CNN explores an Ebola isolation unit where a doctor believes he is successfully treating patients with a medication meant for HIV.

[Emily]

http://www.youtube.com/watch?v=GXIqIEL3LNk

Published on Sep 26, 2014

CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

Dr. Logan has tried the drug, Lamivudine, on 15 patients and only 2 died. (7% vs the 70% rate without treatment according to the reporter's data.) Four women awaiting quarantine release were shown and one was interviewed and she said she feel's fine, has a good appetite, and credits the drug treatment.

The CNN reporter said they contacted top doctors in the US and they said that since there are similarities between Ebola and HIV viruses, the mechanism sounds possible, but a lot more proof would be needed for this to be determined effective.

 

[Graupel]

Re: CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

Re: CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

NB: 2 of 15 = 13.3 % (95% CI: 2-40%).

 

[Emily]

Re: CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

Re: CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

My calculator agrees with you, Graupel. I listened to the video again and I'm still hearing 7% from the CNN reporter. But even at 13%, that would be a great improvement if this can be replicated.

 

[Graupel]

Re: CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

Re: CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

Sorry to be pedantic, but with N=15 and no further detail, it really means very little (ie, randomization, initial prognosis etc). If those 15 happened to be younger/fitter than the 'average' patient, well...

On the very positive side, 3TC has *a lot* of study, is cheap, and should be readily available in large quantities.

 

[Emily]

Re: CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

Re: CNN explores an Ebola isolation unit where a doctor is successfully treating patients with a medication meant for HIV.

I think you are just being realistic, Graupel. I noticed that the 2 recovered women I could see clearly were young and wondered the same thing about the age factor. Also I wondered about the virus mutating to be less deadly.

The women interviewed did attribute their recovery to the drug so must have experienced at least a correlation in timing. I can only hope that this drug proves useful.

 

[Emily]

Re: CNN explores an Ebola isolation unit where a doctor believes he is successfully treating patients with a medication meant for HIV.

http://www.cnn.com/2014/09/27/health/ebola-hiv-drug/

Doctor treats Ebola with HIV drug in Liberia -- seemingly successfully
By Elizabeth Cohen, Senior Medical Correspondent
updated 12:36 PM EDT, Mon September 29, 2014
(CNN) -- A doctor in rural Liberia inundated with Ebola patients says he's had good results with a treatment he tried out of sheer desperation: an HIV drug.

Dr. Gorbee Logan has given the drug, lamivudine, to 15 Ebola patients, and all but two survived. That's about a 13% mortality rate.

Across West Africa, the virus has killed 70% of its victims.

Outside Logan's Ebola center in Tubmanburg, four of his recovering patients walk the grounds, always staying inside the fence that separates the Ebola patients from everyone else.

...

"I'm sure that when [patients] present early, this medicine can help," Logan said. "I've proven it right in my center."

Logan is mindful that lamivudine can cause liver and other problems, but he says it's worth the risk since Ebola is so deadly.

He also knows American researchers will say only a real study can prove effectiveness. That would involve taking a much larger patient population and giving half of them lamivudine and the other half a placebo.

"Our people are dying and you're taking about studies?" he said. "It's a matter of doing all that I can do as a doctor to save some people's lives."

Logan said he got the idea to try lamivudine when he read in scientific journals that HIV and Ebola replicate inside the body in much the same way.

"Ebola is a brainchild of HIV," he said. "It's a destructive strain of HIV."

At first he tried a drug called acyclovir, which is often given to HIV patients to treat infections that occur with their weakened immune systems. But it didn't seem to be effective. Then he tried lamivudine on a health care worker who'd become ill, and within a day or two he showed signs of improvement and survived...

This does look hopeful even if unproven. Dr. Anthony Fauci asked CNN to give his contact info to Dr. Logan so they can discuss this. Dr. Fauci says that Lamivudine is a nucleocide analog, and other drugs in this class are being studied to treat Ebola.

One thing to note is that in another article, Dr. Logan emphasizes that Lamivudine is just part of his approach to treating Ebola. He uses rehydration, antibiotics, fever reducers and some supplements.

