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Tag: infectious diseases

Are we curing HIV with stem-cells?

March 7th, 2019 by The Hello Doctor Team

Ever since HIV was first identified in the 1980s, the medical community has been trying to identify a viable cure for it. This week, they got one step closer. In the UK, a patient’s HIV became “undetectable” following a stem cell transplant, only the second case of its kind.

What is a stem cell transplant?

A stem cell transplant has replaced the traditional “bone marrow transplant” used as an effective treatment for diseases of the blood and bone marrow, like leukaemia. Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains special cells that develop into either red blood cells, that carry oxygen through your body, white blood cells that fight infections, and platelets that help with blood clotting

In the “old days”, actual bone marrow needed to be extracted and replaced with healthy marrow, but these days, doctors use “stem cells”. Stem cells form the foundation of your entire body and act as building blocks for the blood, immune system, tissue and organs. These cells are not only able to replicate and regenerate themselves, but they also can differentiate into any kind of specialised cell in the body. Stem cells are essentially “master cells”, taking the form of whatever cell is needed. In the case of a bone marrow transplant, stem cells from a healthy person are extracted via the blood and then transfused into the person needing the transplant. The new stem cells find their way into the bone marrow, where they grow and start to produce healthy red blood cells, white blood cells and platelets.

 

The “Berlin patient”: the first person to be cured of HIV

In 2005, an HIV positive man was diagnosed with acute myeloid leukaemia, a cancer of the blood and bone marrow which causes an overproduction of white blood cells. His treatment required both chemotherapy and a stem cell transplant. During their search for a donor, his medical team came up with the idea to look for a donor with a mutation called “CCR5 Delta 32”. CCR5 is a protein found on the surface of CD4 cells which acts as an entry point for HIV. Without this protein, there is no way for HIV to enter the cells.

The theory was that if the patient’s original bone marrow could be replaced with stem cells from a donor with this mutation, the new bone marrow and blood cells produced would be immune to HIV.

After 2 stem cell transplants done in 2006 and 2008, doctors could find no evidence of HIV in the patients’ blood.

 

What are the results?

The recent case followed a similar pattern. The patient was diagnosed with HIV in 2003 and advanced Hodgkin’s lymphoma, a cancer of the white blood cells, in 2012. This patient received chemotherapy and a stem cell transplant from a donor resistant to HIV and has been in remission from both cancer and HIV for the last 18 months. Even after stopping anti-retroviral treatment, HIV has become undetectable in their blood.

Can we cure HIV with this procedure?

This finding is encouraging, but it is not yet the cure or treatment that millions of people are looking for. This approach is aggressive, expensive and not without complications. It’s also difficult to implement on a large scale basis.

However, results like these help direct future research towards different ways of approaching HIV, specifically how the body can naturally resist infection. This in turn, as a “proof of concept”, reaffirms the belief that HIV is curable.

References

Can HIV increase your risk for TB?

January 23rd, 2019 by The Hello Doctor Team

Tuberculosis (TB) is the world’s leading infectious killer. It’s also the number one cause of death among HIV-positive people. In 2015, over 10 million people across the globe had TB disease. Of these, about one million also lived with HIV (Human Immunodeficiency Virus).

If you’re wondering why these two infections often go together, and what you can do to stay free of TB if you’re HIV-positive, read on.

Why HIV increases your risk for TB

HIV is a virus that destroys those cells in your body that help to fight germs and infections. These are called CD4 cells. When you don’t manage your HIV properly, your body finds it hard to fight off the bacteria that cause TB.

If you’re healthy, your immune system is usually able to destroy TB bacteria before they make you sick. But if your immune system is struggling because of HIV, the TB bacteria can infect your body and stay there. The bacteria can either make you sick straight away or cause symptoms (e.g. coughing, chest pain, or coughing up blood) at a later stage.

Your risk of getting TB increases about three weeks after first becoming infected with HIV. If your HIV is not managed with antiretroviral treatment (ART) this risk can double by the end of your first year of HIV infection. If you’re HIV-positive, your risk of getting TB is around 27 times higher than people who don’t have HIV.

How TB hurts if you have HIV

If you do get TB, it can affect how fast HIV develops into AIDS (the final stages of HIV infection when your immune system is very weak). The TB infection speeds up the loss of your infection-fighting CD4 cells and ups your risk for other life-threatening infections.

