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When HIV exploded in the 1980s, scientists had no idea what was making patients so sick. So, what have scientists figured out since then? We explain. Just the FAQs, USA TODAY

People around the world on Sunday observed the 31stannual World AIDS Day, an eventfirst declared in 1981 aimed atraising awareness of the HIV/AIDS epidemic. It was first declared by the World Health Organization.

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 37.9 million people around the world were living with HIV at the end of 2018. UNAIDS reports 1.7 million people worldwide were newly infected in 2018.

The Centers for Disease Control and Prevention reports 1.1 million people were living with HIV in the United States at the end of 2016 and 1 in 7 people nationwide who had the disease didnt know they were infected.

According to the CDC, 37,832 people received an HIV diagnosis in the United States and dependent areas.

Worldwide, 770,000 people died from AIDS-related illnesses in 2018, according to UNAIDS. The CDC reports there were 16,350 deaths among people diagnosed with HIV in the United States. The agency added the deaths may be due to any cause.

An activist paints his hand with AIDS awareness message during a campaign on the eve of World AIDS Day in Kolkata, Eastern India.(Photo: PIYAL ADHIKARY/EPA-EFE)

HIV stands forhuman immunodeficiency virus. AIDS stands for acquired immunodeficiency syndrome.

HIV is a virus that can lead to AIDS.AIDS is the lastof thethree stages of HIV infection.

According to the CDC, people in the first stage, acute HIV infection, experience a flu-like illness within 2 to 4 weeks after infection.Itcan last a few weeks. People in this stagehavelarge amounts of the virus in their blood,and so are more likely to transmit the infection.

The second stage, clinical latency, marks a period where the virus is active but reproduces only at low levels, HIV.gov says. People in this stagemight not experience symptoms but can still transmit HIV to others. This stage can last decades, depending on treatment, but can also be shorter.

AIDS, the third stage,leads to the mostsevere illnessesbecause the virus damages the immune system over time, the CDC says. On average, people with AIDS who don't get treatment survive three years, according to the CDC.

Treatment at all three stagescan prevent or slow symptoms and reduce the risk of transmission, the CDC says.

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Testing is the best way to determine whether you have HIV, but symptoms can occur beforeHIV shows up on a test. Some experience flu-like symptomsincludingfever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodesor mouth ulcerswithin two weeks of infection.

HIV attacks your immune system by reducing CD4 cells, or T cells, makingit harder to fight other infections."Over time, HIV can destroy so many of these cells that the body cant fight off infections and disease," according to HIV.gov.

According to HIV.gov, the condition becomesAIDS whenT cellcounts drop below200 cells per cubic millimeter of blood,or certain AIDS-related complications suchassevere infectionsappear.

Students carry a red ribbon during world Aids day campaign in Dharamsala, India on December 1, 2019. World AIDS Day is observed every December 1 with calls from international health and advocacy organizations for the public to get involved in programs for awareness, prevention and treatment of human immunodeficiency virus infection and acquired immune deficiency syndrome. (Photo: Sanjay Baid, EPA-EFE)

A person can become infected with HIV only through certain activities in which they come intocontact with certain bodily fluids.

Blood, semen, pre-seminal fluid, rectal fluids, vaginal fluidsand breast milk can transmit HIV, according to the CDC.

"These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to occur," the CDC says.

Unprotected anal or vaginal sex with someone who has HIV is one of two main ways the virus is spread in the United States, according to HIV.gov. The use of a contaminated needle or syringe is the other.

A mother may pass the virus on to her child duringpregnancy, birthor breastfeeding. It can also be contracted bybeing struck by an item contaminated with HIV. Other rare but possible ways to spread HIV can be found here.

The Chain Bridge is illuminated in red to mark World AIDS Day in Budapest, Hungary on December 1, 2019.(Photo: Marton Monus, EPA-EFE)

U.S. scientists found the first clinical evidence for the disease that would become known as AIDS in 1981, according to the United Nations. Chimpanzees in Central Africa have been identified as the source of HIV in humans. Their version of the virus, calledSIV,was likely transmitted to humans and then mutated, the CDC says. HIV has existed in the United States since the mid- to late 1970s.

Yes. People with HIV can take a series of drugs, called antiretroviral therapy, or ART,that slows the virus from progressing, keeps them healthy for years and drastically reduces their likelihood of spreading the virus, the CDC says.

epaselect epa08037135 A 3D printed statue of the Dutch AIDS foundation is unveiled in the center of Amsterdam, the Netherlands, 01 December 2019. The image sheds a tear every 40 seconds and was unveiled on the occasion of World AIDS Day. EPA-EFE/ROBIN VAN LONKHUIJSEN ORG XMIT: 402553629(Photo: ROBIN VAN LONKHUIJSEN, EPA-EFE)

Not yet. Researchers are working toward a cure. Ifa cure were to be found, it'd likely take one of two forms, according tothe National Institute of Allergy and Infectious Diseases (NIAID).

Viral eradication would mean HIV was eliminated from a patient's body. The approachwould involve "prodding the virus out of its latent state so that an enhanced immune system or administered therapies can target and eliminate HIV-infected cells," the NIAID says. Researchers are also studying gene mutations in certain people whose immune cells resist HIV.

A functional cure, or sustained ART-free remission, would mean that HIV wasnot eliminated, but rather suppressed to a point at which daily medication would no longer be longer required.

No, but there have been a number of developments. The National Institutes of Health (NIH) opened the first clinical trial with138 healthy, HIV-negative volunteers in 1987, according tothe NIAID.

In 2016,the NIH announced avaccine-efficacy trial in South Africa of 5,400 people, the largest in the country's history. Researchers are building on a 2009 success in Thailand, where for the first time ever a vaccine showed modest success in preventing HIV infections.

Princy Mangaika, executive director of Positive Women's Network (PWN), herself an HIV-infected patient, makes AIDS awareness ribbons at her residence in Colombo, Sri Lanka, on Sunday.(Photo: Chamila Karunarathne, EPA-EFE)

The CDC recommends everyone from ages 13 to 64 get tested at least once.

People at greater risk of infection, such as sexually active gay or bisexual men, people who have had sex with an HIV-positive partner, people who have shared needles and sex workers, among othersshould get tested more often.

The CDC recommends testing once a year for people engaging in these higher-risk behaviors. Forsexually active gay and bisexual men, the CDC says testing every three to six months is beneficial.

If you are pregnant, and even if you are in a monogamous relationship, the CDC recommends testing to be sure and to reduce the risk of transmitting HIV to your child or partner. The sooner a pregnant woman starts treatment, the less likely she is to transmit HIV to her child.

Most HIV tests involve blood or oral fluid. Clinics, hospitals, community health centers and many other locations provide HIV testing. Home testing equipment is also available.

HIV does not always show up right away in a test. Your body and the test type determinehow long HIV can take to be detected. Here's a useful guide from theSan Francisco AIDS Foundation on testing windows.

For more information on local testing sites,call1-800-CDC-INFO (1-800-232-4636) or

visitgettested.cdc.gov.

The red ribbon was created in 1991 by artists in New York workingto increase awareness of HIV/AIDS. The artists saw the red ribbon as an easy-to-copy way to show compassion for those living with HIV, given the stigma surrounding it.

"They chose red for its boldness, and for its symbolic associations with passion, the heart and love," according toWorld AIDS Day organizers.

Contributing: Jordan Culver, USA TODAY

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World AIDS Day 2019: 37.9M people worldwide were living with HIV at the end of 2018 - USA TODAY

LOUISVILLE, Ky.--(BUSINESS WIRE)--The National Stem Cell Foundation (NSCF) announced today that research teams from Aspen Neuroscience and the New York Stem Cell Foundation (NYSCF) Research Institute will send a first-in-kind study of neurodegenerative disease to the International Space Station (ISS) on the nineteenth SpaceX Commercial Resupply Services (CRS-19) mission, scheduled to launch December 4th from the Kennedy Space Center in Cape Canaveral, Florida. This is the second space flight for the research teams. A preliminary experiment was launched to the ISS in July 2019 onboard SpaceX CRS-18 to test custom flight hardware systems and refine post-flight analytical methods in preparation for the SpaceX CRS-19 launch.

The NSCF-funded collaboration between researchers at the NYSCF Research Institute and Aspen Neuroscience will perform the first study of long-term cell cultures of patient-derived induced pluripotent stem cell (iPSC) neural organoids with microglia on the ISS to study Parkinsons disease and primary progressive multiple sclerosis in microgravity. The ability to observe cell interaction, cell signaling, migration, changes in gene expression and the common pathways of neuroinflammation for both diseases in microgravity provides an opportunity to view the biological processes in a way that is not possible on Earth. This innovative approach to modelling disease has the potential to provide valuable new insight into the fundamental mechanisms underlying neurodegenerative disorders that may accelerate biomarker discovery and potential new drug and cell therapy options for patients. These models also offer potential for better translational study and future personalized medicine applications.

The development of patient-specific, 3-dimensional human organoids that incorporate microglia (the inflammatory cells of the immune system implicated in the development of Parkinsons, MS and other neurodegenerative diseases) for observation and study in the unique research environment of microgravity has the potential to enable progress across the field for a wide variety of conditions that affect a significant portion of the global population. The engineering required to facilitate the transport of cells and culture on orbit is being led by space flight engineering partner Space Tango.

Dr. Paula Grisanti, CEO of NSCF said, Supporting this collaboration between world-class research teams during a time of explosive growth in our understanding of the research advances possible in space is a great privilege. We are delighted to be funding such innovative science at the frontier of new drug and cell therapy discovery.

We are thrilled to be working with such a comprehensive team of scientists and fantastic organizations and feel honored to use our technology to better understand neurodegenerative disorders affecting so many persons globally, said Dr. Andres Bratt-Leal, Vice President of Research and Development, Aspen Neuroscience.

We feel privileged to have the opportunity to help understand the behavior of neural cells in microgravity and to help model neurodegenerative disease in such a novel way. We are excited about this fantastic project and look forward to learning the results, said Dr. Jeanne Loring, Chief Scientific Officer, Aspen Neuroscience.

