It’s not easy battling HIV on two fronts, let alone on two continents, but with the help of his colleagues in Atlanta and in South Africa that’s exactly what Dr. Manu Platt is doing.
If all goes according to plan the Georgia Tech and Emory biomedical engineering professor’s cutting-edge research will give doctors the ability to predict, treat, and prevent the occurrence of cardiovascular disease in HIV patients while he also develops a low-cost diagnostic tool that could help monitor patient success with treatment to help stem the spread of HIV in Africa.
At the time not much was known about the connection between HIV and cardiovascular disease; although it was clear that HIV patients were at much higher risk of suffering cardiovascular events than the general population. The risk was even higher for children born with HIV, something that is far too common in countries like South Africa where 10-15% of the population is HIV positive.Dr. Platt, an assistant professor in the Georgia Tech and Emory University Wallace H. Coulter Dept. of Biomedical Engineering, began his foray into HIV research as a first-year professor in 2009 when he answered a call for new researchers that was jointly sponsored by the National Institute of Health (NIH) and the International AIDS Society (IAS).
While attending the 2009 IAS conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa, Platt realized that his lab at Georgia Tech was ideally suited for addressing this critical gap in HIV research.
“Here at Georgia Tech we do tissue engineering,” says Platt. “We’ve been doing it for years and we’ve been doing it very effectively in the cardiovascular arena.”
“We can make tissue-engineered arteries with human cells that can be infected by this human virus. We’re also great at having bioreactors that can recreate the human physiological flow environment with shear stress and pressure. We have an excellent test system for HIV-mediated cardiovascular disease. “
The difficulty is that there is limited access to HIV samples within the United States, and that’s where Platt’s collaboration with Dr. Denise Evans in South Africa comes in. The duo met at the IAS conference in Cape Town and instantly realized that their areas of research dovetailed very nicely. Evans works out of the Helen Joseph Clinic in Johannesburg that sees over 400 HIV positive patients per day, that agree to donate their for research purposes and get reimbursed for travel while awaiting their chance to see the doctor.
Knowing what enzymes are tied to cardiovascular events in HIV negative patients, Platt and his Georgia Tech collaborator, Dr. Rudy Gleason (Mechanical Engineering and Biomedical Engineering), travelled to South Africa’s University of Witwatersrand last fall and ran tests on samples drawn from patients at the Helen Joseph Clinic in order to determine if those markers were higher than in the general population.
“We knew that these enzymes are important to the disease and we had already developed a test to measure them,” said Platt, “but we had not measured them in HIV patients.”
Platt and Gleason will continue analyzing their results over the next few months while they also work with their other collaborator, Dr. Roy Sutliff, from the Emory University School of Medicine’s Department of Pulmonology, who specializes in mouse models which have been instrumental in the group’s cardiovascular research. Once they complete their analysis of the results the trio should be able to guide other researchers and drug companies in developing new and more effective ways to treat cardiovascular disease in HIV patients.
But that’s not all. Like many fields of research, Dr. Platt’s work had an unforeseen application. When he was developing tests for the enzymes that cause cardiovascular disease it was suggested to Platt by Dr. Evans that he also look for a few other key markers in the samples drawn from the South African samples. The theory was that by measuring viral load and T-cell counts conclusions could be drawn about how well patients are following their drug regimen since t-T-cell counts should be tied to how regularly they are taking the antiretroviral drug cocktail used by HIV patients in Africa.
The problem is that the drugs have to be taken daily, and a single lapse could cause a patient’s viral load to spike and their T-cell count to drop, greatly endangering their health.
While many patients are very adherent to the drug regimen not all are, and local community groups have been looking for a simple, low-cost bio-marker that would help indicate how adherent a patient has been and how well the antiretroviral cocktail is working. Platt and his colleagues are developing that test and are in the process of adapting it for the field so that it can be easily transported and used by traveling doctors.
“If it starts to pan out we’ll have a great test to send out in the field to see if people are taking their drugs,” said Platt. “That’s where the engineering comes in- we’re trying to optimize it to make it even simpler, easier, and inexpensive.
“It’s a test that we also use for cancer studies in my lab. We already have a post-doc working on improving the device so it can be put on a cancer clinician’s bench. While they’re doing that it will totally work in parallel with the HIV analysis.”
HIV patients who are undergoing regular drug treatments greatly reduce their risk of transmitting the virus which is why the phrase “Treatment is Prevention” is the mantra in the world of AIDS.
By developing a tool that can help clinicians monitor patient progress Platt is helping to stem the spread of HIV while simultaneously using his cardiovascular research to improve the lives of those already living with the virus.