While your body is focussed on fighting the TB bacteria, it takes the pressure off the HI virus, which means it can make new copies of itself faster.

How TB spreads

When you come into close contact with someone who has TB, you can easily become infected. When someone who is infected with TB coughs or speaks, the bacteria spreads through the air. If you’re nearby, you may breathe in the bacteria and become infected, too. The bacteria can lodge themselves in your lungs and begin to replicate. From here, they can move through your blood to other parts of your body, including your kidneys, bones and brain. When this happens, your life could be at risk.

Tips to prevent TB disease

If you have HIV, it’s important to take great care to prevent TB disease.

  • Start ART as soon as possible. Visit a doctor or clinic without delay, as your risk for TB and other infections is high.
  • Take your antiretroviral treatment as prescribed, for the rest of your life. This will help keep your immune system strong.
  • Get tested for TB. This is easily done with a blood or sputum test at your doctor’s consultation rooms or clinic.
  • Speak to your doctor about using an anti-TB drug. If it is prescribed, it’s important to complete the course.

If you do get TB, complete your course of antibiotics and regularly check in with your doctor to see if the medicine is working. If you don’t use your medicine exactly as prescribed, the TB bacteria may become stronger, and therefore harder to kill.

References:

How to prevent Hand, Foot and Mouth disease

December 8th, 2017 by The Hello Doctor Team

Hand, Foot and Mouth Disease (HFMD) is a common contagious, viral illness that often affects infants and children, although it’s possible for older children and adults to contract it too. Don’t confuse HFMD with that similar-sounding disease that affects animals though!

What causes HFMD?
HFMD is a viral infection that’s brought on by the Coxsackie A16 virus. Although a different, related virus called Enterovirus 71 can also cause HFMD, it’s highly unlikely that there are other strains of viruses that will cause the same symptoms.

The virus is highly contagious and can spread directly via saliva drops or bodily fluids, or unwashed hands and surfaces contaminated with the virus.

Symptoms
HFMD may cause some of these symptoms, or all of them. These include:

  • Fever.
  • Sore throat.
  • Painful sores on the hands and feet and inside the mouth.
  • A loss of appetite.
  • A general feeling of irritability and not being well.
  • A blistering, red rash on the soles of the feet, the palms of the hands and sometimes the buttock cheeks.

Am I at risk?
HFMD is more common among infants and toddlers younger than 10 and more often, those younger than five, especially in day-care and preschools. This is because the virus is more likely to spread through nappy changes and children putting their hands and feet in their mouths. Older children and adults can also contract HFMD.

How do I treat HFMD?
There’s no specific treatment for HFMD. The symptoms are treated separately to give relief and comfort, and usually clear up after two to seven days. The blisters and sores can last a bit longer. The symptoms often just run their course.

It’s recommended to treat the fever and sore throat by giving your child paracetamol and plenty of water to prevent dehydration.

Avoid acidic foods and drinks as these can be painful on the lesions in your child’s mouth. Ice cubes and fruity ice lollies can relieve those painful sores. Let the blisters on the skin dry out naturally. Monitor the blisters and sores regularly to avoid them getting infected.

How do I protect my family against HFMD?
There’s no immunisation or vaccination against HFMD. The best you can do is to avoid the disease from spreading.

  • Wash your hands frequently with warm water and soap, especially after changing nappies.
  • Don’t touch your eyes, mouth and mouth with unwashed hands.
  • Avoid close contact like hugging, kissing and sharing surfaces and utensils with someone who has HFMD.
  • If you or your child has HFMD, stay home from school or work until the symptoms clear up to avoid contaminating others.
  • Make sure your child’s day-care or preschool knows immediately, as other children might have been contaminated with the virus too.
  • Disinfect commonly shared areas like the bathroom and kitchen regularly.
  • Disinfect toys, blankets, bottle teats or dummies that might be infected with the virus.
  • Management at your child’s day-care or preschool should inform the parents when there is a case of HFMD.

Resources:

Is it an STD or bladder infection?

June 23rd, 2017 by The Hello Doctor Team

Does it itch, burn or scratch down under – and you don’t quite know what it is? Infections are common but embarrassing. The good news is that they’re treatable too! It’s important to know what’s what – down there. Here’s a guide.