We are excited to collaborate on the first study of progressive multiple sclerosis and Parkinsons patient brain cells in space. This work will provide important insights into the mechanisms behind these diseases and advance targets for future treatments," noted Susan L. Solomon, NYSCF Chief Executive Officer.

There is significant potential to advance our understanding of MS and PD as we initiate these long-term studies of patient cells in microgravity now that we have completed our preliminary tests, said Dr. Valentina Fossati, NYSCF Senior Research Investigator. We look forward to leveraging the unique capabilities of spaceflight research to better understand the role of microglia in multiple sclerosis and Parkinsons disease, as well as how dysfunction in these cells can be targeted therapeutically.

It takes vision, passion, and courage to change the paradigms of current understanding, said Jana Stoudemire, Commercial Innovation Officer at Space Tango. We are honored to support the groundbreaking work of the National Stem Cell Foundation and these recognized leaders in stem cell biology. Their commitment and dedication to advancing the frontiers of science using new tools and new approaches has been inspiring to witness, and has the potential to provide an entirely new perspective on Parkinsons and progressive MS.

To learn more about this unique collaboration, visit https://www.stemcellsinspace.org/.

About The National Stem Cell Foundation (NSCF)

The National Stem Cell Foundation is a 501(c)3 non-profit organization that funds adult stem cell and regenerative medicine research, connects children with limited resources to clinical trials for rare diseases and underwrites the National STEM Scholar Program for middle school science teachers inspiring the next generation of STEM (science, technology, engineering and math) pioneers nationwide. For more information, visit https://nationalstemcellfoundation.org/.

About The New York Stem Cell Foundation (NYSCF) Research Institute

The New York Stem Cell Foundation Research Institute is an independent organization accelerating cures and better treatments for patients through stem cell research. The NYSCF global community includes over 180 researchers at leading institutions worldwide, including NYSCF Druckenmiller Fellows, NYSCF Robertson Investigators, NYSCF Robertson Stem Cell Prize Recipients, and NYSCF Research Institute scientists and engineers. The NYSCF Research Institute is an acknowledged world leader in stem cell research and in developing pioneering stem cell technologies, including the NYSCF Global Stem Cell Array and in enabling large-scale stem cell research for scientists around the globe. NYSCF focuses on translational research in a model designed to overcome the barriers that slow discovery and replace silos with collaboration. For more information, visit http://www.nyscf.org.

About Aspen Neuroscience, Inc.

Aspen Neuroscience is a development stage, private biotechnology company that uses innovative genomic approaches combined with stem cell biology to deliver patient-specific, restorative cell therapies that modify the course of Parkinsons disease. The pipeline technology of Aspen is based upon the scientific work of world-renowned stem cell scientist, Dr. Jeanne Loring, who has developed a novel method for autologous neuron replacement. For more information and important updates, please visit http://www.aspenneuroscience.com.

About Space Tango, Inc.

Space Tango provides improved access to microgravity through their Open Orbit platform for bioengineering and manufacturing applications that benefit life on Earth. With their first operational TangoLab facility installed on the International Space Station in 2016, and a second facility installed in 2017, Space Tango has designed and flown nearly 80 diverse payloads. As a recognized leader in the development of fully automated, remote-controlled systems for research and manufacturing in orbit, Space Tango continues to provide expertise in technology and scientific consulting for industry and academic partners. Leveraging this current work, Space Tango is developing new commercial market segments in space with the announcement of ST-42 a fully autonomous orbital platform designed specifically for scalable manufacturing in space. Space Tango envisions a future where the next important breakthroughs in both technology and healthcare will occur off the planet, creating a new global market 250 miles up in low Earth orbit. For more information, visit http://www.spacetango.com.

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With the cold and flu season upon us, there are other protective measures we can take beyond just regularly washing our hands. Food is powerful medicine that can kick our immune systems into gear, both to fend off viruses as well as reduce the severity and duration of symptoms such as congestion, sore throat and fatigue.

I often prescribe these essentials as part of any cold-sufferers diet:

Garlic

Garlic has been studied for centuries for its anti-bacterial properties. When garlic is sliced, chewed or crushed, sulfur compounds such allicin, diallyl disulfide, vinyldithiins and s-allyl cycteine are activated (giving off that distinctive garlic smell). These have been shown to support the disease-fighting response of some types of white blood cells, helping them to fight viruses. Garlic can also be taken as a preventative supplement: I recommend 300 mg a day, or incorporating one to two fresh cloves daily into your diet, including in salad dressings, green juices, or simply rubbing it on whole grain bread for delicious flavored toast.

Chicken Soup

Good, old fashioned chicken soup has been used forever as a common cold aide and there are some real benefits. The warm broth can help alleviate congestion and the electrolytes (sodium) found in the broth can help keep you hydrated and soothe a sore throat. The added chicken and vegetables provide additional protein and nutrients, with carrots, celery, onion, turnip and fresh herbs supplying an even bigger nutritional boost.

Tea

When you arent feeling your best, warm fluids can soothe that scratchy throat and help to loosen mucus. Opt for decaffeinated tea as caffeine is dehydrating, which is the last thing you need when you are trying to flush a virus from your system. I always recommend ginger tea, as it can soothe a stomach thats upset from loose mucus draining into the digestive system. Ginger also has anti-inflammatory properties that assist with immune function.

Non-Fat Greek Yogurt

Loaded with live cultures and probiotics, yogurt helps to keep your gut lining healthy. Approximately 70% of our immune system is located in our gut, so it is important to keep it in good fighting shape in case your body encounters a virus. Consuming probiotic rich foods can lower the risk of catching a cold and help to speed recovery if you have caught one. Another perk, non-fat Greek yogurt has triple the protein of regular yogurt (without the added sugar).

Red Bell Peppers

Vitamin C is essential for the function of immune cells, and during infections our bodies quickly become deficient of this vitamin. Eating foods rich in vitamin C during a cold or virus can speed the bodys recovery and reduce symptoms. Since vitamin C is water soluble, its more efficient to consume it through foods high in vitamin C, such as red bell peppers, rather than from solid supplements which require more work for the body to digest and absorb. One cup of chopped red bell pepper contains 190 mg of this important vitamin. Other foods high in vitamin C include kiwifruit, broccoli, dark leafy greens and citrus fruits.

Blueberries

Blueberries are a great source of anthocyanins, a type of flavonoid that gives the berry (and other colorful fruits and vegetables) its rich, deep color. Flavinoids have anti-inflammatory, anti-bacterial and antioxidant properties that can help reduce cell damage and boost immune function. A powerhouse berry thats low in calories, you can snack on them, add to salads or treat yourself to a crumble.

Diane May, MPH, MS, CDN, RD, CSOWM is a registered dietitian with Scarsdale Medical Group. To make an appointment, call (914) 723-8100.

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What To Eat When You Have a Cold - theLoop

When babies are born with HIV, starting treatment within hours to days is better than waiting even the few weeks to months thats the norm in many countries, researchers reported Wednesday.

The findings, from a small but unique study in Botswana, could influence care in Africa and other regions hit hard by the virus. They also might offer a clue in scientists quest for a cure.

The Harvard-led team found super early treatment limits how HIV takes root in a newborns body, shrinking the reservoir of virus that hides out, ready to rebound if those youngsters ever stop their medications.

We dont think the current intervention is itself curative, but it sets the stage for future attempts, said Dr. Daniel Kuritzkes of Bostons Brigham and Womens Hospital, who co-authored the study.

Giving pregnant women a cocktail of anti-HIV drugs can prevent them from spreading the virus to their unborn children, a step that has dramatically reduced the number of babies born with the virus worldwide. Still, some 300 to 500 infants are estimated to be infected every day in sub-Saharan Africa.

Doctors have long known that treating babies in the first weeks to months of life is important, because their developing immune systems are especially vulnerable to HIV. But an infant dubbed the Mississippi baby raised a critical question: Should treatment start even earlier? The girl received a three-drug combination within 30 hours of her birth in July 2010, highly unusual for the time. Her family quit treatment when she was a toddler yet her HIV remained in remission for a remarkable 27 months before she relapsed and restarted therapy.

The Botswana study was one of several funded by the U.S. National Institutes of Health after doctors learned of the Mississippi baby, to further explore very early treatment.

The findings are encouraging, said Dr. Deborah Persaud, a pediatric HIV specialist at Johns Hopkins University who wasnt involved with the Botswana study but helped evaluate the Mississippi baby.

The study showed what we hypothesized happened in the Mississippi baby, that very early treatment really prevents establishment of these long-lived reservoir cells that currently are the barrier to HIV eradication, Persaud said.

She cautioned: Very early treatment is important, but prevention should still be our top priority.

In Botswana, researchers tested at-risk newborns, enrolling 40 born with HIV, treating them within hours to a few days, and tracking them for two years. On Wednesday, they reported results from the first 10 patients, comparing them with 10 infants getting regular care treatment beginning when they were a few months old.

Medication brought HIV under control in both groups. But the children treated earliest had a much smaller reservoir of HIV in their blood, starting about six months into treatment, the researchers reported in Science Translational Medicine.

The earliest-treated children also got another benefit: more normal functioning of some key parts of the immune system.

One big question: Did the HIV reservoir shrink enough to make a long-term difference? To find out, next year the researchers will give these children experimental antibodies designed to help keep HIV in check, and test how they fare with a temporary stop to their anti-HIV drugs.

In the U.S., Europe and South Africa, its becoming common to test at-risk infants at birth. But in most lower-income countries, babies arent tested until theyre 4 to 6 weeks old, said study co-author Dr. Roger Shapiro, a Harvard infectious disease specialist.

Lauran Neergaard

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Human herpesvirus 6A (HHV-6A), but not awidespread variant of the virus called HHV-6B, could be one of the root causes of multiple sclerosis (MS), new research suggests.

Compared to healthy people, those with MS show greater numbers of antibodies to HHV-6A viruses, reflecting greater exposure to this type of infection and suggesting a link to this disease.

The study reporting these findings, Increased serological response against human herpesvirus 6A is associated with risk for multiple sclerosis, was published in the journal Frontiers in Immunology.

