In almost one-third of the AIDS-related deaths serviced by Sebrell Funeral Home, the family or next-of-kin will either abandon the deceased entirely or refuse to accept the cremains.
HIV/AIDS is a growing problem in the American South, due to social stigma, poverty, and decreased access to healthcare. In this short documentary, we meet Trey Sebrell, who thinks of caring for all deceased people, no matter who they were in life, as part of his mission as a funeral director.
Some recent genetic testing of the blood of AIDS patients has determined that the strain of HIV responsible for the majority of the AIDS cases in the US spread from Zaire to Haiti around 1967, from Haiti to NYC around 1971, and from there to San Francisco around 1976 and that Gaétan Dugas (aka Patient Zero) was not responsible for setting the epidemic in motion.
The strain of H.I.V. responsible for almost all AIDS cases in the United States, which was carried from Zaire to Haiti around 1967, spread from there to New York City around 1971, researchers concluded in the journal Nature. From New York, it spread to San Francisco around 1976.
The new analysis shows that Mr. Dugas’s blood, sampled in 1983, contained a viral strain already infecting men in New York before he began visiting gay bars in the city after being hired by Air Canada in 1974.
The researchers also reported that originally, Mr. Dugas was not even called Patient Zero — in an early epidemiological study of cases, he was designated Patient O, for “outside Southern California,” where the study began. The ambiguous circular symbol on a chart was later read as a zero, stoking the notion that blame for the epidemic could be placed on one man.
After starting on treatment, the baby’s immune system responded and tests showed diminishing levels of the virus until it was undetectable 29 days after birth. Ten months later, when the baby returned to the hospital (her mother stopped bringing her, without explanation) the researchers tested her again for HIV and found no sign of the virus. It appeared she had been functionally cured.
AIDS patients are susceptible to cancers, but they usually stop taking HIV drugs before receiving cancer treatment. “That allows the virus to come back and it infects their donor cells,” Kuritzkes said.
About 34 million people are infected with HIV, the virus that causes AIDS, globally; 25 million have died from it. While there’s no vaccine, cocktails of powerful antiviral drugs called antiretroviral therapy (ART) can keep the virus suppressed and keep patients healthy. No matter how long patients take ART, however, they are never cured. The virus lurks in the body and comes back if the drugs are stopped. Scientists want to flush out these so-called reservoirs and find a way to kill the virus for good.
Brown, and now these two other men, offer some real hope.
Dr. Timothy Henrich and colleagues at Brigham and Women’s Hospital launched a search about a year ago for HIV patients with leukemia or lymphoma who had received bone marrow stem cell transplants. Bone marrow is the body’s source of immune system cells that HIV infects and it’s a likely place to look for HIV’s reservoirs.
“If you took an HIV patient getting treated for various cancers, you can check the effect on the viral reservoirs of various cancer treatments,” Kuritzkes, who works with Henrich, said. They found the two patients by asking colleagues at Dana-Farber Cancer Institute in Boston which, like Brigham and Women’s, is associated with Harvard Medical School.
Both men had endured multiple rounds of treatment for lymphoma, both had stem cell treatments and both had stayed on their HIV drugs throughout. “They went through the transplants on therapy,” Kuritzkes said.
It turns out that was key.
“We found that immediately before the transplant and after the transplant, HIV DNA was in the cells. As the patients’ cells were replaced by the donor cells, the HIV DNA disappeared,” Kuritzkes said. The donor cells, it appears, killed off and replaced the infected cells. And the HIV drugs protected the donor cells while they did it.
The two men have been HIV-free for two years and three-and-a-half years, respectively. Another man who benefited from a bone marrow transplant from a donor whose immune cells resist HIV infection has been free of HIV for five years. (via @gavinpurcell)
I almost stopped reading this about halfway through because she wouldn’t stop having children, but it’s worth sticking it out until the end. (via dooce)
Doctors who carried out a stem cell transplant on an HIV-infected man with leukaemia in 2007 say they now believe the man to have been cured of HIV infection as a result of the treatment, which introduced stem cells which happened to be resistant to HIV infection.
The man received bone marrow from a donor who had natural resistance to HIV infection; this was due to a genetic profile which led to the CCR5 co-receptor being absent from his cells. The most common variety of HIV uses CCR5 as its ‘docking station’, attaching to it in order to enter and infect CD4 cells, and people with this mutation are almost completely protected against infection.
Scientists are working on two fronts toward a cure for AIDS: 1) neutralizing HIV in the human body so that regular medication is unnecessary, and 2) eradicating all traces of HIV in the body.
