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Gail Henderson to Advise Federal Agencies on Human Genome Initiatives and to Present at HIV Conference in Thailand
The new year is proving fruitful for Gail Henderson, PhD. The professor of Social Medicine and Director of the Center for Genomics and Society at UNC has been confirmed for a four-year term as a member of the National Advisory Council for Human Genome Research, and asked to speak at the 19th Bangkok International Symposium on HIV Medicine.
“Serving on the Advisory Council is a distinct honor,” said Henderson.
In her new role, Henderson will work with other council members on advising the U.S. Department of Health and Human Services, the National Institutes of Health (NIH) and National Human Genome Research Institute (NHGRI) about genetics, genomic research, training, and programs related to the human genome initiative.
Since 1990, the National Human Genome Research Institute has supported research on ethical, legal, and social implications (ELSI) of genomics, and UNC has become a major center for this work. For Henderson, this began in 1999 with funding to study how researchers and study participants understood the possibilities of new, cutting-edge genetic technology—in gene therapy trials. Since then, UNC investigators from the Schools of Medicine, Public Health, Nursing, Law, and Arts and Sciences have pursued ELSI issues in genomics as investigator-initiated grants and larger consortia. And more than a decade ago, the Center for Genomics and Society at UNC was funded to support research and training on ELSI issues now and in the future.
Henderson has served as director and principal investigator of the interdisciplinary Center for Genomics and Society at UNC since 2007. In 2013, the Center was renewed for another five years, to conduct “GeneScreen” – a study of the harms and benefits of screening asymptomatic adults for rare, medically actionable mutations.
Research Focuses on Study Volunteer Behavior
In mid-January, Henderson will travel to Thailand to present during the 19th Bangkok International Symposium on HIV Medicine. Her talk is titled “Why Do People Join or Decline HIV Cure Research?” The talk is based on data from a recently awarded, four-year R01 from the National Institute of Allergy and Infectious Disease (NIAID) that explores decision making for HIV remission trials taking place in Bangkok.
This award is part of a special NIAID Program Announcement for research on ethical and social issues in HIV research. In this work, colleagues at UNC, RTI, the U.S. Military HIV Research Program/Henry Jackson Foundation, and the Thai Red Cross AIDS Research Centre are collaborating on a longitudinal study of HIV remission trial joiners and decliners.
“We are collecting empirical data on how people in actual, ongoing HIV remission trials come to these decisions and why,” Henderson said.
The Democratic Republic of the Congo (DRC) has one of the highest rates of people living with malaria. Rapid diagnostic tests (RDTs) account for more than 70 percent of diagnostic testing for malaria in Africa. Most rapid test diagnostics rely on the detection of histidine-rich protein 2 (HRP2), an antigen specific to Plasmodium falciparum malaria. However, one of every 15 children infected with Plasmodium falciparum malaria parasites in the DRC is infected by a pfhrp2-deleted mutant, producing a false-negative result when an RDT is used, investigators from the University of North Carolina at Chapel Hill found. Their results were published in the Journal of Infectious Diseases and discussed during a recent World Health Organization meeting during the American Society of Tropical Medicine and Hygiene’s annual conference in Atlanta.
“This is the first nationwide study to demonstrate the presence and estimate the prevalence of malaria caused by pfhrp2-deleted P. falciparum in asymptomatic children,” said Jonathan Parr, M.D., M.P.H., the study’s lead author and a researcher within UNC’s Infectious Disease Epidemiology and Ecology Lab. “Because most rapid diagnostic tests in the DRC are HRP2-based, they will fail to detect these parasites. Their spread would represent a serious threat to malaria elimination efforts.”
Samples were collected from children under the age of 5 during the 2013-2014 Demographic and Health Survey in the DRC. The UNC team focused on 783 samples with opposing rapid test diagnostic test and polymerase chain reaction (PCR) results. PCR testing showed positive results for malaria where rapid diagnostic testing did not.