While the origin of MS remains unclear, research has proposed that viral infections by HHV-6 could be one of its causes.

The hypothesis is that the virus is able to mislead the immune system into attacking the bodys own tissues, damaging the brain and spinal cord.However, it has been impossible to say which specific type of the virus 6A or 6B is responsible for such risk.

HHV-6B is a very common virus acquired early in life. About 80% of all children are estimated to be infected before the age of 2. In children, HHV-6B can cause relatively mild conditions such as roseola, an illness marked by days of high fever, rashes, and, in some cases, febrile seizures.

Less is known about the consequences of HHV-6A, although this specific variant has been linked with MS.

Upon exposure to HHV-6, a persons immune system raises antibodies against specific viral proteins, which help to protect them against the virus for the rest of their lives. The presence of these specific antibodies can be tested in blood samples to find whos been exposed to the virus.

As HHV-6A and HHV-6B are extremely similar, it has not been possible to date to determine which of these herpes viruses the antibodies are reacting against when a person tests positive for this viral infection through a blood test.

Scientists at theKarolinska Institutet in Sweden devised a way to overcome this problem.

They were able to distinguish between 6A and 6B types by measuring antibodies in the blood that recognize the proteins that diverge most between the two viruses called immediate early protein 1A and 1B (IE1A and IE1B).

Researchers compared antibody levels in blood samples of 8,742 people with MS and 7,215 healthy people, all in Sweden and matched for gender, date of birth, and other factors.

Results showed that MS patients had a 55% higher risk of carrying antibodies against HHV-6A than healthy people.

Further analysis in a group of 478 patients whose blood samples were collected before the onset of MS showed that viral infection by HHV-6A more than doubled a persons risk of developing MS later on.

Researchers also saw that the younger the age at which patients tested positive for the HHV-6A virus, the higher the risk of MS.

In contrast, carrying antibodies against HHV-6B was not associated with MS development. In fact, MS patients tended to have lower amounts of antibodies against this type of virus than people without this disease.

This is a big breakthrough for both the MS and herpes virus research, Anna Fogdell-Hahn, an associate professor at Karolinska and one of the studys senior authors, said in a news story.

For one, it supports the theory that HHV-6A could be a contributing factor to the development of MS. On top of that, we are now able, with this new method, to find out how common these two different types of HHV-6 are, something we havent been able to do previously, Fogdell-Hahnadded.

Infection by another herpes virus, called Epstein-Barr virus (EBV) and best known as the cause of mononucleosis, also has been proposed as a risk factor for MS.

Researchers analyzed antibodies against EBV, and observed that individuals affected with both viruses EBV and HHV-6A had an even higher risk of developing MS.This indicates that multiple viral infections can act together to raise a persons susceptibility to the disease.

Both HHV-6A and 6B can infect our brain cells, but they do it in slightly different ways. Therefore, it is now interesting to go forward and attempt to map out exactly how the viruses could affect the onset of MS, Fogdell-Hahn said.

A cause-effect relationship between the virus and MS, however, is not by any means established, and more studies are needed, the team emphasized.

For more information about this research, the Karolinska Institutet posted a video that can be viewed usingthis link.

Ana is a molecular biologist with a passion for discovery and communication. As a science writer she looks for connecting the public, in particular patient and healthcare communities, with clear and quality information about the latest medical advances. Ana holds a PhD in Biomedical Sciences from the University of Lisbon, Portugal, where she specialized in genetics, molecular biology, and infectious diseases

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Patrcia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.

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MS Risk Linked to Herpes Virus 6A and Not More Common 6B, Study Suggests - Multiple Sclerosis News Today

My New Democratic MLA, David Shepherd, was in the local paper Monday morning. Davids a pleasant fella, and I always feel awkward exposing Edmonton news items like worn-out ginch to a national audience, but he has presented an example of something that happens all across the country, all the time, and that ideally wouldnt, or shouldnt.

You see, there was a small protest at the Alberta legislature on Sunday. The hundred or so protesters were sufferers (and friends of sufferers) of inflammatory bowel disease Crohns and ulcerative colitis. The IBD patients recently received a letter from Janssen Inc., which makes one of the miracle drugs of our time, Remicade.

Remicade is a monoclonal antibody a mab, as your pharmacist would say to another pharmacist. This means its an ultra-complicated lab-designed molecule that is somewhat like a prosthesis for your immune system. Before Remicade, the old approach to IBD disorders was to wait until they became disabling or life-threatening, as opposed to just colossally inconvenient and painful, and then deluge them with steroids. With Remicade, many patients with severe IBD can live in remission indefinitely.

This is not cheap, which is why vis prescribed to only a fraction of those with IBD. Remicade is nonetheless the single largest prescription drug expense, by far, that the Alberta government has. In the year ending March 31, 2018, Alberta Health spent more than $80 million dispensing the drug to 2,535 patients.

You might expect that this situation would attract the attention of capitalism, and countless drug companies are indeed developing biosimilar alternatives to Remicade. Health Canada, acting more slowly than other developed countries, has approved a couple.

Biosimilars are drugs that have the same overall molecular structure as some reference drug and have been shown in the laboratory to target the same receptors in the body. Simple molecules dont attract imitators like these, but the mabs are (on the molecular scale) huge, intricate wads whose activity may not be perfectly understandable. Mabs were introduced because in-vitro laboratory drug creation using computer models and biological first principles got a lot better around the turn of the century. Biosimilar rivals, marketable for lower cost, exist for the same reason.

Remicade is the single largest prescription drug expense that the Alberta government has

So government drug plans have been itching to move patients onto cheaper biosimilars, or perhaps force discounts on Remicade. In British Columbia, the government a New Democratic government is currently in the process of switching everybody to biosimilars by fiat, with exceptional Special Authority approval (!) required for patients who prefer the name brand. Janssen wrote to Remicade patients when it learned that Alberta and Ontario were also eyeing their big Remicade bills.

Alberta hasnt decided whether to follow B.C.s guillotine approach. Theres a serious, evolving discussion about the evidence base for the biosimilars. It is fairly well established that patients can switch to one of the best biosimilars without risk, and that the biosimilars behave like the name brand within the immune system as far as any testing can show. But the empirical studies have been short in duration, and no one has been able to check what happens if doctors engage in multiple switching among biosimilar molecules.

This should not be a partisan conversation, but, well, if you are protesting on the legislature steps, your handmade sign is not going to read The magnitude of the nocebo effect is contested! The Sunday protest in Edmonton was led by a Crohns patient, Nick Arrand, who told the Journals Jonny Wakefield, The government should have no right to tell you what medications to take.

The story adds that Mr. Arrand is on his wifes insurance, so the government is not, in fact, telling him what medications to take. His insurer, one supposes, might eventually have something to say about it. Should he picket that companys headquarters if this happens? Or should he go bother Janssen about the price of Remicade? What would Bernie Sanders do?

For patients on government health plans, the government does decide what to pay for (if there were a punctuation mark meaning duh, it would go here), and it has no choice but to take cost into account, as an NDP-led government in idyllic B.C. has. This did not discourage MLA Shepherd from joining the Edmonton protest to denounce barbarous right-wing Alberta-government cost-chopping that might or might not happen. And which is, at root, a negotiation between Albertas public treasury and a constellation of drug manufacturers.

What would Bernie Sanders do?

Shepherd accused the Conservatives of intending to try to force their way into the doctor-patient relationship and force these individuals to switch onto new, unproven biosimilars. This is a curious departure from the official position of Crohns and Colitis Canada, which is that Biosimilars are a safe and effective treatment for people with Crohns disease and ulcerative colitis.

The charity, which receives funding from Janssen and organized the pro-Remicade demonstration, expresses concerns with non-medical switching of drugs for cost reasons alone. But it also concedes, quite explicitly, that in these here social democracies, none of us exists in a consecrated doctor-patient relationship without the presence of a third party footing the bill. Even when Bill Gates gets sick, he doesnt ask for the most expensive drug on principle.

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Colby Cosh: Barbarous right-wing cost-chopping ... pioneered by the B.C. NDP? - National Post

The ability to fight disease is a driving force in human survival. Inflammation has emerged as a key weapon in this process. As pathogens change and evolve, the immune system adapts to keep up.

However, to what extent might such evolutionary adaptations also give rise to autoimmune conditions such as lupus and Crohn's disease?

This was a central question in a recent Trends in Immunology review by two scientists from Radboud University, in Nijmegen, Netherlands.

To address the issue, first author Jorge Domnguez-Andrs, a postdoctoral researcher in molecular life science, and senior author Prof. Mihai G. Netea, chair of experimental internal medicine, examined studies in the fields of virology, genetics, microbiology, and immunology.

They focused on people of African or Eurasian descent and how their ancestral origins may have influenced their risk of autoimmune diseases.

Of particular interest was how common pathogens in different communities related to changes in people's DNA, particularly when this involved inflammation.

The team found that the genetic changes made it harder for pathogen infections to take hold.

Over time, however, it seems that inflammation-related diseases, such as inflammatory bowel disease, Crohn's disease, and lupus, have emerged alongside improvements in immune defenses.

The findings also suggest that the human immune system continues to evolve and adapt to changes in environment and lifestyle.

"There seems to be a balance," says Domnguez-Andrs.

"Humans evolve to build defenses against diseases," he continues, "but we are not able to stop disease from happening, so the benefit we obtain on one hand also makes us more sensitive to new diseases on the other hand."

He observes that autoimmune diseases in today's humans tend to emerge later in life. These would not have caused health problems for our ancestors because their lives were much shorter.

"Now that we live so much longer," he explains, "we can see the consequences of infections that happened to our ancestors."

One of the examples that Domnguez-Andrs and Netea cover in detail in their review is malaria.

"Among various infectious diseases," they write, "malaria has exerted the highest evolutionary pressure on the communities across the African continent."

Malaria is a mosquito-borne disease that makes people very ill with flu-like symptoms, such as chills and a high fever.

While there has been much progress in the fight to control and eliminate the potentially fatal disease, it continues to threaten nearly half of the world's population, according to the World Health Organization (WHO).

