Posted December 8, 2008

Inspired to act

Inside a Temple scientist’s mission to study HIV in Ethiopia

Some HIV patients suffer from terrible neurological disease. Others never have any cognitive problems at all. Both groups carry the same virus, but respond very differently. 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. Once a year, however, her research takes her around the world to Ethiopia. Ravaged by HIV, the nation has little capacity to treat those infected with the virus, 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, a Ph.D. and assistant professor of neuroscience and neurovirology at Temple University School of Medicine. “It’s	Photo courtesy of Dianne Langford The face of hope: Langford with toddler Tefsanish, an AIDS orphan. Tefsanish is one of 650,000 children left parentless in Ethiopia because of AIDS. The non-profit People To People runs an orphanage to provide housing for kids, like Tefsanish, whose name means “hope” in Amharic.
a population with unique characteristics not found in other African populations or any other population in the world tested so far.” Ethiopia is suffering gravely because of HIV. Federal figures show nearly one million live with HIV/AIDS. And while AIDS killed 67,000 Ethiopians last year, it’s most devastating toll is on the nation’s children — some 650,000 have been orphaned. Researchers trying to learn more about the killer disease are hampered since, for cultural and religious reasons, autopsies are rare.

Photo by Dianne Langford

Big business: A man sells coffins in the Addis Ababa market, a common practice on the streets of Ethiopia.

That’s why little is known about HIV-1C, a subtype of the virus. Though it accounts for more than 50 percent of HIV infections throughout the world, it is found only in Ethiopia, other sub-Saharan African countries and India. HIV-1C is very different from subtype B, the form of the virus found in the United States. 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 Powerpoint 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. I was so impressed.”

Minutes afterward, Langford met the head of People To People, Enawgaw Mehari, M.D. Langford 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.”

These challenges aside, 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 a woman’s moving story.

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