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“To end the HIV pandemic, we must continue to outthink this virus”

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Mary Rodgers, ‘virus hunter’, Principal Scientist and Head, Abbott Global Surveillance Center explains to Viveka Roychowdhury the importance of tracking virus mutations in HIV and viral hepatitis across the world to update their diagnostic tests

Abbott’s 20-year-old Global Surveillance Programme is the basis of the company’s diagnostics research programme leading to commercial diagnostic test products. What is the significance of your team’s recent discovery of a new strain of HIV called HIV-1 Group M, subtype L?
It has been 25 years since we established the Abbott Viral Surveillance Program to monitor HIV and hepatitis viruses globally to track mutations to help make sure our diagnostic tests remain up to date. The discovery of a new strain of HIV called HIV-1 Group M, subtype L by our team marks the first time a new subtype of HIV-1 has been identified in 19 years – since guidelines for classifying new strains of HIV were established.

This new strain is a part of the major group of HIV (Group M), which is responsible for 90 per cent of the pandemic, and has been traced back to the Democratic Republic of Congo (DRC). The new strain discovery helps researchers and healthcare providers stay one step ahead of mutating viruses and avoiding new HIV outbreaks. Since we live in a global village, we can’t think of viruses being contained to one location. This discovery reminds us that to end the HIV pandemic, we must continue to outthink this virus and use the latest advancements in technology and resources to understand its full scope.

What are the other disease areas tracked by Abbott’s Global Surveillance Programme?
At present, our programme focuses on HIV and viral hepatitis – both continue to be major global public health issues. India has the third largest HIV epidemic in the world, with 2.1 million people living with HIV (2017 data). 1 Globally, more than 257 million people are chronically infected with hepatitis B and 71 people are chronically infected with hepatitis C.2-3 As the only diagnostics company with such a unique, longstanding and large-scale Viral Surveillance Program, we provide a vital tool to keep pace with these evolving threats to help make sure our diagnostic tests remain up to date.

Since such diagnostics research has a huge impact on public health, is the company collaborating with governments of countries most affected so that the research information can be used to detect and possible contain potential pandemics?
As a leader in blood screening and infectious disease testing, Abbott created its Global Viral Surveillance Program 25 years ago to monitor HIV and hepatitis viruses and identify mutations to help our diagnostic tests stay up to date. We partner with blood centres, hospitals and academic institutions around the world. We also partner with researchers in the Ministry of Health in some countries. So far, we have collected more than 78,000 samples containing HIV and hepatitis viruses from 45 countries, identified and characterised more than 5,000 strains, and published 125 research papers to help the scientific community learn more about these viruses.

Last January, Abbott announced its partnership with YR Gaitonde Centre for AIDS Research and Education (YRGCARE) to study the country’s viral diversity to improve accuracy of diagnostic tests. What have been the outcomes of this partnership in this first year?
Our partnership with YRG Care aims to study the country’s HIV and hepatitis viral diversity and to help make sure our diagnostic tests remain up to date to keep pace with these changing viruses. Abbott has provided study protocol and diagnostic equipment, while YRGCARE has helped in screening and sequencing data from infected populations in India.

Our initial findings show diverse strains of HCV in India. Once we are closer to publishing our research, we can share details about the specific genotypes detected in the region. What’s interesting is that the geographical classification of the HIV and HCV strains identified confirmed that higher levels of viral diversity were present in cities near borders with neighboring countries where drug trafficking routes exist. Notably, the HCV strains that predominated in the Northeastern region varied dramatically from those identified in the Northern border. These results support the hypothesis that new strains have been imported to India via the Golden Triangle and Golden Crescent opium trade routes.

How will these outcomes help diagnose, treat and maybe prevent HIV infection in India?
The UNAIDS 90-90-90 goals are that 90 per cent of all people living with HIV will know their status, 90 per cent of all people with diagnosed HIV infection will get antiretroviral therapy, and 90 per cent of all who are on therapy will achieve viral suppression.

Continuous research, including the new HIV virus discovery, supports the first and the most important pillar of 90-90-90 goals. As we take it a step further to geographically classify viral strains and map where these strains cluster, this information allows us to understand what might be driving viral diversity in specific regions. This information could give us insights, not only into how we can diagnose—and even prevent—these infections, but also into where the global health community’s efforts should be focussed.

As a virus hunter, could you comment on ongoing efforts of other virus hunters to contain and treat cases of the novel Coronavirus?
My job as a virus hunter at Abbott means I’m always watching for the next threat to people’s health. When news like this breaks, we immediately start to track the situation. The public health community has learned a lot from past outbreaks, and those lessons likely led to a faster initial response to this one. The WHO, CDC and other organisations are taking swift action to address this serious public health concern.

References
1. HIV and AIDS in India. AVERT. https://www.avert.org/professionals/hiv-around-world/asia-pacific/india
2. Hepatitis B. WHO. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
3. Hepatitis C. WHO. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c

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