The cause of malaria is parasites belonging to the species Plasmodium. These parasites spread to humans through the bites of infected female Anopheles mosquitoes.

Domnguez-Andrs and Netea note that Plasmodium has been infecting people in Africa for millions of years. During that period, the immune systems of those human populations have evolved stronger resistance to infection by increasing inflammation.

However, the downside of increasing inflammation to withstand infectious disease is that it favors health problems that tend to occur later in life.

Modern humans of African descent are more prone to developing such conditions, which include atherosclerosis and other cardiovascular diseases.

Another example of how ancestral changes in DNA leave imprints in the immune systems of modern humans is the interbreeding of early Eurasians with Neanderthals.

Modern humans whose genomes harbor remnants of Neanderthal DNA have immune systems that are better able to withstand staph infections and HIV-1. However, they are also more prone to asthma, hay fever, and other allergies.

Improvements in technology are making it more possible to find the downsides that can accompany disease-fighting adaptations.

Next generation sequencing, for example, is allowing scientists to delve more deeply into what happens at the DNA level between pathogens and the organisms that they infect.

Not only is new technology getting better at revealing genetic changes that occurred in our ancestors, but it is also showing that the human immune system continues to evolve and adapt.

In Africa, there are still tribes that hunt for food as their ancestors did. Thanks to new tools, scientists can see how the gut bacteria of these tribes are more diverse than those of, for example, contemporary African American people, who buy food in stores.

Other changes that have had an effect on DNA are the improvements in hygiene that have occurred in recent centuries. These have reduced exposure to pathogens and the diversity of gut bacteria.

"This reduced microbiota diversity in Western societies," the authors observe, "has been associated with a higher incidence of the so-called 'diseases of civilization,' such as cardiovascular diseases, diabetes, obesity, and autoimmune disorders, which are very unusual in hunter-gatherer societies, compared with communities living a Western-type lifestyle."

Domnguez-Andrs and Netea are extending their research to populations whose ancestry is other than African or Eurasian.

"Today, we are suffering or benefiting from defenses built into our DNA by our ancestors' immune systems fighting off infections or growing accustomed to new lifestyles."

Jorge Domnguez-Andrs, Ph.D.

See the original post:
Humans and autoimmune diseases continue to evolve together - Medical News Today

The burden of flu on our society is tremendous The Centers for Disease Control and Prevention (CDC) estimates that influenza has resulted in between 9.3 million 49.0 million illnesses, between 140,000 960,000 hospitalizations and between 12,000 79,000 deaths annually since 2010.

The CDC recommends that everyone 6 months of age and older should get an influenza (flu) vaccine every year, with rare exceptions.

The primary reason to not get the flu vaccine is an allergy to one of the components of the vaccine (for example gelatin) or an allergy to eggs (because the virus is raised in eggs). If you have had the rare neurologic condition called Guillian-Barre Syndrome, you also should not get the vaccine.

The standard flu shot is given into the muscle of the arm and this is the form recommended for most persons. There is an intradermal form that is injected into the skin using a much smaller needle. This form can be given to persons age 18 to 64 years.

Persons over age 65 are recommended to get the high dose form of the vaccine Fluzone high dose. This form of the vaccine contains four times as much antigen (the part of the vaccine that causes the body to form antibodies against the flu virus) as the standard vaccine. The higher dose is intended to give older persons better protection by causing a better immune response. Vaccines are also available that contain an adjuvant. An adjuvant is an ingredient that helps to cause a greater immune response. This form of the vaccine is recommended for persons age 65 and older.

A nasal form of the vaccine is also available. This form of the vaccine provides protection against two forms of influenza A and two forms of influenza B. It may be given to persons age 2 through 49 years. This form of the vaccine contains a weakened but living form of the viruses. It is not recommended for pregnant women, persons with weakened immune systems and young children with asthma or who are taking aspirin. Ask your doctor if you can use this form of the vaccine.

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The flu vaccine is especially important for persons at high risk of complications from the flu. High risk groups include: persons over the age of 65 years; persons with diabetes; persons with asthma or chronic lung diseases (chronic obstructive pulmonary disease and cystic fibrosis); persons with chronic kidney or liver disease; persons with weakened immune systems (those with HIV or AIDS). Certain cancers (especially leukemia), persons receiving chemotherapy or radiation therapy for cancer and persons on drugs that weaken the immune system are also at increased risk. Again it is important to ask your healthcare provider about your risk and whether it is safe for you to get the vaccine.

If despite getting the vaccine you get the flu, avoid contact with other persons (as much as possible except to seek medical help) until your fever has been gone for 24 hours.

Dr. Samuel Abbate is a local physician practicing in Wasilla.

Originally posted here:
Who needs the flu vaccine? | Valley Health - Mat-Su Valley Frontiersman

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"People will judge me, but I'd just say walk a mile in my shoes."

Jane, not her real name, was 17 years old when she was diagnosed with HIV.

"I'd only slept with one person when I got HIV, I know people will hear that and think it's a sob story, but it's the truth," she told BBC News NI.

When Jane was diagnosed she was one of the youngest women in Northern Ireland known to have the virus.

HIV is a virus which, over time, damages the human immune system leading to illness and infection.

There are 1,130 people receiving treatment for HIV in Northern Ireland. It is not known how many more people are living with the virus undiagnosed.

The charity Positive Life says there is still a myth that it's a "gay man's disease".

Figures show that in Northern Ireland almost 40% of those living with HIV contracted the virus through heterosexual contact and more than 200 women have been diagnosed HIV-positive.

"When I was first diagnosed, I started to research stuff online and I watched some films where people had HIV and it really scared me," said Jane.

"It showed people getting really sick and their skin started to get really bad and it showed people dying. I thought: 'Is this what is going to happen to me?'"

In 2018, 96,142 people were receiving HIV-related care across the UK.

HIV - Human Immunodeficiency Virus - is a virus which, over time, damages the human immune system.

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The immune system is the body's defence against infectious organisms and infections. Problems with the immune system can lead to illness and infection.

Aids - Acquired Immunodeficiency Syndrome - is the result of damage to the immune system caused by HIV.

Jane's mother admits she initially struggled with her daughter's diagnosis.

"At the start, I had all the stereotypes and stigmas in my head that you could think of.

"I just thought: 'This can't be happening to her.' And how unfair it was to be happening to someone her age, to someone who wasn't promiscuous.

"But I know now it doesn't matter if you're promiscuous or not, it only takes one time, and the rest of your life can be changed forever."

Those living with HIV have the same life expectancy as those without the condition, thanks to antiviral treatments used since 1996.

Following her diagnosis, Jane began medication which suppressed the virus and made HIV levels virtually undetectable in her system.

This meant it couldn't be transmitted - even through sexual activity.

Since then, Jane has given birth to a baby boy.

"During my pregnancy I was on three different types of tablets to make sure that my baby wouldn't get HIV," she said.

"I have a wee boy now, but the medication worked, because he doesn't have HIV.

"HIV isn't going to stop me being there for my son. I still have a roof over my head, I have family support."

There were 4,500 pregnancies to HIV-positive women in the UK and Ireland between 2015 and 2018.

Of those, less than 20 have transmitted the virus to their children, either through pregnancy, birth or breastfeeding.

There are still many misconceptions about HIV, according to the charity Positive Life.

"People will still ask if you can catch HIV off a toilet seat or by using the cutlery of people who are HIV-positive - there is still a lot of negative language around it, " said Positive Life's Jacquie Richardson.

"The three biggest myths we hear are that it's a gay man's disease, that it's contracted as a result of a promiscuous lifestyle and that you'll die if you've a diagnosis.

"We're working very hard to counter those myths."

GETTY

in Northern Ireland

There is still a lot of work to be done to educate the public about women and HIV, said Ms Richardson.

"Many people wouldn't even consider that if a woman is HIV-positive she can now, through early diagnosis and medication, have a baby that doesn't have HIV, and that's a powerful message," she said.

"That's why stories like Jane's are so important in challenging all the myths and misconceptions.

"This is a young woman from Northern Ireland, engaging in her first sexual activity, in a heterosexual relationship and she contracts HIV - all of the stereotypes and assumptions people associate with HIV are turned on its head by this very powerful story."

Jane's mother believes more should be done to educate young people about the risks of contracting HIV.

"HIV is still such a taboo subject," she said. "My daughter's story shows it's possible for a young girl in her prime to get HIV and I believe more could be done around sexual education in schools."

She added: "Because of organisations like Positive Life, we're more informed now. We know her HIV can't be cured, but it can be treated.

"But that also means she is going to be on very strong medication for the rest of her life and that does worry me."

Jane is determined not to be defined by being HIV-positive.

"I can't change the past, but what I would say to anyone, if you're sexually active, whether it's your first time or not, just be safe," she said.

"I have to live with the fact that I'm HIV-positive, but I won't let it ruin my life."

Continued here:
HIV, my baby and me: 'I was 17 years old when I was diagnosed' - BBC News

Early treatment with antiretroviral therapy, an HIV drug not usually administered right after birth, can help babies born with the virus that infects 300-500 infants in sub-Saharan Africa every day, Boston doctors have determined.

We find that ART initiation within hours after birth is doable and translates into multiple benefits for the infants lower frequencies of reservoir cells and improved immune responses, said corresponding author of the study published in Science Translational Medicine, Dr. Mathias Lichterfeld, associate infectious disease physician at Brigham and Womens Hospital.

Antiretroviral therapy is a combination of at least three drugs that are highly effective at suppressing HIV and stopping its progression.

The therapy is not typically given to babies right after birth, but new research shows the number of infected cells in HIV-positive babies given the treatment within days or hours of birth was extremely small compared to infected infants who started treatment later.

What excites me most about this work is that making a comparatively small change in the timing of treatment may have a large impact on long-term treatment outcomes, said Lichterfeld.

The study was conducted in two major maternity hospitals in the Francistown and Gaborone regions of Botswana, a country with the third-highest HIV-1 prevalence in the world.

HIV progresses much faster in infants than in adults because of their weaker immune systems.

