T-Minus Two Days

Hello (soon-to-be) loyal readers!

Now that the whirl-wind that was the first year of medical school is done, I have time and energy to focus my energies on my next adventure: a summer of research in Malawi! This new-found time and energy is just in the nick of time, too, because I take off in exactly 48 hours and 30 minutes!

In Malawi I will be working with the UNC Project, a partnership between the Univeristy of North Carolina and the Malawian Ministry of Health. As such, I will be working with investigators from Baylor University and University of North Carolina to test a new method of diagnosing HIV in neonates.

Traditional HIV tests, which look for antibodies to the virus, cannot be used in children under 18 months because maternal antibodies which are acquired during gestation and delivery are still presesnt in the newborn (potentially giving false positives). This presents a problem because it has been found that if parents of potentially HIV-positive newborns take their children home, they may not have the ability, resources, or desire to return for testing 18 months later.

Thus to effectively initiate antiretroviral therapy (ART) in HIV+ newborns researchers and clinicians need to overcome a public health problem and a diagnositc problem. Clinicians need a diagnostic tool that doesn't look for antibodies and they need a tool that can be used at point-of-care (POC) so that the families don't have to return to the hopsital. The test that we will be evaluating this summer has already been shown to be diagnostically useful, it is called the p24 assay and it looks for a viral protein, which will only be present in children who are themselves HIV+, regardless of the maternal antibodies they carry. The study will also evaluate various manners of administering the test, in terms of which hospital personell are responsible, how the lab work is divided amongst responsible parties etc. The ultimate goal will be to find the most efficient way to identify HIV-positive newborns in order to initiate ART.

Contrary to what was believed in the early days of the HIV epidemic, it is now generally accepted that early initiation of ART therapy is critical to the patient's prognosis and can help sustain CD4 counts and prolong life expectancy. Thus this is an issue of critical importance to the estimated 91,000 Malawian children living with HIV.

While I have a background in HIV-related research in the 'developing world' and currently serve as an HIV testing counselor through the UNC student clinic, SHAC, I anticipate that this summer will be full of new lessons and new challenges. I am looking forward to learning about Malawian people and culture, putting the skills I learned this year into use, and contributing to an important project that has the potential to vastly improve the prognosis for children born with HIV in Malawi.

I'm thrilled and honored to be working with some of the best, brightest and most dedicated in this field, and alongside two of my classmates who are as committed and excited as I am. I'm glad that you all will be joining me on my adventures, some of you actively and some of you vicariously. As the summer progresses and I learn more about blogging I hope to improve the look of the blog and provide pictures, info on Malawi and more about the project. I look forward to your questions and comments and sharing what I'm sure is going to be a great experience with you!