Joanne Langley and Innocent Valea on Ebola vaccine in people living with HIV

So we're here to talk about your study that's published in the October issue of The Lancet HIV and is online already.

And it's about the intersection of Ebola and HIV.

And Ebola outbreaks affect regions where HIV is a public health concern.

And what do we know about how HIV impacts Ebola outbreaks and how Ebola interacts with HIV?

That's a very interesting question.

I think we know much more about how Ebola outbreaks affect actually health delivery services, which of course include HIV services, than what is actually the biological interaction.

between HIV and Ebola infection.

I can answer this question, or I see it in actually three perspectives.

The infection itself, then the transmission, and finally the programs that are implemented in the various countries.

So your question actually includes three small questions, if I may say so.

Does HIV make Ebola infection more severe? This is one.

To answer this, I could say this is possible, but not yet fully demonstrated currently.

As we know, untreated or advanced HIV might impair the body's human function.

So, in theory, it could worsen Ebola outcomes because Ebola survival depends, as we know, on early unit and adaptive human control.

There is a review that actually compares Ebola and Sudan virus infection states, which states that actually HIV has been suggested, has a risk factor for susceptibility and death, but robust human epidemiological evidence is still lacking currently.

Data are sparse, if I may say so.

There is very few data set directly examining HIV co-infection.

I could myself identify, I think, one of them.

It was in Uganda, an outbreak, a Sudan virus outbreak in Uganda, where about 18% of tested Ebola patients were HIV positive.

But the paper did not show any difference in Ebola outcomes by HIV status, actually.

So to date, what we have to know is that the most established mortality predictors remain for Ebola, the virus viral load, the age, the severity of adpresentation, Of course, the organ dysfunction and also the delay to care rather than actually HIV status effect.

Second point I can see in your

question, does HIV increase Ebola transmission? Once again, there's no strong evidence that HIV changes the usual transmission pattern of Ebola.

What we know is that Ebola spreads mainly through the direct contact with blood or body fluids of symptomatic persons.

or someone who died from Ebola.