Infants enrolled in the study began treatment right after birth and researchers compared their results to those of infants not in the study who received the drug within a median of four months after birth. The babies were then followed for two years with blood sampling at regular intervals.

The study was small and focused on 10 HIV-positive babies that were enrolled. A total of 40 infants have been recruited into the study and samples from the remaining babies are now being analyzed.

A new clinical trial has also been started with some of the same infants in which a different treatment is being evaluated.

As of June, an estimated 24.5 million people globally were accessing antiretroviral therapy, according to the Joint United Nations Program on HIV/AIDS.

Antiretroviral therapy does not cure HIV, but helps infected patients live longer and healthier lives. It also reduces the risk of HIV transmission by lessening the amount of the virus in the body, which in turn gives the immune system a chance to recover.

Nearly 38 million people across the globe were living with HIV as of last year and about 8 million didnt know they were infected.

See the article here:
Boston docs: Early treatment helps African babies with HIV - Boston Herald

Longstanding research has found that exercise that increases our cardiovascular activity brings a number of health benefits, including lowered blood pressure; improved cardiovascular health; strengthening of the immune system; regulation of weight; and moderation of blood sugar. Interestingly, it appears that vigorous aerobic activity (maintaining more than 60% of aerobic capacity) brings greater cardiovascular health benefit than moderate activity. Exercise therapy has been found to improve a measure called heart rate variability, which is associated with greater levels of psychological well-being and resilience in the face of stress. One strand of research finds that aerobic exercise conducted in a mindful state (i.e., with enhanced self-awareness, such as yoga and Feldenkrais) brings greater mood benefits than routine vigorous or moderate cardio workouts. Many of the activities we associate with self-development, from counseling and psychotherapy to meditation, are pursued in a state of reduced physical activity and enhanced self-awareness. Might it be the case that vigorous aerobic activity is an equally promising path toward emotional well-being and a positive psychology?

According to the National Institutes of Healths National Center for Complementary and Integrative Health, yoga, a discipline of meditative movement is associated with such benefits as stress relief, pain reduction, and emotional well-being. There is also evidence that yoga also improves the aforementioned heart rate variability and lessens symptoms of depression. In an excellent review article, Julia Belluz notes the limitations of much of the research on the benefits of yoga, but cites fascinating evidence that yoga may be uniquely helpful in reducing inflammation in the body. Similar amounts of time spent in yoga and general physical activity yield greater inflammation benefit for the yoga participants, presumably because of the added components of mindfulness.

In a review of brief approaches to psychotherapy that I conducted with two colleagues at SUNY Upstate Medical University in Syracuse, an important conclusion was that these methods are effective to the degree that they generate novel, constructive experiences for clients. Such corrective emotional experiences deal with maladaptive patterns of emotion and behavior by activating more constructive ones. Thus, for instance, when a client retreats from a therapist out of fear of rejection, the therapist may encourage engagement and provide an active experience of acceptance and understanding. Such emotional experiences are readily internalized, helping people build new modes of construing and doing. This is the basis for many behavioral and cognitive therapies, where we learn to face and challenge our patterns of anxiety, negative thinking, and depression in emotionally impactful ways.

The unexpected benefits of aerobic exercise, yoga, and similar disciplines may arise from their ability to provide similar corrective emotional experiences, albeit outside of a therapeutic relationship. Through vigorous exercise, we directly challenge our limits and experience ourselves as efficacious and achieving. Through mindful movement, we experience enhanced levels of self-control and mastery. A great example of this occurs among the money managers and traders I work with, who make active use of meditation to deal with the stresses of markets and their inherent risks and uncertainty. In the midst of threat, direct experiences of calm and focus promote a unique experience of the self as being in control, facilitating sound decision-making. Exercise, like coaching, counseling, and psychotherapy, is a vehicle for generating fresh experiences of the self, reinforcing and expanding our strengths.

In recent articles, Ive explored the psychological benefits of living a purposeful life and the importance of emotionally connecting with a positive vision of our future selves. All of these can be paths toward emotional resilience, increased mindfulness, and an enhanced capacity to pursue life goals. In a recent interview, Steven Goldstein and Mark Randall explore the mindfulness associated with special forces operations, highlighting the idea of mindfitness. A well-constructed program of exercise, expanding our abilities to extend our limits and sustain self-control and efficacy, provides a uniquely effective form of self-developmenta promising therapy for the mentally well and program for mindfitness.

More:
The Unexpected Psychological Benefits Of Aerobic Fitness - Forbes

FOXBOROUGH, Mass. In a Patriots locker room thats battling widespread illness recently and plenty of injuries during the season, quarterback Tom Brady said hes managed to stay unaffected.

Im a pretty healthy guy. Cant avoid it all the time. I try to for the most part. I keep my immune system nice and strong if possible, he said Friday as the Patriots prepare for Sunday nights game at Houston.

His immune system might be able to stop the flu, but it cant hold off opposing defenders.

I wouldnt be in the self-preservation business if I was trying to be a football player, said Brady, who is expected to play Sunday. Youre going to get hit. You just have to understand thats part of the game. You have to understand when they blitz, you dont have as much time to throw. So you have to throw the ball a little quicker. ... Taking hits is part of it. My whole objective is standing there and trying to get the ball to someone who can do something with it.

He said throwing the ball away is more about protecting a drive and protecting possession than protecting himself.

Im throwing it away because I dont want to take a sack, Brady said. I think negative plays actually have a big impact on the game. Turnovers and negative plays I think really keep you from winning games. So, if you can drop-back pass, because Im not really a scrambler ... But, if Im going to hold it back there, then usually good things arent going to happen. So, I try to throw the ball away to save plays and live for the next down.

Pats getting healthier

All that Vitamin C is finally paying off for the Patriots. After a flu bug ripped through their locker room eight players missed Wednesdays practice with illness they were almost at full strength for Fridays walkthrough.

Kyle Van Noy was a new absence, and Ryan Izzo has been out all week with the flu. One of the leagues best linebackers, Van Noy will be sorely missed if he isnt good to go by Sunday.

Donta Hightower, Isaiah Wynn and JoeJuan Williams all returned. All three players were healthy enough for Fridays walkthrough. The biggest takeaway from Friday: The Patriots seem to have weathered the worst of their flu bug.

Players listened to an assortment of college football fight songs on Friday. With rivalry games all weekend, the Patriots were listening to band songs. Tom Brady pumped his fist when Michigans The Victors began.

See the original post here:
Hey, Brady's healthy; Pats' Hightower, Wynn return to practice - The Union Leader

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Findings, in mice, could guide research into future therapies

A new study led by Washington University School of Medicine in St. Louis reveals details about how gut microbes interact with norovirus infection in the mouse gut. The research opens up new ways of thinking about potential therapies for this intestinal infection. Shown are Norovirus particles.

The highly contagious norovirus causes diarrhea and vomiting and is notorious for spreading rapidly through densely populated spaces, such as cruise ships, nursing homes, schools and day care centers. Each year, it is responsible for some 200,000 deaths, mostly in the developing world. There are no treatments for this intestinal virus, often incorrectly referred to as stomach flu.

Now, a new study led by scientists at Washington University School of Medicine in St. Louis has shown that gut microbes can tamp down or boost the severity of norovirus infection based on where along the intestine the virus takes hold.

The study, published Nov. 25 in the journal Nature Microbiology, suggests new routes to possible therapies for norovirus infection. Collaborators included researchers at the University of Florida, the University of Michigan and Yale University Medical School.

There are currently no treatments for norovirus, which is very easily spread through fecal-oral transmission, said co-senior author Megan T. Baldridge, MD, PhD, an assistant professor of medicine at Washington University. Norovirus is especially dangerous in young children, older adults and people with compromised immune systems. We are trying to understand how the gut microbes interact with norovirus in an effort to pursue new therapeutic strategies.

In these mouse studies, the researchers found that normal gut bacteria boosted the severity of viral infection in the lower small intestine, which is in line with past work in the field. But simultaneously, normal gut bacteria blocked or inhibited viral infection in the upper small intestine. In other words, gut microbes can have totally opposite effects on norovirus infection depending on the infections location along the length of the gut.

These results were a huge surprise to us, Baldridge said. We showed that different parts of the intestine can show dramatically different responses to this type of infection. Our research reveals that we cant view the gut as a homogeneous tube that responds to infection in a uniform way.

Baldridge and her colleagues found that the difference in response was driven by bile acids, which are mainly known for their roles in digestion.

Bile acids are powerfully regulated by bacteria all along the gut, Baldridge said. But there had not been a realization that these bile acids could prime the gut to mount an immune response against intestinal viruses.

In the new study, the researchers showed that bile acids in the upper small intestine but not the lower stimulated the immune system to respond to the infection. The researchers determined that bile acids in that region of the gut triggered a molecule called interferon III one of the bodys key antiviral defenses in the intestine to become activated.

Baldridge noted that this complexity of interactions between gut microbes and bile acids could explain some of the variability seen in norovirus infections. Some people become extremely ill with this virus; others develop no symptoms at all.

The different ways people respond to viral infections could be related to their individual gut microbial community, Baldridge said. The severity of an infection could be tied to where exactly along the gut you get an infection, and that might be controlled by your individual microbiome. Subtle differences along the intestine could end up having dramatic effects on how the gut perceives the virus and responds to it.

Baldridge also said that this changes how researchers might think about strategies to protect against or treat norovirus infection. They might seek ways to expand the immune interferon signaling that they observed only in the upper small intestine such that it extends along the entire length of the gut, for example.

She and her colleagues are planning more studies to help investigate whether there may be ways to manipulate the gut environment through bile acids or the microbiome itself to stimulate the immune system in ways that could shut down norovirus infection.

This work was supported by the National Institutes of Health (NIH), grant numbers R01AI116892, R01AI081921, R01AI141478, R01AI141478, K22 AI127846-01, P30 DK052574, R21 AI103961, T90DE021990, T32DK094775, K08 AI28043; the Global Probiotics Councils Young Investigator Grant for Probiotics Research; the University of Michigan Host-Microbiome Initiative; and the Burroughs Wellcome Fund.