The difference
A bladder infection means that a type of bacteria has invaded your bladder, causing pain and discomfort. An STD is a sexually transmitted disease that’s passed on during intercourse (most commonly). An STD is also an infection, and could be caused by bacteria, yeast, viruses or parasites.

With a bladder infection, the bacteria travel from the rectum or vagina into the urethra which is responsible for transporting urine into the bladder. This is what causes an infection. Once the bacteria are in the bladder, it attaches to its lining and causes an inflammation. The bacteria can also spread to the kidney, causing a kidney infection. A woman’s short urethra makes her more susceptible to getting an infection, as the bacteria can reach the bladder quickly.

An STD is contracted through sexual intercourse or transference (putting your hands, mouth and genitals on the sore of someone who’s infected). These diseases have a high chance of spreading from one person to the other. The infections and diseases usually carry no symptoms, so it’s a good idea to go for regular check-ups. STDs can be contracted through anal, oral, and vaginal sex, as well as sex toys.

Both can have similar symptoms, but there are some clear differences.

It’s a bladder infection if you have:

  • Burning or pain while urinating or during sexual intercourse.
  • Cloudy, bloody or smelly urine.
  • Trouble delaying urination.
  • A frequent and strong urge to urinate.
  • Pain in the pelvis, abdomen and in the vagina. Men are likely to feel pain in their prostate, scrotum or penis.
  • Nausea and vomitting.
  • Abdominal pains.

It’s an STDs if you have:

Well, the answer is not so simple. An STD can span everything from chlamydia to genital warts, and all of them have different symptoms. Here are common ones:

  • Pain and burning during urination.
  • White, cloudy or water discharge (males and females).
  • Pain in the lower abdomen during and after sex.
  • Flesh-coloured or grey bumps and swelling on the genitals.
  • Itching around the anus and vagina.
  • Blisters or sores on the mouth, penis or vagina, anus, urinary tract opening or cervix.
  • Infections in the rectum, genitals and throat. A pregnant woman with gonorrhea may spread the infection to the newborn baby during birth.
  • Sores on the genitals, rectum or mouth.

Good to know

  • Straight, gay, married or single; anyone can be at risk of getting an infection.
  • With infections like herpes, syphilis, and HPV, no penetration needs to happen or fluids exchanged for the infection to be passed. This is because the infections are transmitted through skin-to-skin contact.
  • It’s important to get any symptoms of an infection checked out by your doctor as soon as possible. Most of these infections can be successfully treated.
  • HIV can be transmitted through contact with infected blood, semen or vaginal fluids. This virus can cause AIDS and interferes with the body’s ability to fight infections.

The bottom-line is: if you have any symptoms down there, it’s a good idea not to wait it out, but go to your doctor. There is treatment available, and you wouldn’t want to infect your partner with a nasty bug!

References

 

How to live better with TB

March 23rd, 2017 by The Hello Doctor Team

Tuberculosis (TB) is a chronic infectious disease caused by a bacterium called mycobacterium tuberculosis. It usually manifests and destroys parts of the lungs, making it difficult to breathe, but can also spread to and attack the bones, joints and nervous system.

TB bacteria can live in the body for years without any symptoms or spreading to others.

How TB is spread
TB travels through the air. When a person with TB of the lungs or throat coughs, sneezes, or talks, droplets of the TB bacteria are released into the air. People nearby may breathe in these bacteria and become infected.

Signs and symptoms of TB include

  • Persistent cough lasting longer than two weeks.
  • Night sweats.
  • Chest pain.
  • Weakness and fatigue.
  • Poor appetite.
  • Rapid weight loss.

Treatment
Successful treatment takes at least six months, and medication must be taken exactly as prescribed. Incomplete treatment or not following a consistent program may cause you to develop drug-resistant strains of TB, which could be extremely difficult to cure, and even fatal.

Patients are put on a course of treatment for six to eight months as soon as TB is diagnosed. You will then receive tablets, and in some cases, injections for the first two months of treatment.

The treatment is also known as DOTS (Daily Observed Treatment Short course). The tablets have to be taken under supervision to guarantee regular and effective therapy.

Patients usually respond well to treatment and can soon return to work and live relatively normally again.

