Monthly Archives: September 2015

Let’s talk about viruses

One of the biggest debates in modern microbiology revolves around this question: are viruses living organisms? As you might think, this isn’t quite a black and white question. In order for something to be classified as a living organism, it needs to be able to replicate on its own.

Viruses however, are incapable of this – they need a host cell to replicate and ‘live.’ Once inside a cell, a virus can then perform the same functions living cells can – like producing proteins, replicating, and protecting itself form danger.

A viral life cycle contains five different distinct phases: exposure, entry, replication, shedding, and latency.

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Generally, a viral infection occurs when a host (i.e. Human) is exposed to a virus. This can be through a physical breach (a cut in the skin), direct inoculation (unsafe needle injections) or direct infection of the surface (inhaling the virus into the lungs). Only after a virus enters the host, can it gain access to certain cells to infect.

Once a host has been exposed, the virus needs to enter the host’s cells; and when inside the cell, the virus hijacks the cell’s machinery to replicate. To get inside the cell, proteins on the viral surface connect with proteins on the cell surface which results in the creation of a pore. Using this pore, viruses enter the cell and begin making copies of itself.

Next, the virus takes control of the cell’s replication machinery and quickly begins making millions of copies of itself.

Once a virus has made enough copies and used up all of the resources inside a cell, shedding occurs. The cell is no longer useful for the virus, and so the cell dies and all the new viruses are released to now infect new cells.

Some special viruses, like HIV, have a latency period. During this time, the virus hides inside the cell and does not replicate in order to evade the host’s immune system. The virus waits, until the time is right to begin replication and start the infection.

As you can see, this question is a difficult one to answer. When you look at the viral life cycle, arguments can be made for both sides; but ultimately, regardless of whether viruses are classified as living or not, efforts should be placed on developing vaccines and treatments.

CBC Radio On The Coast interview with Dr. Brian Conway

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Click on the photo to listen to the broadcast. Stephen Quinn’s interview with Dr. Conway starts on 1:40:20.

Last Thursday (September 10) our President and Medical Director, Dr. Brian Conway, was on the CBC Radio show On The Coast as the Hepatitis C Expert.

The interview was a response to the recently published study from UBC with shocking results concerning Vancouver’s Downtown Eastside (DTES) residents.

 

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UBC News article on the study.

According to the study, DTES residents are dying at a much higher rate compared to the national average, and not due to HIV/AIDS or substance overdose.

“We were somewhat surprised because most people thinking about the Downtown Eastside think about HIV/AIDS or the possibility of overdosing on opioids like heroin,” said Dr. William Honer, professor and head of UBC’s Department of Psychiatry and co-author of the study. “Our system is not doing as well in getting treatments out there for psychosis and hepatitis C in this group, and it’s interesting that those two illnesses are causing risk for early mortality.

— UBC News

Dr. Conway came on the show to speak on these findings — findings that, as VIDC’s President and Medical Director, does not surprise him. These results, as he mentions on the interview, parallels what we see when on our regular visits to the DTES for our Community Pop-Up Clinics (CPCs). The surprise that came with the results confirm one more important reality: there still isn’t enough awareness about hepatitis C.

According to Dr. Conway, the prevalence of HCV in the DTES community is because of a number of things. However, the main factors are: prevalence of injection-drug use, lack of awareness and education about the cure available for HCV, and the social situation of the residents. Not only is a very vulnerable population not aware of the disease and its cure, most of them have difficulty even accessing basic health care. It also does not help that HCV is asymptomatic (does not show symptoms) until about 20-25 years after infection.

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We have Community Pop-Up Clinics at various locations in the DTES to provide point-of-care testing for HIV and HCV.

This is one of main driving forces behind VIDC’s CPCs and the health-care model that we have at VIDC. By heading out into the community, we promote awareness and education while making health care a lot more accessible to the community members. Also, at VIDC, we understand that often treatment for a disease that is asymptomatic is the last thing on their minds. Why would they seek treatment when they are worried about where they can spend the weekend and how they will eat for the next couple of weeks? This is why our patient care takes all these into considerations. Often our nurses, research coordinators, clinic staff, and physicians would help patients with their housing application, or contact shelters and soup kitchens for them — all these on top of getting them started on treatment, applying for treatment fundings, and providing general health care.

To find out more about this, here a couple of very useful links:

Community Spotlight: Bradford McIntyre

This month’s community spotlight sheds light on an issue that’s worth celebrating yet heartbreaking. Bradford McIntyre — more commonly known as Brad to us at VIDC — is a friend of VIDC who has successfully outlived the 6-months-to-live diagnosis he was given in 1984.

Brad was recently featured in an article by the Vancouver Courier entitled “Living longer with HIV.” He was the prime example of how the field of HIV is rapidly changing. Not too long ago, being diagnosed with HIV was considered a death sentence; now, because of the new treatments available, people like Brad are living well into their sixties.

“New research from the Canadian Observational Cohort Collaboration found the average life expectancy for HIV-positive people receiving antiretroviral therapy is now 65. ” Vancouver Courier (19 Aug 2015)

This is great news! This means we are slowly but surely making great progress in our fight against HIV. However, this also spotlights a new issue: an aging HIV-positive population.

“McIntyre has been a longtime advocate for HIV/AIDS awareness and started his website positivelypositive.ca in 2003 to share his story and the latest research. He has a good life and enjoys cooking, gardening and spending time at the beach. But he says aging with the virus comes with its own unique set of challenges. These include health, emotional, financial and social effects. ” Vancouver Courier

Because of the advancements in the field of HIV research, people who were expecting to die at a young age, are now given a new hope — a new hope with a new challenge. That means there is a growing population of more senior individuals living with HIV.

The challenge, however, is not just on the individuals who are now given a shot at a longer (and ideally, a more fruitful) life. Society, at large, is also faced with a new challenge. Because an aging HIV population is a fairly recent phenomenon, our society has yet to catch up with services and infrastructures — and especially  the knowledge — to care for and support this growing population.  Most importantly, the stigma and discrimination that comes with the virus, is ever so present.

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Brad’s photo on the Vancouver Courier website.

This is the new reality that Brad — along with the rest of society — has to face.  All the more reason for Brad to keep doing what he does!

As mentioned earlier, Brad has a blog called positivelypositive.ca where his primarily goal is to promote HIV/AIDS awareness and education.

“I receive thousands of emails from around the world,” says McIntyre. “Oftentimes there’s an individual that has just found out they’re positive and is thinking the worst. Then they find my website and see that I’ve lived all these years and I’m married and it gives them hope.” – -Vancouver Courier

Brad turned a death-sentence into a mission. His website provides information, resources, and — most importantly — hope. Resources like positivelypositive.ca are constant reminders that although stigma and discrimination that come with HIV is very real, there is hope of dispelling them through education and awareness.

To find out more about the work that Brad is involved with — did you know that he is a recipient of the Queen Elizabeth II Diamond Jubilee Medal for excellence in the field of HIV/AIDS in Canada? — visit his blog: positivelypositive.ca!

It is because of amazing individuals like Brad that we are encouraged to keep doing what we’re doing. People like him remind us that there is hope, and that there are more and more people getting involved with promoting HIV/AIDS awareness, research, education, prevention, etc!