Grau KR, Zhu S, Peterson ST, Winesett E, Philip D, Phillips M, Hernandez A, Turula H, Frasse P, Graziano VR, Wilen CB, Wobus CE, Baldridge MT, Karst SM. The intestinal regionalization of acute norovirus infection is regulated by the microbiota via bile acid-mediated priming of type III interferon. Nature Microbiology. Nov. 25, 2019.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

See original here:
Gut microbes alter characteristics of norovirus infection - Washington University School of Medicine in St. Louis

Despite the fact that we live in a highly advanced technological society, when it comes to important things like health and nutrition, a lot of people are still willing to take most of their advice from bloggers and social media influencers who have little to no scientific training. This is especially true when it comes to gut health and the gut microbiome. Luckily, the scientists and researchers at Viome are on a mission to change all that.

Over the past few decades, the scientific community has made some incredible advancements in our understanding of the human gut microbiome. We now know, for example, that the complex community of bacteria and other microorganisms that live in our digestive tract affects almost every system in the body, including the digestive system, immune system, and cardiovascular system. There have also been studies that specifically link gut health to a number of human diseases and conditions, such as diabetes, obesity, irritable bowel syndrome, and colon cancer. But how do we put this information to use?

A lot of people have been led to believe that you can ward off all these illnesses and conditions simply by eating a bunch of exotic fermented foods you saw on Instagram. Unfortunately, thats like throwing a bunch of random ingredients into a pot and hoping they turn into your favorite soup. The stuff you put into the pot might be delicious, but different soups call for different ingredients.

Similarly, one of the most important things weve learned about the human gut microbiome in recent years is that everyone is totally unique. Thus, whats good for one gut isnt necessarily whats good for the next. Thats why, if you want to get serious about gut health, you need to start by taking the Gut Intelligence Test by Viome.

At Viome, their goal is to take the guesswork out of building a healthy gut. To do that, theyve created the worlds most scientifically advanced microbiome test.

A microbiome test is like a DNA test, only instead of mapping out genes, it maps out the specific strains of bacteria and other microorganisms that live in your digestive tract. What makes Viomes test superior to any others currently available is its proprietary microbe identification technology and its advanced analytics engine.

Viome is the only company in the world that uses advanced metatranscriptomic sequencing technology, which was originally developed at the Los Alamos National Laboratory for national security purposes. This technology helps them identify and quantify all the strains and species of microorganisms in your gut and determine exactly how active they all are. Then Viome runs all this data through an advanced AI algorithm called VIE, which uses a massive and continually growing database of information to come up with personalized nutrition recommendations.

When your gut microbiome is out of balance, your body doesnt absorb nutrients the way it should. It can also produce toxins that cause inflammation, which scientists now realize is at the root of almost every chronic disease. The foods Viome recommends are intended to stimulate your microbiome so that it maximizes the production of healthy nutrients and minimizes the production of toxins.

With the Gut Intelligence Test by Viome, you dont have to go to a cold sterile lab to be poked and prodded. The entire process is pain-free and takes place in the comfort of your own home. Once you place your order, Viome will send you an easy to use, non-invasive at-home kit to collect your sample. Then you simply return your sample using the postage-paid box provided, and Viome will process it and send you the results.

With Viome, all test results and dietary recommendations come with detailed explanations, and all of them are conveniently delivered straight to your phone via the Viome mobile app, which makes them incredibly easy to put into action.

The default reports and recommendations are aimed at increasing microorganism species associated with overall wellness and decreasing species typically associated with poor health. However, you can also customize your recommendations based on specific health and wellness goals, including weight loss, better sleep, or increased mental clarity.

Viome does not promise that everyone who takes their test will see the same level of results because not all health and wellness issues can be fixed by diet alone. What Viome does promise is a better, more scientific understanding of whats going on in your body.

Right now, Viomes Gut Intelligence Test is 62 percent off the regular price. If youre tired at guessing about matters related to your health and wellness, order your test from Viome today.

Futurism fans: To create this content, a non-editorial team worked with Viome, who is offering Futurism readers $20 off with code FUTURISM. They help us keep the lights on, and Futurism may receive a commission from sales. This post does not reflect the views or the endorsement of the Futurism.com editorial staff.

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Unlock the Mysteries of Your Gut Microbiome With Viome's Gut Intelligence Test - Futurism

Hilary celebrated Thanksgiving with her family (Picture: NBCU Photobank/Getty Images)

Hilary Duff made sure to spend some quality family time as she celebrated Thanksgiving and it looks like one family member was enjoying eating something that is not considered edible.

Her youngest daughter, Banks, 13 months, thought it was funny to eat some dirt rather than turkey which is what most Americans eat at the dinner table for Thanksgiving.

Taking to Instagram, Hilary shared an adorable picture of her alongside partner Matthew Koma, and her oldest kid, seven-year-old Luca and of course, Banks, with dirt all over her face.

HAPPY THANKSGIVING, she wrote. Banks just ate dirt.

As you do.

Banks you ate better than me today!!!! one fan wrote in the comments.

All that good food and you eat dirt, Banks, LOL, another added.

Banks is my spirit animal, another fan commented.

And one fan actually thought that the dirt on Banks face was a speck of dirt on their phone screen.

I kept trying to wipe my screen thinking it had something on it, they wrote.

But then I read your caption, Banks is building up her immune system.

Hilary is no stranger to sharing the love and appreciation she has for her kids on social media and more recently, she found herself struggling to help Luca with his school homework as she claimed she left real school in the third grade.

View this post on Instagram

This guy with his spirit and kindness?Homework is already no joke in 2nd grade. I stopped going to “real” school in 3rd grade so I’m actually doomed... I am left scratching my head alll the time looking at his homework and I’m terrified for next year! Although Singapore math is the shit....also learned a lot about tick birds this week. #rhinosbegrateful

A post shared by Hilary Duff (@hilaryduff) on Oct 19, 2019 at 7:09pm PDT

Taking to Instagram, she shared a selfie of her and Luca at the table while in the middle of hitting the books.

This guy with his spirit and kindness. Homework is already no joke in 2nd grade, she wrote.

I stopped going to real school in 3rd grade so Im actually doomedI am left scratching my head all the time looking at his homework and Im terrified for next year!

In the meantime, the 32-year-old has been currently busy filming for the upcoming Lizzie McGuire revival and her co-star Adam Lamberg, who played David Gordo Gordin, will also be making a return.

If you've got a celebrity story, video or pictures get in touch with the Metro.co.uk entertainment team by emailing us celebtips@metro.co.uk, calling 020 3615 2145 or by visiting our Submit Stuff page - we'd love to hear from you.

MORE: X Factor: Celebrity confirms all acts are getting paid after confusion from Drag Races The Vivienne

MORE: Love Islands Molly-Mae Hague looks comfortably chic in beige hoodie and coat combo

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Hilary Duff's daughter Banks gets dirt on her face in Thanksgiving pic - Metro.co.uk

Sarah Ross guessed it was leukemia long before the doctors confirmed it. Five years ago, she had been feeling lousy in a way she had never experienced before. When a blood test came back with some indicators pointing to the disease, Ross stalled for a while before doing a follow-up.

In her heart, she said, she already knew what was happening. Ross, who had worked for years as a veterinarian's technician, would eventually need a bone marrow transplant at Roswell Park Comprehensive Cancer Center. She has spent the last few years in recovery, receiving treatment for some related complications.

A few days ago, lost in thought after an appointment at Roswell, she was headed toward a lobby exit lobby when any worries or fatigue vanished from her mind. Her stride accelerated as she made a sharp pivot, and she asked her mother, Frances Ross, to wait for just one minute.

Ross had spotted Bella, which meant the dog was doing her job even before Ross, of Tonawanda, realized just how much they have in common.

Bella is a Weimaraner, a memorable breed whose striking appearance has led to the nickname of "gray ghost." About three years ago, the dog moved in with Sue and Shane Currey of Tonawanda after their dog, Sophie, another Weimaraner, died at 11. Bella came to them from a breeder near Erie, Pa. he called the dog Bertha, a name the Curreys decided to change and made her available for adoption.

She is perfect, it turns out, for the role she plays at Roswell.

In the lobby, Ross made a beeline to the dog, who wore a bright red bandana. She asked Currey if it was OK to say hello, then dropped onto her knees, where a few strokes of velvet fur and the dog's long ears quickly shifted into a full embrace.

Ross loves animals. She explained how she often distracts herself during appointments at Roswell by thinking of her rabbits, Quake and Thunder, and she offered a gentle gasp when she heard Bella's story.

The dog is also a cancer survivor.

Roswell Park Comprehensive Cancer Center patient Donato Morgante gets a kiss from Bella at the hospital as Bella's owner Sue Currey, left and Jacquie Morgante, Donato's mother, enjoy the moment. (Mark Mulville/Buffalo News)

Sue Currey, an executive assistant at Roswell, had seen the difference therapy dogs can make for patients. Sue dreamed someday of bringing in her own dog for those duties. Bella went through a sequence of training sessions, tests and community interactions to become one of roughly a dozen dogs who provide that service at Roswell, which Bella did even before the Curreys knew about her illness.

Bella, it turns out, had a form of cancer that required the surgical removal over the summer of six malignant tumors. Sue, for a while, feared for Bella's life. But the dog recovered quickly from surgery, and she was back to her rounds at Roswell by this fall.

Ross, her forehead pressed against Bella's soft fur, was not surprised at the tale.

"Dogs and kids," she said. "They put no limitations on themselves."

Dr. Philip McCarthy, director of Roswell's blood and marrow transplant program, said the demeanor of each dog is critically important. Any scratch or bite from a restless or anxious animal could lead to infections for patients with fragile immune systems, he said.

When you find such dogs as Bella, animals of serene and soulful demeanor?

In that case, McCarthy said, they often "emanate good feelings and unconditional love."

[Related: Sean Kirst: Cancer survivor rides for Roswell and for the doctor who saved him]

"The effect these dogs have is amazing," said Barb Lenahan, who certifies the animals as part of Therapy Dogs International.