“We identified 149 P. falciparum isolates with a deletion of the pfhrp2 gene, representing a country-wide prevalence of 6.4 percent,” Parr said. “This proved that pfhrp2-deleted P. falciparum is a common cause of rapid diagnostic test negative, but PCR positive malaria test results among asymptomatic children in the Democratic Republic of the Congo. Surveillance for these deletions is needed and alternatives to HRP2-specific rapid diagnostic tests may be necessary.”
The WHO and UNC coordinated a meeting Tuesday morning in Atlanta to address these parasites. The meeting brought together leading researchers, policy makers, commercial diagnostic developers, and representatives from diverse national malaria control programs to review what’s known and to formulate a response. Alternate rapid diagnostic tests will be deployed in settings where they are found to be common, and further research into their clinical impact and distribution throughout Africa will be undertaken.
The DRC project resulted from an NIH-funded study of malaria transmission led by Steven Meshnick, M.D., Ph.D., professor and associate chair of epidemiology at the UNC Gillings School of Global Public Health. Meshnick emphasized the need for a measured response.
“It is important to note that these mutated parasites have only been found in a small number of places in the world,” Meshnick said. “HRP2-based rapid tests continue to play a key role in malaria control and elimination efforts.”
The team is actively investigating these parasites through applied genomics studies recently funded by the Thrasher Research Fund and the ASTMH/Burroughs Wellcome Fund and ongoing NIH-funded epidemiological studies in Kinshasa Province, DRC.
This November David Currin, RN, ACRN, CCRC, will check two achievements off his bucket list. Currin will take a river boat cruise down the Danube in Europe. And he will also be honored as the HIV/AIDS Nursing Certification Board’s 2016 Certified Nurse of the Year.
“I was so surprised and excited when I received the letter that I would be receiving this year’s award,” says Currin, who serves as the Certified Clinical Research Coordinator and the Clinical Quality Program Manager for UNC’s Global HIV Prevention and Treatment Clinical Trials Unit. “Honors and awards are not why I do this work. I am going to dedicate this award to the memory of the friends I lost in the 1980s and 1990s to HIV.”
Certified as a research coordinator and an HIV nurse clinician, Currin has spent the past 15 years seeing patients on study at UNC and at affiliated site like the Wake County Health Department. At any given time, he sees participants from five to six studies, including those funded by the government and those trials funded by pharmaceutical companies. He splits his time between these duties and overseeing the team who manage the data collected by the unit’s many studies.
“My heart is really in seeing research patients,” Currin says. “I got my start after nursing school at the state’s mental health hospital. When I came to UNC in 2001, the first studies I saw patients on were treatment naïve trials. These were people who were being diagnosed with HIV and had never initiated therapy. Because of my psychiatry background, I felt I could help them identify ways to accept their diagnosis and the lifelong commitment of taking daily medications.”
Currin has watched as the research field has shifted from studies aimed at identifying the best treatment for HIV to those focused on prevention and a cure. He has also witnessed the demographic of those infected with the virus shift from an older population to youth.
“When I first started at UNC, I was seeing patients on study who were my age,” Currin says. “But now those newly diagnosed are in their teens and twenties. We are seeing the next generation living with or at risk for HIV. But what is exciting is that we have these important studies about pre-exposure prophylaxis, or PrEP, to prevent HIV now. HIV Prevention Trials Unit (HPTN) 073 was my first PrEP study. We also have a cure for another viral infection – hepatitis C virus. I was the study coordinator for that successful treatment trial at UNC. It gives me hope that maybe we will see a cure for HIV.”
“David has worked in HIV/AIDS nursing for the last 15 years, initially as a study nurse, followed by years of progressively increased responsibility,” Marcus says. “He always brings the highest level of professionalism and commitment to everything he does, providing superb care, spotless data and personalized support to each study volunteer. He fosters collaboration and continuous learning among his peers, serving as a trainer, mentor, friendly advisor and role model. I am privileged to work with him and was pleased to nominate him for this well-deserved honor.”
Farel works with Currin to connect patients from the Wake County Health Department and the UNC ID Clinic with research studies.