This might not be relevant to how nucleocide analogs work, but it describes a similarity between ebola virus and HIV:

http://www.nature.com/nm/journal/v7/n12/abs/nm1201-1313.html

Nature Medicine 7, 1313 - 1319 (2001)
doi:10.1038/nm1201-1313
HIV-1 and Ebola virus encode small peptide motifs that recruit Tsg101 to sites of particle assembly to facilitate egress
Juan Martin-Serrano, Trinity Zang & Paul D. Bieniasz

Aaron Diamond AIDS Research Center and The Rockefeller University, New York, New York, USA
Correspondence should be addressed to Paul D. Bieniasz pbienias@adarc.org
Retroviral Gag proteins encode sequences, termed late domains, which facilitate the final stages of particle budding from the plasma membrane. We report here that interactions between Tsg101, a factor involved in endosomal protein sorting, and short peptide motifs in the HIV-1 Gag late domain and Ebola virus matrix (EbVp40) proteins are essential for efficient egress of HIV-1 virions and Ebola virus-like particles. EbVp40 recruits Tsg101 to sites of particle assembly and a short, EbVp40-derived Tsg101-binding peptide sequence can functionally substitute for the HIV-1 Gag late domain. Notably, recruitment of Tsg101 to assembling virions restores budding competence to a late-domain−defective HIV-1 in the complete absence of viral late domain. These studies define an essential virus−host interaction that is conserved in two unrelated viruses. Because the Tsg101 is recruited by small, conserved viral sequence motifs, agents that mimic these structures are potential inhibitors of the replication of these lethal human pathogens.

 

[Vibrant62]

Re: CNN explores an Ebola isolation unit where a doctor believes he is successfully treating patients with a medication meant for HIV.

And for 'good news', lamivudine is an old drug and therefore available as a generic.

 

[Emily]

Re: CNN explores an Ebola isolation unit where a doctor believes he is successfully treating patients with a medication meant for HIV.

http://www.liberianobserver.com/news/dr-logan-wants-support-his-ebola-treatment-protocol%E2%80%99-which-he-has-used-%E2%80%98cure%E2%80%99-10-ebola-patients

Dr. Logan Wants Support for His Ebola Treatment Protocol
Sun, 10/05/2014 - 22:27 admin
By: Alvin Worzi

...

He, however, stressed to the Observer that it was yet too early to say that his experiment was working or works effectively against the deadly disease, which has so far killed over 2000 persons in Liberia alone. He said he determined to carry out the test on as many as 500 patients so as to validate his claim that his self-invented protocol works well against the virus.

...

He explained that only people who come for early treatment can be provided the Lamivudine drug especially from the first day of the symptoms of Ebola to the fifth day, adding that, ?Not only Lamivudine drug that is needed to cure Ebola patients and anyone who comes late cannot be given the drug.?

According to him, blood samples of the 10 were taken and tested by all professional doctors and nurses including people from the Centers for Disease Control (CDC) as well as other international partners working in collaboration with the County Task Force in Bomi...

Good! Again the article stresses that due to potential liver toxicity, this drug MUST be administered and monitored carefully by a qualified doctor.

 

[AlaskaDenise]

Re: CNN explores an Ebola isolation unit where a doctor believes he is successfully treating patients with a medication meant for HIV.

According to Wikipedia writeup on Lamivudine, it was originally use for hep-B. It is a chain terminator of DNA synthesis, thereby stopping viral DNA growth.

See: http://en.wikipedia.org/wiki/Lamivudine

.

 

[Emily]

Re: CNN explores an Ebola isolation unit where a doctor believes he is successfully treating patients with a medication meant for HIV.

Thank you, AlaskaDenise! There is an interview with a virologist here:

http://www.independent.co.uk/news/world/africa/ebola-outbreak-liberia-doctor-treating-patients-with-hiv-drugs-claims-13-out-of-15-survived-9759642.html

It's amazing yet it was invented decades ago.

 

[Emily]

Re: CNN explores an Ebola isolation unit where a doctor believes he is successfully treating patients with a medication meant for HIV.

There is a comment after the post below that gives the background as to why HIV was thought of as a slow hemorrhagic fever virus.

http://www.virology.ws/2014/10/09/treatment-of-ebola-virus-infection-with-brincidofovir/