From the lobby, Sue and Bella followed Jim Hickey, a Roswell volunteer, through the hospital corridors, where the dog touched off lightning transformations. Doctors, nurses, patients, weary relatives: They crouched down, tired faces instantly softening. They spoke in familiar, quiet tones to Bella, whose curious eyes did a long study of each of them.

[Related: Murphy, the therapy dog, spreads joy at Oishei Children's Hospital, Roswell Park]

The point made by Ross about childhood resilience was evident in a reception area for the pediatric clinic. When Bella entered the room, Owen Chase of South Buffalo, a 5-year-old in Teenage Mutant Ninja Turtles pajamas, was tugging around a rolling IV, followed by his mother, Colleen.

She and her husband, Michael, learned of Owen's leukemia more than 11 months ago, just before Christmas, and the child is now receiving "infusions of chemo," Colleen said. He is doing well, and Colleen said the couple is buoyed each day by an avalanche of love and support.

"A lot of families," she said, "go through a lot worse."

Owen and Bella stood eye to eye, and the little boy whose dog at home, Gemma, often sleeps on his bed dropped his hand delicately onto the dog's neck. After a moment or two of communion, Bella turned to walk directly into a nose-to-nose encounter with 1-year-old Donato Morgante.

Not long ago, Jacquie and Joe Morgante of Clarence learned their child had a grapefruit-sized growth on his kidney, the result of a rare childhood cancer known as Wilms tumor. That sent him into surgery, and then chemotherapy.

"He's been really good with all of it," said Jacquie, who talked it over with Joe and then stayed home with their son on Thanksgiving, because his system remains too vulnerable for a big family crowd.

Owen Chase, left, who is at Roswell Park for leukemia treatment, and his mother, Colleen Chase, visit with Bella and her owner Sue Currey, in the pediatric unit at the hospital. (Mark Mulville/Buffalo News)

When the toddler saw Bella, there was instantly no Roswell, no chemo, no waiting room. It was only Donato and this dog with ears as soft as Hush Puppies.

"Fantastic," Jacquie said. "It just relieves all the stress."

The response was the same for Krista Gabler, a Florida resident and native of West Seneca who has spent two months in Buffalo while her mother, Sandy Mussehl, receives radiation treatment for cancer of the tongue. Gabler had just stepped through the door of a waiting room, fatigue in her expression, when she noticed Bella approaching in the corridor.

Instantly, Gabler dropped down, bowed her head and placed it alongside the dog's.

"I needed something uplifting today," she said.

Brendon Edwards shared in that communion. At 14, he is a freshman at Frewsburg High School in Chautauqua County, a teen who loves football and has played on youth teams since he was in grade school. His favorite Buffalo Bill, he said, is Dawson Knox, an interesting choice: Brendon picked a rookie, not one of the big names on that ascending squad, a guy whose quiet contributions are filling a hole.

Bella wandered straight to Brendon, who had thrown himself deep into the soft cushions of a couch. The kid began petting the dog and scratching her neck, and boy and dog stayed that way for a long time while the adults around them talked.

His aunt, Brandy Davies, said she figured it was just a bug when Brendon had some stomach problems this autumn. She took him to a doctor. It was colon cancer, and it had already started to spread. Brendon is now in chemotherapy at Roswell, where his love for football is a kind of gleaming template, with his goal of playing again a central theme as he receives each treatment.

The teenager has always loved dogs, Brandy said, and Bella clearly sensed this was a guy who understood. At Roswell, the dog flipped onto her back and allowed him to scratch her stomach, revealing the scars from her own cancer surgery.

Asked for his dream in life, Brendon replied, "Beating this."

The proof that it can happen watched him speak, and wagged her tail.

Sean Kirst is a columnist with The Buffalo News. Email him at skirst@buffnews.com or read more of his work in this archive.

Excerpt from:
Column: At Roswell, dog that beat cancer provides joy and comfort to patients - Buffalo News

The holiday season is a time for decorations, presents and winter getaways. Its also when you and everyone you know gets sick. Yes, flu and cold season are upon us, and those nasty viruses never seem to care if you have travel plans. But should you be pushing through and getting on a plane if youre feeling sick?

As you head off on your holiday travel, the last thing you want to experience is a health emergency in the air where you cant get medical attention, Dr. Nate Favini, medical lead at Forward (a membership-based preventive care clinic), told The Points Guy. Theres also the risk of getting kicked off your flight and, of course, you dont want to spread an infection to other passengers.

In fact, according to theJournal of Environmental Health Research, you are 100 times more likely to catch a cold on a plane. And the Wall Street Journal previously cited a study that said the likelihood increases by 20%. So many people got sick at once during a 2008 flight from Boston (BOS) to Los Angeles (LAX) after an ill passenger with norovirus boarded that the plane actually made an emergency landing three hours into the trip.

With this in mind, we consulted several experts to learn how to tell when youre too sick to fly, for your sake as well as the safety of other passengers.

For more TPG news delivered each morning to your inbox, sign up for our daily newsletter.

A good rule of thumb is to never fly when you have a fever, according to New York-based internist Dr. Frank Contacessa. Of course, this would include having the flu. In addition to the obvious risk of spreading your germs, the cabin environment is not a friendly place when you are sick, he said. Having a fever, in general, will accelerate fluid loss from your body. The very low humidity of the cabin air will dehydrate you even faster. Dehydration makes you feel even worse, increasing weakness, headaches, lightheadedness, etc.

Sure, there might be vomit bags in the seatback pocket. But you probably shouldnt be using them if youre throwing up before you get on the plane. If you have a fever over 100.4 degrees or are experiencing vomiting, theres a really good chance that youre contagious, said Favini. Airlines have been known to remove passengers who are experiencing these symptoms.

Related: Its flu season heres how to avoid getting sick on a plane

Another potential problem can arise if you have a lower respiratory infection such as bronchitis or pneumonia. The pressurized cabin air has less oxygen, which can make you feel short of breath if your airways are already inflamed from an infection, said Contacessa.

Favini added, Flying is stressful on your body and your immune system in particular, so it can reduce your ability to fight off an infection. The air onboard is incredibly dry, and even healthy people end up extremely dehydrated at the end of their flight. You may end up being sicker or sick for longer because of flying while ill.

If you have the flu and youre still experiencing any symptoms, including fever, cough, runny nose, congestion, nausea, vomiting or diarrhea, you are still contagious and should avoid flying, according to Favini. The CDC states that people with flu are most contagious in the first 3 to 4 days after their illness begins.

Not only are you able to infect someone up to six feet away, but you could also feel horrendous on the plane. Anyone who has flown with sinus congestion will agree that the headache can be unbearable, Contacessa added. So, having a fever and sinus congestion should be good reasons to ask for a medical note from your doctor to change your flight reservation.

Related: How to boost your immune system so you dont get sick while traveling

Do you know how your ears sometimes pop during taking off or landing? Well, if you have ear pain and pressure, then that brief moment of discomfort can become severe. The changes in pressure during the flight can cause your eardrum to burst if you have an ear infection and its not properly treated before you take off, said Favini.

Even if you dont have the sniffles or more obvious symptoms of being sick, there is one tell-tale warning sign that you absolutely shouldnt fly. If you do, you could experience a serious medical emergency.

If youre experiencing chest pain or a racing heartbeat, especially if this is new or severe, dont get on your flight, said Favini. This can be a sign of a life-threatening medical condition, and even if the pilot does land your flight, it might not be fast enough for you to get the help you need. The same goes for shortness of breath.

Related: The best travel insurance policies and providers

Ok, lets say youve determined youre too sick to fly. When can you reschedule your trip?

If you do change your plans and postpone your trip, you should wait until you have been without a fever for at least 24 to 48 hours, said Contacessa. If you are recovering from the flu, you should wear a mask to protect your fellow travelers. If in doubt, use your common sense. If you think that you are too sick, stay home.

Featured photo by Roos-Koole/Getty Images.

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How to tell when youre too sick to fly - The Points Guy

Injections of stem cellseither a patients own or from a donorinto the hearts of people with cardiac conditions has been shown in some cases to improve heart function. How the cells help has been a mystery. A paper in Nature today (November 27) shows that activation of an innate immune response can explain, and even recapitulate, the beneficial effects of stem cell transplants in the hearts of mice.

The findings suggest stem cells may not be required to boost cardiac repair, but some researchers argue that, by finally providing a mechanistic explanation, the study supports the use of cell therapy.

This work is paradigm-shifting because it demonstrates a mechanism to explain a perplexing phenomenon that has intrigued cardiologists as a result of decades of cardiac stem cell trials, writes cardiologist Jonathan Epstein of the University of Pennsylvanias Perelman School of Medicine in an email to The Scientist. Now the focus can shift from injecting cells into the heart to understanding how to modulate the immune system so that heart function is improved, continues Epstein, who was not involved in the study.

The idea of applying stem cells, derived from the bone marrow or elsewhere, to the heart to fix damage caused by myocardial infarction or cardiovascular disease has been the subject of intense pre-clinical and clinical investigations for the best part of two decades, and yet the field is highly controversial. Aside from the retractions of fraudulent papers that misguided the larger heart regeneration community for years, the observed benefits of cell transplant therapies are generally modest and, because the underlying mechanism of repair is unknown, there is a lack of consensus about which of the many types of stem cells and delivery approaches might work best, as well as which types of patients may benefit.

A better knowledge of the mechanism would drive better clinical trial design, says Jeffery Molkentin, a cardiovascular biologist at Cincinnati Children's Hospital Medical Center who led the latest project. Indeed, he says, if mechanistic studies had been done up-front then we would have been much further along in the clinical trials [at this point].

For transplanted cells to produce functional benefits in the heart, its likely the cells would need to remain there after injection. So Molkentins team studied a variety of stem cell types injected into mice to see if any of them ever engrafted in the heart, he says. We had a list of five of the most prominent ones and none of the five ever engrafted, and they were all cleared within less than two weeks and sometimes within five or six days. But, the team did spot something else happening. In all [cases], he says, there was this really noticeable inflammatory response.

