OT-Melissa and Hubby

iVillage Member
Registered: 09-09-2007
OT-Melissa and Hubby
14
Sun, 01-11-2009 - 8:28pm

I was wondering what you both thought of this...

"The first baby in the UK tested before conception for a genetic form of breast cancer has been born."

http://news.bbc.co.uk/2/hi/health/7819651.stm

"Pre-implantation genetic diagnosis (PGD) involves taking a cell from an embryo at the eight-cell stage of development, when it is around three-days old, and testing it.

This is before conception - defined as when the embryo is implanted in the womb.

Doctors then select an embryo free from rogue genes to continue the pregnancy, and discard any whose genetic profile points to future problems. "

Photobucket Thanks to Andie for my siggy!



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iVillage Member
Registered: 06-24-2008
Wed, 01-21-2009 - 11:43am
Yes, Anthony is his name :) I'm sure he can put together the rest of his response this evening.. but then I work evenings .. so I'll post it either late tonight or tomorrow morning :)


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Lilypie Expecting a baby Ticker


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iVillage Member
Registered: 10-18-2007
Wed, 01-21-2009 - 11:54am

I thought I saw that :o) **** edited to say, looking at your siggy, I thought Anthony was the name of your baby until I saw it in our discussions... man I'm getting old ****

No rush, I appreciate taking the time to respond - I'm sure he's got other things to do. Mostly curiosity, and HIV/AIDS research is rather vast and overwhelming. Thanks again.




Edited 1/21/2009 11:56 am ET by criticalthinker
iVillage Member
Registered: 06-24-2008
Thu, 01-22-2009 - 11:10am

Now answer your second question:
what are your long term
> thoughts on antiretroviral treatment for those diagnosed with HIV infection
> but are asymptomatic?

First of all, let me delve into a little bit of HIV virology and
treatment as it applies to the current state of medicine. The virus
itself is extremely variable and has a high mutation rate, so most
drugs we develop against it will eventually be outmoded by the rapid
evolution of the virus. Additionally, the virus is segregated into
three main families Main (M) composing most of the worlds infections,
New (N) composing newly evolved HIV that does not fall into group M
and Outlier (O) which is composed of viridae with extremely unique
characteristics. In group M alone there are about 12 subvariants
called Clades A-L and even within these clades viruses can cross over
and make recombinants with other clades should a person be infected
with two strains. Add this to 15 genes cross over possibilities and
you have a When we speak about antiretrovirals (ARV's) we are speaking
of several distinct classes of drugs that have variegated actions
against HIV. The first ARV's were developed almost 20 years ago and
were known as Reverse transcriptase inhibitors (like AZT). RT
inhibitors essentially are faulty analogues of DNA and thus bind up
the viral enzyme that is responsible for making viral DNA from RNA.
In the beginning of the HIV epidemic these drugs were extremely
effective and prolonged people's lifespans from months to several
years by helping to indirectly raise CD4 count and thus prevent
opportunistic infection. The virus, however, has evolved many ways
around these drugs and now there are many other classes of ARV's
targeted at almost every step of the viral life cycle. For example
there are now protease inhibitors that prevent the viral protease from
cleaving its structural proteins before assembly, integrase inhibitors
that prevent the integration of newly transcribed viral DNA into the
host genome, and fusion inhibitors that prevent entry into the host
cell (although these regimens can cost 20,000 per year). In the early
90's Dr. David Ho and his team combined two RT inhibitors plus a
protease inhibitor to create the now famous triple cocktail which has
saved many from an early death due to this virus. Now with the
advances in medicine we have it may be possible to have life
expectancies of 20 + years with HIV and years with normal CD4 counts
and low viral titers. In fact, some of these people have nearly
undetectable viral titers while on medication but once they come off
of the drugs they rapidly deteriorate within a matter of weeks or
months. We will probably never completely conquer this virus with
medication even if we had all of the drugs to stop it at each point of
its life cycle because many of these drugs are extremely hard on the
patient and can actually cause severe complications themselves so it
would be difficult for most people to mix and match therapies to
certain degrees. As far as people with very low viral titers are
concerned, I would still place them on ARV's if they were my patient
for several reasons. First of all it should be known that some people
(long term non-progressors or LTNP) are genetically different and
actually can control the virus well for quite some time. In these
people several factors can be at play
1. A faulty virus as in the "Australian cohort" described in the
literature who were infected with a virus lacking a functional "nef"
protein that allowed them to live for many years. It is, however
still a good idea to monitor these people and place them on ARV's
since the virus could backmutate and regain it's normal phenotype
2. There is also a group of LTNP known as elite controllers who
actually have a particular variant of major histocompatibiltiy genes
that is highly efficient at presenting HIV antigens to CD8 T-cells
3. The final group of controllers includes those who generate high
titer neutralizing antibodies (see work by David Montefeori on patient
AC) but these people also have an ability to produce antibodies that
are of unusual shape and affinity.

In all of these groups I would still recommend ARV's for these
patients since these viruses could easily overtake the body if they
gained mutations literally overnight. Also, when these viral titers
are suppressed greatly, it decreases the risk of transmission to
others. This is especially important for a virus that is mutating
against the phenotypic background of an LTNP since these viruses are
often quite well developed and very hard to neutralize.

I hope this answers your questions but feel free to ask more HIV and
Influenza were my research specialty so I'd be glad to answer any
questions I just don't have a lot of time so these are kind of like
midnight snack diaries or something like that.

Anthony



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Lilypie Expecting a baby Ticker


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iVillage Member
Registered: 10-18-2007
Thu, 01-22-2009 - 12:43pm

<>

:o)

Thanks for your time and insight.

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