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Baltimore Project Aims to Decrease HIV in Nigeria

Dr. William Blattner, director of epidemiology and prevention at the Institute of Human Virology
Dr. William Blattner (Newsline photo by Nikole Albowicz)
By Nikole Albowicz
Maryland Newsline
Friday, April 23, 2003

BALTIMORE - Dr. William Blattner sees a devastating similarity between Baltimore and Nigeria: unbelievably high rates of HIV.

But Blattner, a professor and associate director at the Institute of Human Virology, hopes to turn that negative connection into something positive. He hopes that by working together, Baltimoreans and Africans can learn ways to lower the number of HIV infections in both places.

Blattner's vehicle to accomplish this difficult task is the University Technical Assistant Program, in which institute faculty offer advice and training on HIV prevention and treatment techniques to the Nigerian government and medical community.

"There is no doubt of the importance of a program that deals with HIV in Africa," says Boliji Adebiyi, deputy information attache for the Nigerian Embassy in Washington, D.C.  "It's a welcome development.  I'm sure it will be a tremendous help to Nigerians in educating them on HIV."

Battling Drug Resistance and Newborn Infections

Armed with a five-year, $4.4 million grant from the Centers for Disease Control and Prevention, Blattner and his colleagues will focus on helping Nigerian officials combat drug resistance and halt transmissions of the virus from mother to child.
Audio:
Blattner talks about how the HIV virus becomes drug resistant.
Avoiding resistance to drugs used to fight HIV-- something that experts in the United States failed to do --is a major goal. Ten percent to 15 percent of all new HIV infections in Baltimore involve a drug-resistant virus, Blattner says.

Resistance occurs when drug levels decrease in the body and the virus, which is no longer suppressed, mutates, Blattner says. It can happen when patients participate in multiple drug therapies or take drugs inconsistently, he says. The mutated, drug-resistant version of HIV soon emerges as the dominant virus in the body.

"Large-scale application of antiretroviral drugs, if not properly planned and monitored, can result in drug resistance and treatment failures," says Dr. Johnson Onoja, a Fogarty International Center trainee from Nigeria who is working at the institute.

As part of the program, experts from the institute will work with Nigerian officials to educate patients about HIV medications, Blattner says. Institute faculty will also work to ensure that patients in Nigeria take their medications consistently. 

"The goal that we have is to try and learn from some of the mistakes that we've made," Blattner says.

Staff will also educate Nigerian officials on techniques to prevent mothers from transmitting HIV to their newborns, such as promoting safe sex and encouraging use of bottled milk rather than breastfeeding, Blattner says.

In Africa, more than one in three children will become infected with HIV before their first birthday, according to institute’s 2001-2002 annual report.

“If you were married and were going to have a child and you were looking at the probability of hopelessness of bringing a child into the world with the prospects that they’re going to die at a young age from this virus, then you would feel very strongly that this is something that has to stop,” he says.

The War on AIDS vs. the War in Iraq

About 20 people from the institute are working on the project, along with five CDC officers (two in Nigeria), Blattner says. Each of the four Nigerian Centers of Excellence, which are located in Benin, Kano, Abuja and Nnewi, has two leaders and will eventually have a staff of at least 20.

2001 HIV/AIDS Statistics

Area People Living with HIV/AIDS
Baltimore City 12,292
Maryland 24,200
Nigeria 3,500,000
Sub-Saharan Africa 28,000,000
SOURCES: The Maryland AIDS Administration and UNAIDS 
Teams from the institute, usually made up of two people, travel to Nigeria on a rotating basis to work on the project. Faculty made their first visit to the African country in January. The last group to visit Nigeria returned home about two and a half months ago.

But the U.S.-led war on Iraq is slowing down the progress of the program, which began in November 2002 and is still in the early stages. 

A decision was made to suspend travel to Nigeria due to instability of the region right now, Blattner says. "So unfortunately, world events slow down our fight against AIDS."

But Blattner says a Nigerian team scheduled to come to the United States and meet with staff at the institute in early May still plans to make its trip.

Once travel resumes, some staff members will continue to rotate visits in shifts that last from 10 days to two weeks, while others may stay for longer periods, Blattner says.

Audio:
Blattner talks about his goals for the program.

Onoja says that researchers need to note differences in American and Nigerian cultures, such as attitudes toward superstitions. These factors, if not taken into consideration, may pose challenges to acceptance of the program, he says.

But Blattner is confident that the program will be a success. He even speculated that it could result in new techniques to fight HIV that could be used in the United States.

"There's an opportunity to learn both ways," he says.
 

Copyright © 2003 University of Maryland Philip Merrill College of Journalism


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