The team then showed that whether they injected live stem cells, dead stem cells, or zymosana potent activator of the innate immune systeminto the hearts of mice that had been given an experimental myocardial infarction, functional improvement of the heart occurred. By contrast, an injection of cyclosporinewhich suppresses the innate immune systemafter the cell delivery eliminated the beneficial effects.

The team went on to show that in the injured hearts of mice that received cell therapy or zymosan treatment there was evidence of improved muscle mechanical properties as well as scar remodeling and reduction. Both treatments recruited certain subtypes of macrophages that experiments indicated were driving this remodeling.

A heart attack triggers innate immunity automatically, prompting the essential scarring without which the heart would rupture, says Molkentin. The cell therapy (or zymosan treatment), being delayed by one week, does not exacerbate this initial inflammation, he says, but instead somehow realigns the healing process and makes for a better scar.

It seems like it optimize[s] the properties of the area around the scar and the contractility of that area, Molkentin says, but we dont know exactly why yet. . . . Were trying to figure this out.

Whatever the precise mechanism, the study shows the importance of the immune system, says Paul Riley of the University of Oxford who studies regenerative medicine but was not involved in the research. Its certainly very important for the field to be aware of this [finding], he continues. It will stimulate further interest in targeting or modulating, or thinking about the way the immune response . . . can effect more optimal function and repair after acute myocardial infarction.

If the results hold true in humans, it could have implications for any future trials in which patients might receive immunosuppression to prevent cell rejection, suggests Riley. Although its not thought any such trials are currently underway, according to Molkentin and Joshua Hare, a cardiologist and stem cell researcher at the University of Miami who was not involved in the study, if embryonic stem cells were ever approved for trial they would require immunosuppressives, Hare says.

Hare has been involved in a number of stem cell therapy trials and sees the paper not as evidence that the stem cells themselves arent necessary, but instead as a mechanistic explanation for the fact that they do work. It is often the case in medicine, he says, that once a treatment is in use, we change our perspective on how they work. Fundamentally, he says, we know that the cells are working, and that theyre safe. He therefore thinks the paper supports the field and . . . substantiates that we were on the right track. That said, he adds, If someone takes these findings and comes up with a better approach, a safer approach, a more efficacious approach, thats great.

R.J. Vagnozzi et al., An acute immune response underlies the benefit of cardiac stem-cell therapy,Nature, doi:10.1038/s41586-019-1802-2,2019.

Ruth Williams is a freelance journalist based in Connecticut. Email her atruth@wordsbyruth.comor find her on Twitter @rooph.

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Activation of the Immune System Underlies Cardiac Cell Therapies - The Scientist

A newborn immune system responds to HIV infection less effectively than a more mature one, so an HIV-positive baby should be started on antiretroviral therapy as soon after birth as possible, new research suggests.

Although treatment early in life was known to be advantageous, the study, published Wednesday in Science Translational Medicine, shows the immune systems response in detail for the first time. The study could energize efforts to treat newborns with HIV, several experts say, and it may help pave the way for an eventual long-lasting treatment or even a cure.

In the study, 10 HIV-positive newborns in Botswana were started on antiretroviral therapythe gold-standard treatment for HIVwithin hours or days of birth instead of the more typical four months. If an HIV-positive pregnant woman is receiving treatment, and the amount of virus in her body is well controlled, she will not pass the disease on to her baby, although the infant will have antibodies to HIV in his or her bloodstream. If the mothers disease is not well controlled, the baby may be born with HIV.

To look for HIV-positive babies, the team screened more than 10,000 newborns using very small amounts of blood. The researchers identified 40 who were HIV-positive and began treating them with a three-drug cocktail within days of birth. The study reported on 10 of those babies, who are now almost two years old, and compared them with HIV-positive babies who did not receive treatment until four months of age.

The early treated babies fared much better in measures of viral levels in their bloodstream and lower levels of immune activity, which predicts the course of the disease, according to the study, which was conducted by a research team at the Ragon Institute of Massachusetts General Hospital, the Massachusetts Institute of Technology and Harvard University, Brigham and Womens Hospital, and the Botswana Harvard AIDS Institute Partnership in Botswana. The babies coped well with the drug regimen, with only one having to discontinue therapy because of side effects, said Roger Shapiro, a seniorauthor of the paper and an immunologist at the Harvard T. H. Chan School of Public Health, in a news conference on Tuesday.

The stakes are high for getting these babies treated, says Pat Flynn, an infectious disease specialist at St. Jude Childrens Research Hospital in Memphis, Tenn., who was not involved in the new study. HIV infection can have devastating neurological consequences, likely because of ongoing inflammation in the brain.

Every day, between 300 and 500 babies in sub-Saharan Africa are infected with HIV, according to the studys authors, who cite data from the Joint United Nations Program on HIV/AIDS (UNAIDS). Up to half of them will die by age two if they do not receive antiretroviral therapy. Infants infected in utero face even worse outcomes than those infected during birth or breastfeeding, said Mathias Lichterfeld, a co-author and an infectious disease specialist at the Ragon Institute and Brigham and Womens in the news conference. Putting all HIV-positive pregnant women on antiretroviral therapy is the best way to prevent them passing the virus to their babies, but many such women face barriers to accessing treatment, Shapiro said.

Scientists have known since a study published in 2008 that treating HIV-positive babies as early as possible leads to better outcomes, but the new paper provides a very comprehensive scientific rationale for why that is the case, says Sten Vermund, dean of the Yale School of Public Health and a pediatrician and infectious disease epidemiologist, who was not involved in the new research. As soon as possible might be too late. We really would be better treating right at birth.

Compared with the immune system of an older baby or an adult, Vermund says, the newborn immune system is much more immature but developing at a breakneck pace. Thats why infants are particularly vulnerable to intrauterine infections, which include toxoplasmosis, rubella, syphilis and Zika. And, he says, HIV can be added to that list, given the findings of this study.

Unfortunately, Vermund says, it is unrealistic to think that most HIV-positive babies born in sub-Saharan Africa could be treated soon after birth. The science is terrific, he says of the new paper, but it may not have much effect in the real world. The clinical relevance in Africa is not at all obvious to me, Vermund adds.

In most countries in sub-Saharan Africa, infants are tested for HIV at four to six weeks of age, Shapiro said in the conference. This practice enables doctors to catch babies who are infected during pregnancy, at delivery or very early in life,but it missesthe chance to start treatment immediately if the child is infected at birth. Adding a second test at birthas South Africa now doeswould be complicated and expensive, he conceded, but thats really the direction that the rest of the world should be following.

Yet even something that is simple in the U.S.such as drawing blood from a newborn, taking the blood to a lab, and getting results back to the clinic and the familyremains a major barrier to identifying those babies who are infected very early on, Flynn says. Instead it may make sense to determine women who are at high risk for transmitting HIV and put their infants on therapy even before the test results can be returned. But even then, maintaining stocks of antiretroviral drugs continues to be an issue in sub-Saharan Africa, she says, with funding streams to pay for medications being uncertain.

In the U.S., no more than about 50 babies are born each year to mothers who did not know they were HIV-positive, and they are generally identified at birth, Vermund says. The new study should stimulate obstetricians and pediatricians to be especially aggressive in promptly diagnosing and treating those newborns, Vermund says.

The research team plans to follow the babies and track how much viral reservoir they continue to carry. In a natural experiment in the U.S., the so-called Mississippi Baby was thought to be cured when her HIV remained undetectable for two years after stopping therapy. But then the disease rebounded, suggesting that early aggressive therapy is not a cure.

To improve long-term treatment of HIV-positive children, the researchers hope to put some of the babies on so-called broadly neutralizing antibodieswhich can recognize and block many types of HIV from entering healthy cells. They want to see if, long-term, these antibodies can substitute for the antiretroviral regimen, which is costly and cumbersome and comes with significant side effects.

Yvonne Maldonado, an expert in pediatric infectious diseases and epidemiology at Stanford University, who was not part of the new study, says the real benefit of the new study may not be in how it impacts the care of newborns with HIV but rather in the insights it offers into the HIV reservoirs that remain in the body even during treatment. This is really geared toward How do you get to the cure? rather than How do you treat babies? she says.

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HIV-Positive Babies Fare Better When Treatment Starts at Birth - Scientific American

Millions get the flu every year, and getting the yearly flu vaccine is far and away the best way to protect against it. But medical researchers have discovered that for the more than two-thirds of Americans who are overweight or obese, the vaccine doesnt seem to work as well, NPR reports.

Health officials first noticed the pattern during the 2009 flu pandemic, when they observed that the disease was especially bad for those who were significantly overweight. For some reason, the virus was able to grow to higher concentrations in obese patients, even spreading deeper into their lungs,Stacey Schultz-Cherry, an infectious disease specialist at St. Jude Children's Research Hospital, told NPR.

Besides getting people sicker, this also made them more likely to spread the disease, which is bad news for public health. When researchers studied the phenomenon more closely they found that the breath of obese patients contained more virus particles and that overweight people could spread the virus for an extra day, on average, compared to those with lower body weight.

Now, researchers are trying to figure out why so they can make the flu vaccine more effective.

Melinda Beck, a professor of nutrition at the University of North Carolina at Chapel Hill, is studying how obesity impacts the immune system. Beingsignificantly overweight changes a persons metabolism, which impacts a range of bodily functions and canhamper the immune system.When we get sick, proteins in our bloodstream called antibodies attack viruses, while other cells, called T cells, also help fight disease. These T cells are what fail in the case of obese patients, Beck told NPR.

Beck has studied this phenomenon in mice and says the loss of T cell function is similar to whats observed in the elderly. So, a "30-year-old obese person has the immune cells that look a lot like what you might expect in an 80-year-old individual," Beck told NPR. She thinks T cells could explain why the flu vaccine doesnt work as well for significantly overweight people and the elderly.

Schultz-Cherry is part of an effort to develop a new vaccine that will work better for these vulnerable groups. Developing this new flu shot is likely to take years, but Schultz-Cherry emphasized that this is no reason not to get the vaccine in the meantime, as its still our best chance of avoiding a disease that infected between 37 and 43 million people last flu season.

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Flu shots are less effective for overweight people - The Hill