Good to know

  • Stay on track with all your medical appointments.
  • Take your medicines as prescribed.
  • Report any side-effects of your medication. If you plan to move during the time that you’re being treated, let your doctor know so that arrangements can be made for you to continue the treatment.
  • Healthy eating and exercise will keep your immune system strong and help to prevent TB, and help you to recover faster.
  • During treatment, eat healthy foods and get enough sleep.
  • Aim for at least 30 minutes of exercise a day to help your body fight off the infection.

Keep safe

  • Don’t spend long periods in stuffy, enclosed rooms with anyone who has active TB until that person has been treated for at least two weeks.
  • Use protective measures, like face masks, if you work in a facility that cares for people who have untreated TB.
  • If you live with someone who has active TB, help and encourage the person to follow treatment instructions.
  • Cover your mouth when you sneeze or cough so as not to infect your family. Oranges, bananas and garlic are helpful in easing symptoms as they inhibit bacterial growth and boost your immune system.

References:

Typhoid outbreak – what you need to know

January 8th, 2017 by The Hello Doctor Team

There has been a recent warning that South Africans could face a Typhoid outbreak after the summer holidays. Hospitals and healthcare centers have been notified to be on high alert, since the Typhoid infections that started in Zimbabwe, could spread here when holiday-goers come back after their holidays.

via GIPHY

What is Typhoid fever?

Typhoid fever is an infection caused by a bacteria (Salmonella Typhi). It spreads easily through food and water contaminated by sewerage. You can also get it from someone who has the infection. It’s quite common in overcrowded areas with overcrowding & poor sanitation.

How do you get typhoid fever?

Typhoid is spread through the faecal-oral route. This means that the bacteria are found in the faeces (stool) of an infected person. You can get the infection from water, food or other objects that have been contaminated with the infected stool. If you eat/drink contaminated items or touch contaminated surfaces you will get the infection.

What are the symptoms?

Unless it’s treated, you can get these symptoms over a few weeks:

Week 1:

  • A step-wise fever: this means it gets higher over the day, and then drops by the morning again.
  • Headache
  • Stomach pain
  • Constipation or diarrhoea
  • Feeling tired
  • Loss of appetite
  • Rash

Week 2:

  • Fever that stays high
  • A swollen stomach
  • Very bad constipation or diarrhoea
  • Weight loss

Week 3:

The person becomes very ill and confused. If he/she isn’t treated, this is usually when the infection gets worse, and complications happen, such as bleeding into the intestines and infection of the blood.

Week 4:

If the person has survived, their fever will start returning to normal this week.

People who recover from Typhoid can still carry the bacteria in their system, without being sick. The bacteria still spreads through their faeces, infecting others.

In 1900, there was a cook who worked in the restaurants in New York city. She infected more than 50 people during her cooking career, and was later called ‘Typhoid Mary’.

How do you get treated?

Luckily we can very successfully treat typhoid with antibiotics. If the infection is treated in time, you can be cured before life-threatening complications happen.

So how can I keep myself from becoming infected?

If you have plans to travel to a country where Typhoid is common – such as Zimbabwe – make sure that you have taken the vaccine. It should be available at your nearest travel clinic. Other than that – be sure to follow basic hygiene rules:

  • avoid ordering raw or unpeeled fruit and vegetables from restaurants
  • wash any fresh fruit and vegetables thoroughly before eating
  • make sure you wash your hands well after using the bathroom
  • wash your hands thoroughly before eating anything – even a snack

Remember: you may not be in touch with an infected person directly, but they touch many other things that you are in contact with: door handles, counters and cutlery. So be sure to wash your hands often.

Article adapted from original by Dr. Lynelle Hoeks

Safe frisky business

November 15th, 2016 by The Hello Doctor Team

Things are getting heated more often now, but you aren’t worried. You always use condoms, you’re on the Pill and you and your partner are free of STIs. You have nothing to worry about, right? Wrong. There are many other factors to think about when it comes to your sexual health.

Continue reading “Safe frisky business”

Swatting the stomach bug

February 26th, 2016 by The Hello Doctor Team

Guard your stomachs everyone, the bug is back. That’s right, it’s the season of the stomach bug, that one virus that can force you to become best frenemies with your porcelain throne for a day. If you don’t want to spend your valuable time hugging or sitting on the loo, then follow these rules. Continue reading “Swatting the stomach bug”

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