So… it was a long journey, but finally I’ve arrived- Lilongwe, Malawi!
This morning, my cousin Linda drove me back to the Jo-burg airport for my flight to Lilongwe. This time the plane was much smaller, there was no entertainment aside from the aggressive on-board duty-free peddling (their air stewards must be on commission), but the ride was smooth and short and there were lots of friendly people on board. Every Malawi resident I met seemed to know of the Baylor Clinic where I’ll be… certainly a good sign for how much headway the clinic has made in Malawi’s capital city during its short 8 months of existence.
I was picked up by one of BIPAI’s drivers, Francis, at the Lilongwe airport and driven to the Clinic itself, changing cash and picking up a cell phone SIM card on the way. I called home quickly and then went off to my new home (at least for the summer), a four bedroom place currently occupied by a doctor who will be getting in later tonight, and soon-to-be-occupied by more. The place is tidy, spacious, fitted with bednets, and generally perfect for my needs- I’m grateful to Baylor for providing it. What came as quite the surprise given the serene-looking surroundings of my house discovering that I have two night guards. Better yet, one of them goes simply by the name “Commander.” Sweet!
I spent the rest of the evening cooking some pasta for myself and the guards and reading the Baylor HIV/AIDS manual. From this point onwards, I think I’m going to include one random/interesting fact about HIV that I pick up from my work here with every post.
(Disclaimer: nothing in this blog should EVER be considered medical advice - I'm barely a quarter-way through med school!)
Todays fact: Post-exposure prophylaxis (PEP). If there’s a chance you’ve been exposed to HIV (eg. accidental needle stick, rape), you have a short window of opportunity to drastically decrease your chances of actually contracting the virus. It takes 24-48 hours for the dendritic cells in the mucous membranes and skin which initially receive HIV to migrate into the lymph nodes and on to the peripheral blood stream where they can spread it widely to CD4 T cells and others. Getting on antiretroviral drugs, particularly AZT, can actually stop transmission of HIV. (This is in contrast to drugs' roles in people who already have HIV, for whom they can only help contain the virus rather than eliminate it altogether.)
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2 comments:
How exactly does the PEP work? Does it target dendritic cells specifically?
Sounds like you're having an exciting time so far! Keep posting man!
P.S. Working for Ali in this lab here at the Brigham is one of the best decisions I've ever made in my life.
hey john,
sorry i've been so delinquent about responding to posts- i've basically had just about enough internet access to upload new posts from my laptop...
but as far as PEP goes, it really consists of just the regular drugs used in HIV treatment- but applied so early after exposure that the virus does not even get a chance to go through its FIRST replication cycle and integrate into cellular genomes. I don't believe its dendritic cell specific, it is just an HIV-specific treatment (eg by inhibiting HIV's reverse transcriptase or protease), but applied before HIV becomes systemic.
I'm glad that things are really working out for you in Ali's lab! Just from knowing him earlier, i had no doubt this would be an awesome learning experience for you.
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