Some HIV patients suffer from terrible neurological disease. Then, there are others that never have any cognitive problems at all. The same virus, but very different responses. That’s why most days you can find Dianne Langford working in a lab on Temple University’s campus, researching how HIV affects the brain. But once a year, her research takes here around the world to Ethiopia. It’s a country ravaged by HIV with little capacity to treat those infected, including infants born to HIV positive mothers.
“An Ethiopian baby is born with an immune cell count as high as any other baby, but as they become adults, their cell count drops significantly below anybody else’s in the world and we don’t know why,” says Langford, Ph.D., assistant professor of neuroscience and neurovirology at Temple University School of Medicine. “It’s a population with unique characteristics not found in other African populations or any other population in the world tested so far.”
It is also a population suffering because of HIV. Federal figures show nearly one million people are living with HIV/AIDS in Ethiopia. And while AIDS killed 67,000 Ethiopians last year, it’s most devastating toll is on the children, leaving some 650,000 as orphans. Researchers trying to learn more about the killer disease are hampered since, for cultural and religious reasons, autopsies are rare.
That’s why little is known about HIV-1C, a subtype of the virus which accounts for more than 50 % of HIV infections all over the world. It is the most dominant form of the virus, yet it is only found in Ethiopia, sub-Saharan Africa and India. And it is very different from subtype B, the form of the HIV found in this country. HIV-1C may be different in its progression and how it affects the brain, which is why Langford focused on Ethiopia. For the past five years, she’s volunteered through the non-profit People To People, a non-governmental organization dedicated to easing the burden of the HIV/AIDS epidemic in Ethiopia and other sub-Saharan countries, but it’s a mission that happened more by chance than choice.
“I was at an international NIH meeting in Baltimore in 2003 and people were giving power point presentations using all kinds of fancy graphics,” says Langford. “Then, a soft-spoken Ethiopian woman stood up and spoke about HIV in her home country. No presentations; just her own experiences and I was so impressed.”
Minutes after that woman’s presentation, Langford met the head of People To People, Dr. Enawgaw Mehari. She doesn’t know what made her say yes, but she found herself agreeing to go to Ethiopia. Three months later, she was on a plane for her first trip there to see in person the effects of HIV. And in the five years since that fateful encounter, she has worked with scientists at Addis Ababa University School of Medicine in Ethiopia to secure a $250,000 NIH grant to study what HIV-1C does to the brains of Ethiopians. As she has crossed continents, she has also lifted taboos. Government officials in Ethiopia agreed to allow her team to perform 200 autopsies to date.
“There was a lot of legal wrangling and delays, but we finally did the autopsies and we’re on the right track to finding out more about this devastating disease,” says Langford. “It mutates from patient to patient, within a patient and even as it travels around the globe and that’s why it’s so hard to find a vaccine.”
It may be hard, but Langford and her fellow researchers are determined to learn how and why HIV-1C is different from other subtypes. Their work could make a difference in how doctors treat the virus. Until then, Dianne Langford will continue on her life’s mission, one inspired by one woman’s story.