B.C. researchers on the leading edge of the fight against HIV/AIDS
July 19, 2015 (The Province) — Sixteen-year-old Nicole Ticea has wasted no time in throwing her considerable brains into the fight against AIDS.
The Vancouver high school student has launched her own company to develop a low-cost HIV test designed to give early-stage proof of whether a person has been infected with the AIDS virus.
Ticea got the idea for the test after studying scientific literature when she was 14. Since then, she has been showered with prizes at science competitions in Canada and the U.S.
Last December, she formed a company, OneWorld Diagnostics Inc., to advance her efforts to develop a prototype of the test.
But Ticea, who will start Grade 12 at York House School this fall, isn’t doing this to get rich. She hopes the test will help to save the lives of people who test positive for the virus, especially in the developing world.
“With AIDS, early (drug) therapy has been linked to a drastically increased survival rate and life expectancy,” she says from California, where she’s doing lab work. “Individuals who know they’re infected will take precautions to keep from passing the virus on.”
Starting Sunday, about 6,000 HIV/AIDS experts from around the world will meet in Vancouver for the eighth International AIDS Society (IAS) conference — the world’s largest scientific gathering on HIV/AIDS. For four days, they will study advances in HIV research and how to apply them to control the disease.
Over the past 20 years, B.C. has built a reputation as a powerhouse in HIV/AIDS research. Researchers such as Ticea are helping to keep the province on the cutting edge of the global effort to subdue AIDS.
Dr. Julio Montaner, director of the B.C. Centre for Excellence in HIV/AIDS and conference co-chair, says B.C. has developed a strategy that can beat the epidemic if the world’s governments make the financial commitment.
Montaner is in an excellent position to know. As the lead researcher on the team that developed the highly active antiretroviral therapy for HIV, he announced the results of trials of the treatment at the 1996 IAS conference in Vancouver.
That form of therapy has since become the global standard for treating HIV. Ten years later, Montaner introduced a strategy he developed called Treatment as Prevention (TasP).
Under TasP, early and sustained antiretroviral therapy reduces the HIV virus in blood and sexual fluids to the point where it prevents the spread of HIV. Since 1994, the number of new AIDS cases in B.C. has fallen by 88 per cent, and AIDS-related deaths by 83 per cent.
The United Nations has embraced TasP as the foundation of its effort to end AIDS globally by 2030.
In May 2014, B.C. extended its pioneering efforts in controlling AIDS by becoming the first province to establish guidelines to normalize testing of adults for HIV. The province is encouraging all B.C. adults to be tested for AIDS every five years.
A study published Friday shows TasP saves money. B.C. could save up to $66.5 million over the next 25 years by expanding the program.
Science has yet to find an AIDS cure or vaccine, making research such as Ticea’s vital, Montaner says.
“If you don’t know you are HIV infected, you cannot protect yourself from the progression of the disease and you cannot protect others,” he says. “Control of the epidemic fundamentally starts by knowing your HIV status.”
Montaner hails research into drug abuse as charting another frontier in the fight to control AIDS.
Earlier this month, Centre for Excellence research scientist Dan Werb was awarded a $1.5-million Avenir Award from the U.S. National Institute on Drug Abuse for a project to look at how to prevent injection drug use and the spread of addiction. The award is given for research on HIV and substance abuse.
Last month, medical marijuana producer National Green Biomed committed $1 million to University of B.C. to support research by assistant professor of medicine M-J Milloy. He will study marijuana’s potential to treat HIV, and to ease pain and nausea triggered by medications used to tackle HIV/AIDS.
Montaner says AIDS patients have long maintained that cannabis helps them. “This contribution will allow us to begin to rigorously assess whether these benefits are truly real,” he says.
In another initiative, Simon Fraser University health sciences professor Mark Brockman — one of Nicole Ticea’s mentors — is looking into factors that increase the risk of HIV infection among adolescents and young adults in South Africa. Brockman and his team will also look into what keeps young people from taking part in HIV clinical trials.
