ZEN SCIENCE SCAN
Book review
“a gripping story of hero-
ic struggles in tackling
complex issues done by
weaving personal lives
into major societal is-
sues whilst finding one's
own life in a new con-
text”
- Professor Teboho Moja, NYU
In This Issue
Aim/The Heroine
Next Door
Real-world study of
HIV/TB/NCDs
Advances in research
& diagnostics
Opportunities & chal-
lenges in TB disease
management
Why HIV/AIDS still
matters
Photo Caption
Aim The purpose of a newsletter is to provide a snapshot of research information to a
general audience. The global realities of co-existing diseases are of particular con-
cern because of poorer clinical outcomes and reduced quality of life. Here, I sum-
marize advances in HIV, TB, and diabetes management (sub-themes in my book),
with a focus on Sub-Saharan Africa.
Disclaimer: Research is an evolving endeavor and information may become
redundant or change as a result of new discoveries. Please seek medical advice
from your personal physician.
The Heroine Next Door The emotionally-wounded survivors of the 9/11 attacks include a fifty-year old,
South African Muslim scientist, Leila, who lost her fiancée, Khalid, on that fateful
day. She is the narrator of a story threading together the lives of four South African
Muslims navigating a technologically advanced and increasingly-complicated
world beset with infectious diseases such as HIV/AIDS and TB.
Atypical abbreviations: bNAb, broadly neutralizing antibody; HAART, highly active
antiretroviral therapy
Communicable and Non-communicable Diseases (NCDs) Newsletter February /March 2015
Real-world study of HIV/TB/NCDs According to the International Diabetes Federation, people with diabetes are more
likely to develop TB compared with non-diabetics. Africa is one of the regions with
the highest anticipated increase in diabetes by 2030. South Africa, a country with
one of the highest global TB burdens, will be one of countries on the continent
facing the deadly duo of diabetes and TB. Moreover, the co-existence of this dis-
ease with other communicable and non-communicable diseases such as hyper-
tension and HIV have been demonstrated in a South African clinic. One of the
important observations made in this study was the higher prevalence of multiple
morbidities, hypertension and diabetes in younger patients (18-35 yr. and 36-45
year age groups respectively) receiving antiretroviral therapy (ART) compared
with patients who did not receive ART.1 In addition, successful management of
HIV patients with ART prolongs life, thereby increasing the burden of HIV+-
individuals with comorbid, non-communicable diseases. Because there are imme-
diate and long-term health consequences in terms of clinical outcomes and risks
for patients with multimorbid diseases, it is necessary to rethink the integration
and coordination of HIV and TB management in Sub-Saharan Africa.
Source: 1. Oni, T. et al. BMC Infect Dis 15, 20, 2015
Diabetes Overall, the Africa region has the highest proportion of undiagnosed diabetes, at
78%. Furthermore, an estimated 344,000 deaths can be attributed to this disease,
representing 6.1% of deaths from all causes.
HIV/NCD management One example of integrated care is illustrated in my book, The Heroine Next Door, and others can be found on Google.
Advances in research & di-agnostics In the absence of the ideal HIV
vaccine, the optimization of target-
ed ART delivery and scale-able
manufacture of clinically effective
microbicide components remain
urgent priorities.
Nanocarriers delivering HAART
and tobacco-plant-based manufac-
ture of a bNAb have been evaluat-
ed in separate preclinical studies
summarized on my website. In
addition, I have mentioned two
diagnostic kits :
http://www.heroinenextdoor.com/
index.html
Improving HIV vaccine efficacy (SlideShare)
HIV/AIDS and diabetes estimates in South Africa (SlideShare)
Clinical Trials
Patients with active, drug-
sensitive TB receive a
standard six-month
course of therapy. Novel
agents that shorten the
treatment duration and
are active against multi-
drug-resistant TB are an
urgent priority in combat-
ting the second leading
cause of infectious
deaths after HIV. Patients
are currently being re-
cruited for clinical trials to
assess two anti-
mycobacterial nitroimid-
azoles, TBA-354 and PA-
824 (Clinicaltrials.gov
IDs: TBA-354
[NCT02288481] and
[NCT02193776]). Preclin-
ical data confirmed and
extended prior findings
demonstrating the effica-
cy of novel nitroimidazole
-containing-drug combi-
nations in treating TB,
irrespective of resistance
to existing drugs. The
outcomes from clinical
trials will determine
whether laboratory data
can be matched in pa-
tients.
Source: Tasneen, R. et
al. Antimicrob Agents
Chemother 59, 129-35,
2015
.
Tuberculosis symptoms and challenges in seeking a durable cure (Norwalk Patch)
Opportunities & challenges of TB disease management Antibiotic stewardship – composed of six core elements (active and supplemental strat-
egies such as prospective audit of antimicrobial use and development of evidence-
based practice guidelines that incorporate local microbiology and resistance patterns;
information technology; microbiology laboratory; monitoring of process and outcome
measurement; comprehensive multidisciplinary team approach ) – is geared towards
minimizing antibiotic resistance and optimizing the use of frontline and last-line medica-
tions against bacterial pathogens.
Appropriate disinfection and decontamination of hospitals, clinics, and other medical
centers to reduce the prevalence of this airborne pathogen will be an important aspect
of any integrated patient-centered care and prevention strategy. The merits and perils
of automated systems such as hydrogen peroxide vapor and ultraviolet light disinfec-
tion systems to reduce the impact of hospital-acquired infections are discussed in Auto-
mated Technologies for Patient Room Disinfection and Decontamination of Biosafety
Level 4 Infectious Agents, Including Ebola Virus.
Strategies for optimizing the development of new antibiotics have been reviewed here
and the possibility exists of improving treatment by alternating antibiotics (Kim, et al).
Source: Kim, S., Lieberman, T. D. & Kishony, R. Proc Natl Acad Sci U S A 111,
14494-9, 2014
Author Bio
Zeena Nackerdien is a sci-entist and writer of numer-ous peer-reviewed and online publications on
science and society.
Contact Information:
Visit me on the web at
http://
www.heroinenextdoor.co
m/index.html
Why HIV/AIDS still matters Some Americans may also point to the low adult HIV prevalence (0.2% versus
4.7% in Sub-Saharan Africa) in this country and declining fatalities as signs of
treatment success and an opportunity to reduce financial aid to other countries
showing similar successes. A closer examination of the numbers suggest that the
answer is no. Only 25% of HIV-infected individuals in the USA have suppressed
viral loads and only one in four people are able to reap full treatment benefits by
successfully navigating the HIV care continuum. Moreover, the disease may be
under-reported in this country, as the number of people with undiagnosed HIV is
estimated to be one in six.
An effective vaccine for HIV/AIDS? Long-term expression of a broad and potent entry inhibitor could bypass the need
for a conventional vaccine. Gardner et al. suggests that stable expression of
bNAbs protected macaques from several challenges with simian HIV, suggesting
that it can function as an effective HIV-1 vaccine.
Source: Gardner, M. R. et al. Nature advance online publication, 2015
Zeena Nackerdien (PhD)
HIV, TB, and NCDs in a nutshell
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