Mayce Al-Sukhni: Tell us a bit about your research….
I’m looking at the infection of the HIV virus in the brain. I’m interested in trying to understand how drug transport, particularly p-glycoprotein (glucose transport)… first of all, to see how structure and function of the protein change in response to inflammatory conditions as seen in the HIV infection of the brain and secondly, how to detect the distribution of antiretroviral drugs in the brain, and ultimately, further down the road, how will this affect efficacy of treatment, long-term outcome, and so on. So, hopefully, it’ll put into context that first off, HIV infection of the brain is a major problem, and secondly, we still need to treat it.
M.Al-S.: What do you think about the human impact of HIV?
P.R.: A lot of the work that has been done at the basic science level has focused mostly on the North American and Western infection.
My personal opinion is that Africa as a whole and Southeast Asia have been largely neglected with respect to a lot of HIV research. I tend to feel that there is a lot of work that needs to be done to look into the way that the viral infection is different in African society.
I think it’s important to start looking at better alternatives, to start looking at, for lack of a better term, “Africocentric” or “Asiocentric” type of treatment because the virus is so different. This is not to say that we should neglect North America; a lot of the insights that we get from North America can be translated to Africa.
M.Al-S.: What about the issue of drug access?
P.R.: I tend to feel that drug access is important, but with the caveat that we don’t know if these drugs will actually work. I think it would be far better to first, start clinical trials and open up access to the medication. And if these medications aren’t working, to start research programs to understand why they aren’t working. The Western world, and to a certain extent some of the developing world, has the technology to combine together and start to answer some of these questions.
HIV is such a complex issue and such a difficult disease to treat, especially when you have, what I like to call, a relatively smart virus that mutates and changes its form almost on a daily basis.
M.Al-S.: How do you feel about the fact that certain scientists and politicians proclaim their own beliefs about the HIV virus that may be contrary to mainstream scientific views?
P.R.: It’s frustrating because it is approaches like that that do generally tend to cause a few impasses. For example, when the president of South Africa announced that HIV doesn’t cause AIDS, researchers in the Western world felt that this is why in portions of the underdeveloped world there is such an issue with treating the disease and promoting awareness.
We can go into clinics anywhere in Africa and say that ‘this is what you need to do to prevent transmission’, but there are cultural differences that we need to take into account.
It’s scary that in Africa, it’s estimated that in some countries approximately two-thirds of the population will be infected. When you have politicians and various focus and political groups getting in the way of the research, it does get a bit frustrating.
At the same time, it also can be quite rewarding when you do make a break, and you can tell people this is what we’ve got, and we think that we might be able to make an impact on the community. For example, there’s a group at U of T, several different departments have looked at developing a mobile HIV testing clinic and they have actually got it in place in Africa, which is great. Seeing things like that happen is really quite encouraging in our field, and we can see that we are making some headway.
