet her family.
We will never know if she works, or share her hopes or dreams, or ask her how she feels about being such a critical part of modern science. For in the realm of scientific research, anonymity is a given. Even in this week’s Nature article, she remains simply CAP 256.
But there are many unsung heroes like her, says Abdool Karim. “Do you see how all the news articles talk about the new research coming from KwaZulu-Natal. People in KZN might be wondering where in the province is this happening? Well it’s Vulindlela.”
What is so special about the place?
Says Abdool Karim: “It is a unique chemistry of the relationship between the community and the researchers that makes it all possible.” - Sunday Argus
Two cleared after marrow treatment
The Berlin Patient – also known as Timothy Brown and believed to be the only person in the world considered cured of HIV after being given a bone marrow treatment when suffering leukemia – is not alone.
Researchers say two HIV-positive men, both from Boston, developed lymphoma and their treatment included a bone marrow transplant, which results in a new immune system. The bone marrow donors did not have HIV.
Seventeen months after the transplants, researchers could not detect any HIV genetic material in the patients’ blood.
Still unclear is whether the virus still lurks in the patients’ tissues.
Researcher Dr Timothy Henrich of Harvard University and Brigham and Women’s Hospital said if doctors became convinced that all trace of the virus is gone, the patients could stop taking antiretroviral drugs and be considered cured.
But they’re not there yet. Only when patients can successfully stop their medication can they be considered cured of HIV.
The only person in that category right now is the Berlin Patient. He had a bone marrow transplant to treat acute myeloid leukemia.
In his case, the bone marrow donor was not only HIV-negative but had a rare genetic mutation that blocks HIV from entering cells.
That effectively makes Brown immune to the virus, and his body has remained HIV-free even without taking antiretroviral drugs.
The two patients in Boston received their bone marrow transplants from people who did not have the rare genetic variant, which is why they are still taking their drugs.
Babies bounce back after high ARV doses
Just hours after delivery, a baby born with HIV in Mississippi, in the US, was given high doses of three antiretroviral drugs.
More than three years later, doctors say the little girl has no evidence of the life-threatening disease in her blood, despite being off medication for nearly two years.
Now doctors say another child born with the virus appears to be free of HIV after receiving similar treatment.
The case report was presented at the annual Conference on Retroviruses and Opportunistic Infections in Boston this week. The girl was delivered at Miller Children’s Hospital in Long Beach, California, last year to a mother with Aids.
Doctors gave the baby high doses of antiretroviral drugs – AZT, 3TC and Nevirapine – four hours after birth. Eleven days later, the virus was undetectable in her body and remains undetectable nine months later.
The California baby is still on antiretroviral treatment, so it’s too soon to tell if the child is actually in remission.