Finding strengths—and weaknesses—in hepatitis C's armor

Using a specially selected library of different hepatitis C viruses, a team of researchers led by Johns Hopkins scientists has identified tiny differences in the pathogens' outer shell proteins that underpin their resistance to antibodies. The findings, reported in the January 2015 issue of the Journal of Clinical Investigation, suggest a reason why some patients' immune systems can't fend off hepatitis C infections, and they reveal distinct challenges for those trying to craft a successful vaccine to prevent them. Due to concerns about the rising costs of newly available hepatitis C drugs, researchers are looking to a vaccine as a more viable and less costly option.

The systems of some people who become infected with the liver-ravaging hepatitis C virus launch a robust immune attack, producing antibodies that attach to a broad array of the germs with different genetic makeups. About one-third of these individuals successfully clear the pathogen from their bodies. However, says Justin Bailey, M.D., Ph.D., assistant professor of medicine in the Division of Infectious Diseases in the Johns Hopkins University School of Medicine, no single antibody has been found that can neutralize all strains of hepatitis C virus.

To better understand how hepatitis C viruses avoid even the most broadly neutralizing antibodies, Bailey; Stuart C. Ray, M.D., professor of medicine in the Division of Infectious Diseases in the Johns Hopkins University School of Medicine; and colleagues tested the power of 18 antibodies known to broadly attack the virus against a library of 19 viral strains that make up about 94 percent of the genetic variability of hepatitis C viruses in the most common genetic group, called genotype 1.

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Seattle-HIV testing in ED serves as link to care

"SEATTLE — An HIV testing program in an ED, which was originally implemented to describe the local epidemic, played a significant role in linking individuals to care, according to data presented at CROI 2015".

“Over a 25-year period, the program evolved, and this change is partially evidenced by declining undiagnosed HIV infection, increased use of antiretroviral therapy, increased viral suppression and decline in HIV incidence,” Thomas C. Quinn, MD, of the National Institute of Allergy and Infectious Diseases, said during his presentation".

"Quinn and colleagues examined local trends in HIV and hepatitis C in the Johns Hopkins Hospital ED population for a 25-year period. They conducted 6- to 8-week identity-unlinked serosurveys in the ED in 1987, 1988, 1992, 2001, 2007 and 2013. The study included 18,144 eligible patients who required a blood draw for a medical reason. Excess sera were collected, and specimens underwent ELISA testing followed by Western blot (from 1992-2013). The specimens also were tested for HCV in 1988 and from 2001 to 2013".

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