Author Archives: JaneWanjiru

A Post-Antibiotic Future is Probable

The discovery of antibiotics (drugs used to fight pathogenic bacteria) revolutionized medicine in 1930’s and ’40’s. Today, these wonder drugs eradicate 548 million bacterial infections successfully every year. Prior to this, bacterial infections were mostly fatal; cholera for instance had a mortality rate of 80% as opposed to today’s less than 1%; without surgery, appendicitis and bacterial meningitis had a mortality rate of 100% as opposed to today’s less than 10%. However, the recurrence of the pre-antibiotic era is very probable due to what The World Health Organization is currently considering one of the world’s most serious health crisis – antibiotic resistance.

What is antibiotic resistance?

Antibiotic resistance is the natural phenomenon in which certain bacteria continue to divide and multiply in the presence of an antibiotic. This happens because like most organisms, bacteria are subject to natural selection (a process in which organisms more suited for their environment survive and multiply while the less-suited ones die). Therefore, when bacteria are exposed to an antibiotic, most die; those that evade the effects of the antibiotic continue to divide, generating a new resistant colony; this evasion is possible due to random mutations or through the possession of unique genes transferred from bacteria to bacteria.

Image from Wikimedia Commons

Selection of antibiotic-resistant bacteria. Image from Wikimedia Commons

Since 1930’s, antibiotic resistance has always been offset by the continuous production of new antibiotics. However, due to antibiotics overuse and lack of advancement in developing new drugs, resistance rates are catching up! Last year, bacterial species resistant to our last resort antibiotic, colistin, was reported in China; this resistance is very worrying as colistin remains the best drug for tackling antibiotic-resistant infections unresponsive to the strongest antibiotics.

What are the effects of antibiotic resistance?

Antibiotic resistance has negative effects in our society. Out of 250,000 patients that acquire antibiotic-resistant bacteria in Canada, 8,000 pass away. This number is larger than the combined number of deaths from breast cancer, AIDS and traffic accidents! With time, it will grow larger due to the gradual loss of antibiotics effectiveness. Therefore, procedures dependent on the use of antibiotics such as chemotherapy and surgery will be harder to complete in the future.

If nothing is done, antibiotic resistance will lead to other unpleasant circumstances. For instance, a greater number of deaths from minor bacterial infections will be observed. Due to longer periods of illness and use of stronger, more expensive drugs, increased financial costs will also result; worldwide, an estimated 1.7 billion dollars is anticipated annually based on infections from one group of resistant bacteria. Lastly, use of stronger medication to treat infections will result in more side effects for patients.

How can we decrease the rates of antibiotic resistance?

Besides finding new treatment alternatives, avoiding overuse of antibiotics is the most effective way to combat antibiotic resistance. It is estimated that 50% of antibiotics  prescribed to humans are for viruses. We should aim to avoid taking antibiotics if they aren’t needed. In addition, finishing all prescribed antibiotics is crucial to minimizing the chance of nurturing antibiotic-resistant bacteria.

Why haven’t we found a vaccine for HIV?

In 1984, after the cause of AIDS was discovered, US Health and Human Services Secretary announced that a vaccine for HIV would be available in two years time. Three decades later, more than eighty clinical trials and over thirty prospective vaccines to date, the virus is still winning!

Image from Wikimedia Commons

HIV/AIDS distribution around the world as of 2008. Image from Wikimedia Commons

Why is it such an impossible task to create an effective vaccine against HIV? A task that seems to have disheartened many researchers from striving to find the solution to a persistent pandemic! Without a cure for AIDS, a vaccine is the only way to slow it down. So far, a total of 78 million people have been infected with HIV and although the number of new infections per year has dropped from 3.4 million as recorded in 2001, it has stagnated at 2.1 million since 2013; a number that is still considerably high. Therefore, with millions of dollars being allocated to HIV vaccine research annually, why is a breakthrough still lacking?

Normally, vaccines are composed of a harmless form of the virus or parts of it such as surface proteins; these stimulate immune cells to produce compounds known as antibodies that bind a small part of the virus component called an epitope; the attachment deactivates the virus preventing it from invading healthy tissues and causing disease. Vaccines also activate immune cells that kill infected cells.