“While we are doing our research in South Africa, identifying ways to really engage young people in making their own health decisions may uncover strategies that can be implemented in Canada as well,” Brockman says. “That might be at-risk or homeless youth or aboriginal and First Nations populations.”
INSTI HIV TEST: RESULT IN 60 SECONDS
Richmond-based BioLytical Laboratories has a fast way to help the estimated 19 million people across the world today who don’t know they have the AIDS virus.
BioLytical’s Insti HIV test will deliver a positive or negative result in as little as 60 seconds after a person supplies a drop of blood.
This makes it the world’s fastest HIV test to have been approved by health regulators in North America, Europe and the World Health Organization, the private company says.
The hand-held Insti test can be brought to remote outreach centres rather than requiring people to come long distances to labs, says Rick Galli, BioLytical’s chief technical officer.
“It reduces the stigma and anxiety around testing so more people may say ‘yes’ to having a test because it’s so quick,” Galli says.
The speed of the antibody test enables thousands of people to be diagnosed in a single clinic in one day, he says.
The city of Rosario, Argentina, used Insti to test 3,733 people across 10 locations in a single day in 2012. The test has an accuracy of 99.5 to 99.9 per cent, he says.
Most people develop HIV antibodies that can be tested within 30 days after infection.
“However, it can take as long as three months to develop HIV antibodies in rare cases, therefore a negative result in any antibody test, including Insti, within the three-month window period following infection does not rule out HIV infection,” the company says.
Last year, UNAIDS (the Joint United Nations Programme on HIV/AIDS) launched the 90-90-90 strategy, which aims to end AIDS around the world by 2030.
The first leg of the strategy is to have 90 per cent of people aware of their HIV status by 2020.
“Tests like ours help to identify those individuals living with HIV who are unaware of their infection,” Galli says.
“That links it to the second and third phases of 90-90-90 by bringing them into therapy.”
Insti, which took eight years for BioLytical to develop and bring to market, is manufactured at the 51-person company’s Richmond facility.
BioLytical declined to identify the test’s selling price.
In Canada, the test is sold to health-care institutions such as pharmacies, hospitals and clinics. It’s not available for over-the-counter sale to the general public.
In this country, the test is performed by health-care professionals such as doctors, nurses and pharmacists.
A JOB TO LIVE FOR
Nicole Ticea has created a summer job that’s to die for — and to live for.
The 16-year-old Vancouverite is developing an early-stage HIV test at a lab at Stanford University in California.
She and her dad are renting a townhouse in Palo Alto in the heart of Silicon Valley so she can make an easy daily commute to Stanford and get on with her work — which is saving lives. It’s her second summer working at Stanford.
Ticea is her own boss, as founder of OneWorld Diagnostics, the company she formed last December as a vehicle for her research. She co-ordinates a team of 14 other researchers who focus on different facets of the test’s development.
She’s hoping to have the do-it-yourself test on the market in five years, initially in poor regions of India and sub-Saharan Africa, followed by the developing world. While the test will work for all ages, it’s mainly targeted at children.
As it stands now, Ticea says, mothers in remote villages must often bring their children to a distant clinic for testing. Samples are sent to labs in large cities. Results take up to a month to be returned to the clinic.
All too often, the mothers can’t get back to the lab to get the results.
“Up to 90 per cent of patients are lost to followup,” Ticea says. “They never get the results and are never put on therapy.”
The test, as Ticea envisions it, will be simple and, at $5 US each, inexpensive. Users will put a drop of blood on the sample application pad, twist the device and read the results 60 minutes later.
• Take a drop of blood (you can do this yourself with a lancet, sort of like a glucometer)
• Apply the fingerstick blood to the sample application pad
• Twist the device
• Read the results 60 minutes later
Ticea notes this is merely a conceptualization of how it works — the team is not at that stage yet. However, the guiding principle and ultimate goal of the research is to make it user-friendly and electricity-free; anything short of that and she says they aren’t achieving their objective.