Advancing HIV/AIDS treatment and research in Houston and beyond

While World AIDS Day is commemorated on December 1, doctors at Baylor College of Medicine are doing their part every day – both locally and globally – to provide care for those living with the disease, to promote HIV prevention and to advance research.

Locally, leaders at the Baylor Teen Health Clinic report that the number of new HIV cases diagnosed at its network of clinics has declined annually since 2014. While this is good news, HIV remains an issue healthcare professionals at the clinics are concerned about, and they will continue their focus on key messages: reduce risky behaviors and know your HIV status.

teen-clinic-photo-cropped
From left: Anthony Magdaleno, David Corpus, Teen Health Clinic Director Dr. Peggy Smith and Baylor President, CEO and Executive Dean Dr. Paul Klotman.

“We promote the ABCs to our teen and young adult clients – practice Abstinence, Be faithful and wear Condoms,” said Dr. Ruth Buzi, director of social work at the Baylor Teen Health Clinic. “We urge our patients to think about the bigger picture by focusing on their future and their education.”

The clinics also perform routine HIV testing of their patients – meaning that when patients come in for an appointment, they are automatically screened for HIV unless they specifically request not to be tested.

If a patient is diagnosed with HIV, the focus turns to linkage to care, Buzi said, since the Teen Health Clinic does not provide HIV/AIDS treatment. One way they do this is through the development of a mobile app called Hi5 4 Health that provides information on clinics that do provide treatment as well as resources on sexual health overall.

One growing area of concern, Buzi said, is that advances in treatment have led some young people to feel like HIV is no longer a significant health issue. “We do activities all year long to make our population of patients aware of HIV/AIDS, with a special focus on prevention. World AIDS Day gives us another opportunity to encourage our patients to reduce their risks and to know their status,” she said.

Globally, the Baylor International Pediatric AIDS Initiative at Texas Children’s Hospital continues to be a leader in providing HIV/AIDS care in Sub-Saharan Africa and beyond. The Center of Excellence in Malawi is representative of the global efforts, and recently celebrated its 10th anniversary. The Center is located at Kamuzu Central Hospital in Lilongwe.

bipai-malawi-1
The Baylor College of Medicine Children’s Clinical Centre of Excellence – Malawi 10th Anniversary Celebration took place on Nov. 11, 2016. Credit: Smiley Pool

Before Baylor Malawi opened in November 2006, there was limited HIV/AIDS care there for adults and particularly for children, for whom antiretroviral medication was not available.

Baylor College of Medicine Children’s Foundation – Malawi altered the landscape in the African nation forever by testing to identify HIV-positive people, then getting them the treatment they needed to regain health. Child formulations of HIV medicines were provided, along with family planning to stop further spread of the virus.

Perhaps most importantly, Baylor Malawi shared its expertise by teaching local health professionals across the country in the specialized care of HIV-infected infants, children and adolescents.

In the decade that followed, Baylor Malawi expanded to test and treat more children and their families, added pediatric care in other childhood conditions, including tuberculosis, malaria and malnutrition. It remains the only stand-alone center in Malawi devoted to the treatment of HIV-positive children and sees an average of 100 patients a day.

Its community outreach program, Tingathe, was founded at Baylor Malawi and has spread across the region, covering 10 countries across southern Africa. The program hosts more than 60 Teen Clubs nationally, to support HIV-positive youth as they transition to adulthood.

Major initial funders for Baylor Malawi included the Malawi Ministry of Health, AbbVie Foundation (formerly the Abbott Fund), Elizabeth Glaser Pediatric AIDS Foundation, Texas Children’s Hospital and Baylor College of Medicine.

Today, Baylor Malawi receives the support of additional partners, including Bristol-Myers Squibb, Children’s Investment Fund Foundation, ConocoPhilips, GIZ, Malawi College of Medicine, National AIDS Commission (Malawi), Norwegian Church Aid, Partners in Hope, UNICEF, and USAIDS.

bipai-malawi-3
Baylor College of Medicine Children’s Clinical Centre of Excellence – Malawi 10th Anniversary Celebration. Credit: Smiley Pool

Another globally-focused project is the Collaborative African Genomics Network (CAfGEN), established almost three years ago with funding from the National Institutes of Health. It’s a partnership of Baylor College of Medicine and BIPAI sites in Botswana and Uganda, along with Makerere University in Uganda and the University of Botswana.

The goal of CAfGEN is to study the genetic and genomic factors that affect the progression of HIV and tuberculosis in children in sub-Saharan Africa. It’s part of the Human Heredity and Health in Africa Initiative (H3Africa).

Baylor researchers recently attended the ninth annual H3Africa conference, where they met with other members of the H3Africa consortium to present their research and provide working group reports. The consortium meetings are held every six months in a different African nation. The latest conference was in Mauritius, and included an opening address by the country’s president, Dr. Ameenah Gurib-Fakim, a renowned scientist who has been working in the field of biodiversity.

Dr. Graeme Mardon, professor of pathology and immunology and principal investigator for the Baylor side of the CAfGEN grant, said that it was gratifying to hear the country’s president emphasize the importance of the consortium and support its members’ efforts to train African scientists in the latest research technology and to solidify their expertise, which is another main goal of H3Africa and CAfGEN.

Six African trainees have been conducting research at Baylor through CAfGEN under the direction of Mardon and Dr. Neil Hanchard, assistant professor of molecular and human genetics. Their research uses state-of-the-art genomics technologies to study a rare group of HIV-infected children who can control the infection for years without needing anti-retroviral therapy to prevent AIDS.

A second area of research is investigating a group of HIV-positive children infected with tuberculosis to identify new genes associated with TB disease progression. Patients in these studies are recruited from the BIPAI centers in Africa.

Additional Resources

Learn more about local HIV/AIDS treatment and research.

Visit the BIPAI and CAfGEN websites.

-By Dana Benson