However, successful in controlling more than 30 most contagious illnesses, this vaccine is defective when it comes to HIV. This is because HIV like the common cold virus undergoes numerous errors when replicating it’s DNA. Therefore, HIV’s epitopes are very prone to changing. Due to the high specificity of antibodies and ‘killer’ cells, viruses that have changed epitopes cannot be deactivated by the same antibodies and ‘killer’ cells. This property of HIV makes it very challenging to create an effective vaccine. Despite being weakened, using live HIV as a vaccine is also gravely concerning; it could possibly evolve into a virulent form as the virus is constantly mutating. HIV particles are also by nature very different despite being incredibly mutable. This is because they descend from numerous ancestors. For an effective vaccine to be created, its breadth should be large enough to account for all HIV variants.

Another setback in the development of HIV vaccine is the fact that AIDS recovery is rare; vaccines are usually geared to mimic the immune response generated by our bodies after infection and recovery from the subsequent disease. In the case of HIV, the body cannot develop this immunity as HIV attacks immune cells. Lastly, HIV integrates its DNA with ours and becomes a part of us! This gives ‘killer’ cells a hard time detecting infected cells where virus assembly takes place. These factors among others are what have stalled HIV vaccine development.

Despite the challenges, we are all capable of taking preventative measures to prevent further spread of the virus. To learn more on how to protect yourself, click here.

-Jane Wanjiru

Why haven’t we found HIV vaccine yet?

In 1984, after the cause of AIDS was discovered, US Health and Human Services Secretary announced that a vaccine for HIV would be available in two years time. Three decades later, more than eighty clinical trials and over thirty prospective vaccines to date, the virus is still winning!

Why is it such an impossible task to create an effective vaccine against HIV? A task that seems to have disheartened many researchers from striving to find the solution to a persistent pandemic! Without a cure for AIDS, a vaccine is the only way to slow it down; it has wiped out over 30 million people world wide and has over 34 million people currently living with HIV. Therefore, with millions of dollars being allocated to HIV vaccine research annually, why is a breakthrough still lacking?

Normally, vaccines are composed of a harmless form of the virus or parts of it such as surface proteins; these stimulate immune cells to produce compounds known as antibodies that bind a small part of the virus component called an epitope; the attachment deactivates the virus preventing it from invading healthy tissues and causing disease. Vaccines also activate immune cells that kill infected cells.

However, this type of vaccine, successful in controlling more than 30 most contagious illnesses, is defective when it comes to HIV. This is because HIV, like the common cold virus, undergoes numerous errors when replicating it’s DNA. Therefore, HIV’s epitopes are very prone to changing. Due to the high specificity of antibodies and “killer” cells, viruses that have changed epitopes cannot be deactivated by the same antibodies and “killer” cells. This property of HIV makes it very challenging to create an effective vaccine. Despite being weakened, using live HIV as a vaccine is also gravely concerning; it could possibly evolve into a virulent form as the virus is constantly mutating (changing). HIV particles are also by nature very different despite being incredibly mutable. This is because they descend from numerous ancestors. For an effective vaccine to be created, its breadth should be large enough to account for all HIV variants.

Another setback in the development of HIV vaccine is the fact that AIDS recovery is rare; vaccines are usually geared to mimic the immune response generated by our bodies after infection and recovery from the subsequent disease. In the case of HIV, the body cannot develop this immunity as HIV attacks immune cells. Lastly, HIV integrates its DNA with ours and becomes a part of us! This gives “killer” cells a hard time detecting infected cells where virus assembly takes place. These factors among others are what have stalled HIV vaccine development. But that does not mean a vaccine is impossible.

Despite the difficulties, no need to worry! We all possess an intangible, non-medicinal vaccine that undoubtedly has the highest success rate in preventing HIV infections so far; the will to take preventative measures as HIV isn’t easily transmissible. Learn more on how to protect yourself here.

-Jane Wanjiru