Human immune-system stem cells are transplanted into pups bred from these mice when they are two days old, and over the next few months, those cells mature and diversify into a working immune system. Then the mice are infected with HIV, which attacks the immune cells. But before transplanting the original human cells, the researchers introduce an enzyme that interferes with the gene for a protein the virus needs to stage the attack. This modification makes a small percentage of the mature immune cells highly resistant to HIV, and because the virus kills the cells it can infect, the modified cells are the only ones that survive over time. Thus, the HIV soon runs out of targets. If this strategy works, the virus will quickly become harmless and the mice will effectively be cured.
HIV was and remains a “relatively poorly transmitted” virus, he said, so the key to the success of the virus was possibly the development of cities such as Leopoldville in the early 1900s.
The large numbers of people living in close proximity would have allowed more opportunity for new infections.
“I think the picture that has emerged here, is that changes the human population experienced may have opened to the door to the spread of HIV,” he said.
Advertising Age reports (via gulfstream) that despite having spent as much as a reported $100 million on advertising and promotion, the (RED) campaign has raised only $18 million to fight AIDS in Africa. (RED) CEO Bobby Shriver responds by saying that the amount will soon be $25 million, they’re in it for the long haul, and that there are non-monetary benefits to all of the advertising — “A phenomenal benefit is that Gap, Apple, Sprint and other sales people are meeting Americans and explaining that 5,500 Africans dying daily of AIDS is preventable”.
The (RED) campaign strikes me as part of a larger trend in the US (and perhaps elsewhere too): the idea that if you, the consumer, spend normally (or even increase your spending), it is possible to break the law of conservation of energy and somehow save more money or lives. Other examples of the spend-to-save trend include the Discover Card Cashback Bonus program, the Bank of America Keep the Change program, and hundreds of retail promotions where, golly, if you spend another $20 on something you don’t need, you get a free something that you really don’t need.
It seems to me that if The Gap really cared about stopping HIV/AIDS in Africa, they would just donate the $7.8 million they spend on (RED) advertising to the Clinton Foundation. If Discover really cared about saving you money, they’d lower their APR to prime + 1.
I realize that the entire US economy is a house of cards kept standing by the escalation of spending and credit card debt by American consumers, but the sad fact is that to save money, you need to cut spending or increase income. And if you really want to help fight AIDS in Africa, instead of buying that (RED) Gap t-shirt for which Gap will donate 50% of its profit to The Global Fund, buy a cheaper one at American Apparel and send the $13 difference to the Global Fund yourself.
Chris Anderson talked about, ba ba baba!, not the long tail. Well, not explicitly. Chris charted how the availability of a surplus in transistors (processors are cheap), storage (hard drives are cheap), and surplus in bandwidth (DSL is cheap) has resulted in so much opportunity for innovation and new technology. His thoughts reminded me of how surplus space in Silicon Valley (in the form of garages) allowed startup entrepreneurs to pursue new ideas without having to procure expensive commercial office space.
Roger Brent crammed a 60 minute talk into 20 minutes. It was about genetic engineering and completely baffling…almost a series of non sequiturs. “Centripital glue engine” was my favorite phrase of the talk, but I’ve got no idea what Brent meant by it.
Homaro Cantu gave a puzzling presentation of a typical meal at his Chicago restaurant, Moto. I’ve seen this presentation twice before and eaten at Moto; all three experiences were clear and focused on the food. This time around, Cantu didn’t explain the food as well or why some of the inventions were so cool. His polymer box that cooks on the table is a genuinely fantastic idea, but I got the feeling that the rest of the audience didn’t understand what it was. Cantu also reiterated his position on copyrighting and patenting his food and inventions. Meg caught him saying that he was trying to solve the famine problem with his edible paper, which statement revealed two problems: a) famines are generally caused by political issues and therefore not solvable by new kinds of food, printed or otherwise, and b) he could do more good if he open sourced his inventions and let anyone produce food or improve the techniques in those famine cases where food would be useful.
Richard Dawkins gave part of his PopTech talk (the “queerer than we can suppose” part of it) at TED in 2005 (video).
Bob Metcalfe’s wrap-up of the conference was a lot less contentious than in past years; hardly any shouting and only one person stormed angrily out of the room. In reference to Hasan Elahi’s situation, Bob said that there’s a tension present in our privacy desires: “I want my privacy, but I need you to be transparent.” Not a bad way of putting it.
Serena Koenig spoke about her work in Haiti with Partners in Health. Koening spoke of a guideline that PIH follows in providing healthcare: act as though each patient is a member of your own family. That sentiment was echoed by Zinhle Thabethe, who talked about her experience as an HIV+ woman living in South Africa, an area with substandard HIV/AIDS-related healthcare. Thabethe’s powerful message: we need to treat everyone with HIV/AIDS the same, with great care. Sounds like the beginning of a new Golden Rule of Healthcare.
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