Eliminating Infectious Diseases
For Dorothy J. Wiley and Dong Sung An, it was the rise of the then-mysterious disease called AIDS in the early 1980s that set them on their current research paths. For Wei-Ti Chen, it was her work in the 1990s as a nurse-midwife taking care of patients infected with HIV.
Now these three members of the UCLA School of Nursing faculty are at the forefront of research in their specialities, aiming to make a difference for those infected with the human immunodeficiency virus (HIV) and, in Wiley’s case, human papillomavirus (HPV).
Professor Wiley, PhD, RN, FAAN, has focused on community and public health prevention strategies for both HIV and HPV and on finding ways to help better fight HPV infections. Improved screening methods for cancers caused by these viruses, early diagnosis and precancer treatment and methods that improve patient adherence are all areas of focus for Wiley. Thirty percent of cancers are caused by external factors, such as viral infections like HPV.
DOROTHY WILEY, PHD, RN, FAAN
The American public is becoming increasingly aware that HPV can cause cervical cancer in women, but it also can cause anal and oropharyngeal cancer in both women and men. A 2013 study led by Wiley found that HIV-positive men who have sex with men are at higher risk for the type of HPVs that most often cause anal cancer. A 2017 study published in Lancet and co-authored by Wiley, looked at various factors of an HPV vaccine that prevented infection by 9 different HPVs administered to women ages 16 to 26. Researchers found the 9vHPV vaccine prevented infection, cytological abnormalities and precancerous lesions. These studies are in their early stages and will follow many vaccinated women across the lifespan. Already protection lasts for six years and “could potentially prevent 90 percent of cervical cases worldwide for a lifetime.”
“We have the ability to stop cervical cancer dead in its tracks, oropharyngeal and anal cancers too, if we do nothing more than get people vaccinated,” Wiley said. “It saddens me daily that somebody dies from HPV-cancers in a country where screening and an effective vaccine are both available."
Wiley noted that in countries where people don’t have access to screening prevention services, there are about 500,000 new cases of cervical cancer per year and about half the stricken women die. In the United States, with all the screening and treatment that is available, nearly 12,000 women were diagnosed with cervical cancer in 2017 and nearly 4,000 died. With screening, the number of new cases of cervical cancer has dropped about 70 percent.
With the advent of the HPV vaccine for young adolescents, “we really have the ability right now” to end HPV-caused cancers. We can prevent nearly 90 percent of cervical cancers in our daughters’ and grandchildren’s generations, and as many anal cancers in this next generation and beyond, Wiley said.
Having an effective vaccine is exciting, Wiley said, “but it’s also depressing that only about one third of these young adolescents are being vaccinated. We have to find better ways to strategize to get people to become vaccinated and among those in my generation and yours, to seek diagnosis and treatment.”
Professor Dong Sung An, MD, PhD, was a medical student in Japan when AIDS erupted in the international consciousness. “I learned there were no drugs or therapy for AIDS back then and I wanted to find a therapy for an HIV cure,” An recalled. After medical school, he went to a graduate school for HIV/AIDS research.