“He does an incredible job of ensuring that patients have all of the information they need to make a good decision,” Farel says. “What’s so important and special is that he makes sure that staff are comfortable communicating this information – this ensures that all of our patients have a chance to be a part of the progress we are making in the fight against HIV and in improving the lives of people living with HIV. He is a patient teacher to staff and colleagues and is always happy to answer a question or explain a study.”
Robert Dodge, PhD, RN, ANP, AACRN, is president of the HIV/AIDS Nursing Certification Board that is presenting Currin with the award.
“David was selected for this commitment and compassion to the nursing field, particularly in the area of HIV,” says Dodge. “He has the ability and interest in teaching other health care professionals what it means to be compassionate, caring and supportive to patients with HIV.”
Currin jokes that he is also known in the research unit as “the hugging nurse.” He said it is a habit he started after noticing the power of touch when he was a nursing student treating his first patient with HIV. The patient had been attacked and stabbed in a phone booth because of his sexual orientation. Because he was living with HIV, he was put in a hospital room much further down the hall than the other patients. Currin noticed the man had a partial plate in his mouth and asked if the patient would like him to clean it.
“As a first semester nursing student, I was only allowed to take a patient’s vital signs, give baths, change their sheets and provide oral care,” Currin says. “When I noticed this patient had a partial plate in his mouth, I offered to take it out and clean it for him. He had been in the hospital several days by this point and had undergone two surgeries. I took it out and he sighed. I looked at the plate and it was so dirty. I realized no one had offered to clean it for him before me. He was my first patient and I will always remember how this small act really made a difference. That is why I offer a hug to my patients. Sometimes just listening and giving someone a hug can make all the difference.”
A donation of pathology equipment between two schools in the University of North Carolina (UNC) system will save lives and improve lab operations in Malawi.
UNC-Pembroke sent a Leica Bond Max Machine for Immunohistochemistry (IHC) and In Situ Hybridization (ISH) to UNC-Chapel Hill’s site in Lilongwe, Malawi. These particular instruments will allow the laboratory at UNC Project-Malawi to get more detailed information about the tumors that are diagnosed in patients there. This information improves the accuracy of the diagnoses the pathologists make, which in turn helps to make certain that patients in Malawi are being treated appropriately.
“The impact the donated equipment will have in Malawi is significant,” says Nate Montgomery, MD, PhD, UNC-Chapel Hill Department of Pathology and Laboratory Medicine. “The stains performed on these instruments are part of the standard-of-care here in the United States, but there is only a very limited capacity to do them in Malawi. The instrument donated by UNC-Pembroke changes that. This gift will help bring an important tool to a place with far too few resources.”
The Leica machine provides automated staining, which will allow UNC Project-Malawi’s lab technicians to process more specimens.
“Neither the pathology lab nor immunohistochemistry existed in Lilongwe until UNC Chapel Hill introduced them in 2012, and immunohistochemistry has now become a routine part of lab operations,” says Satish Gopal, MD, MPH, UNC Project-Malawi Cancer Program Director. “The automated stainer from UNC-Pembroke will allow us to process even more patient specimens with higher efficiency, while freeing up our technicians to do many other vital lab functions. This is essential in a setting where the per capita health care workforce is orders of magnitude smaller than the US. To handle the overwhelming clinical volume with limited trained staff requires high levels of efficiency, and the new instrument will be critical in this regard.”
The equipment donation was born out of a collaboration between Ben Bahr, PhD, William C. Friday Distinguished Professor of Molecular Biology and Biochemistry at UNC-Pembroke, and Stephanie Montgomery, DVM, PhD, Assistant Professor of Pathology and Laboratory Medicine at UNC-Chapel Hill. The pair was working together on the pathology of Alzheimer’s disease when Bahr mentioned his team did not use the Leica machine very often. Months later, Montgomery learned that UNC-Project-Malawi could benefit from this technology and she contacted Bahr.
“I think it is important that we want to make sure this machine is being utilized for the best operation to help people,” says Bahr. “It is very exciting to be part of this worldwide effort and help people on the other side of the planet.”