When you hear the words “HIV outbreak,”
what comes to mind? Does HIV seem like a problem in a distant country or a crisis that happened years ago? Think again: There
have been three HIV cases at Duke University in the past five years, and one as recent as the fall of 2003. Local infectious
disease specialists at the University of North Carolina at Chapel Hill shocked the community by publicizing this information,
and presenting evidence that there is an HIV outbreak here in North Carolina. This HIV presence originates from local colleges
and universities, and is the first HIV outbreak ever documented in US colleges. As if this wasn’t enough to disturb
college communities all over North Carolina, more than half of the HIV positive students in the study were identified through
a new method of HIV testing after they tested negative by traditional means. These
findings were presented by UNC disease specialists in February of 2004 at the 11th annual Conference
on Retroviruses and Opportunistic Infections.
Although
this study was only recently revealed, it dates back to the year 2000, when six males from North Carolina schools were diagnosed
with HIV. Since then, the population of HIV positive college students has risen significantly: 6 were diagnosed in 2000, 19
more in 2001, 29 more in 2002, and 30 additional cases in 2003. Dr. Lisa Hightow of UNC Chapel Hill chose to use the word
“outbreak” because of the dramatic rise of HIV occurrences in such a short time span. Many disease specialists are very concerned with the speed at which the disease is multiplying, want to
spread awareness of this outbreak to ensure that people are protecting themselves from infection.
This outbreak would not have been identified
without the improved HIV tests that were used in the aforementioned study. The new tests are based on P.C.R. (Polymerase Chain
Reaction), and they are able to detect HIV earlier than older tests, and in much smaller traces. Older tests (like the HIV
antibody test) require the subject to develop antibodies in their bodily fluids before they can be accurately tested, which
can take 1-3 months to appear. Some of the subjects in Dr. Hightow’s study tested negative by old testing means, but
were found to be HIV positive through PCR testing methods. They had the HIV virus, but hadn’t produced the antibodies
yet. The new PCR tests detect the virus directly instead of detecting antibodies. Why is this important? Because, someone
who receives negative test results from the antibody test (although they are HIV positive) may continue to have sex with others!
The new PCR tests are critical in stopping an HIV outbreak: If someone uses the new PCR test for HIV, they catch the disease
early, and avoid the transmission of HIV to others.
How exactly does this new testing method detect
HIV “directly’? It basically replicates HIV infected DNA hundreds of times until it is clearly detectable. HIV
testers can detect the virus much more easily when there are thousands of copies of the virus in their sample. There are three
steps to this testing process:
·
Step 1: A group of cells from the test
subject is taken from the body and heated to about 165 ° F until the double helix formation of all the DNA splits into single
strands.
·
Step 2: After the DNA is split into
two complementary strands, the sample is cooled to 55 ° F, which it the optimal temperature to add “primers” to
each strand of DNA. These primers are synthetic pieces of DNA, and they are specific to HIV, meaning they only attach themselves
to DNA that contains the HIV virus.
·
Step 3: After the primers attach themselves,
the sample is reheated to 75 ° F, and the DNA replication process begins: An enzyme reads only the strands with primers, and
fuses individual nucleotides to the strands to recreate the original double helix formation. Only the DNA with attached “primers”
is replicated, so only HIV infected cells are multiplied.
The abundance of DNA copies created in the test
makes any viral infection embedded in the DNA much more prominent and detectable. PCR testing can detect a single HIV infected
cell surrounded by 100,000 healthy cells. These tests are readily available all over the United States, and soon it may be
free to those covered by the Medicare and Medicaid Health Plan.
So, if we have discovered vastly more effective
testing methods for HIV, then why is the virus spreading through North Carolina colleges? Some blame apathy towards sexual
protection. Perhaps people think that HIV is old news, and if it hasn’t affected them yet, then it never will. Hopefully
this study will change their thinking, as well as yours. The above information can only remind you that HIV is still as dangerous
as it ever was, and inform you that it’s all over North Carolina. It’s up to you to protect yourself from HIV.
During your stay here at Duke and wherever you go, make smart decisions about sexual interaction every time you have sex.
Many people are scared to get tested, but most agree that it’s better to know that you have HIV than to unknowingly
spread it to others.
Bibliography
Altman, Lawrence K. New H.I.V. Test Identifies Cases in College
Students. 11 Feb. 2004. The New York Times.
Brown, David. HIV Outbreak Is Identified Early; New Strategy Uncovers Network of Sexual Liaisons in North
Carolina. 11 Feb. 2004. The Washington Post. <http://proquest.umi.com/pqdweb?index=1&did=000000543327591&SrchMode=1&sid=2&Fmt=3&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1077486763&clientId=15020>.
Polymerase Chain Reaction - Xeroxing DNA. National Center for Human Genome Research. <http://www.accessexcellence.org/AB/IE/PCR_Xeroxing_DNA.html>.
Wyler,
Liana. "HIV outbreak hits college campuses." The Chronicle 16 Feb. 2004.