Chloe Orkin | |
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Born | |
Alma mater | |
Known for | Management of HIV/AIDS |
Partner | Flick Thorley |
Scientific career | |
Institutions | |
Website | https://www.qmul.ac.uk/blizard/all-staff/profiles/chloe-orkin.html |
Chloe Meave Orkin MBE FRCP is a British physician and Professor of HIV/AIDS medicine at Queen Mary University of London. [1] She works as a consultant at the Royal London Hospital, Barts Health NHS Trust. She is an internationally renowned expert in HIV therapeutics and led the first phase III clinical trial of injectable anti-retrovirals. [2] She is immediate past chair of the British HIV Association, where she championed the Undetectable=Untransmittable (U=U) campaign [3] within the United Kingdom. She is president elect of the Medical Women's Federation. Orkin is gay [4] and was on the Top 100 Lesbian influencer lists in both the UK and in the US in 2020. [5] She considers herself a medical activist and much of her work focuses on inequalities in healthcare and in Medicine.
Orkin was born in Johannesburg, South Africa. [6] She obtained her medical degree in 1995 from the University of the Witwatersrand and was the prize student in virology and microbiology. [7] She began her clinical training at Chris Hani Baragwanath Hospital, Soweto in the 1990s. At the time, between 30 and 40% of medical inpatients were infected with HIV [8] and Orkin herself, lost close friends to AIDS. [4] She moved to the United Kingdom. In 1998, she completed her specialist training in HIV and Genitourinary Medicine at Chelsea and Westminster Hospital. Towards the end of her specialist training, Orkin moved to Botswana together with nurse colleague and partner Flick Thorley to establish an HIV/AIDS treatment programme in Francistown as part of the government anti-retroviral roll-out. [9] In 2006, Orkin completed a MSc in Infectious Diseases from The London School of Hygiene & Tropical Medicine.
At the age of 29, Orkin was appointed as consultant physician at Barts Health NHS Trust. [4] Her specialist interests are the development of novel antiretroviral therapies, blood-borne virus testing and health inequalities. In 2013, she led the Test Me East HIV testing campaign [10] which was supported by David Furnish, Sir Elton John and Sadie Frost and covered by CNN, Channel 4 [11] and ITV news. In 2015, she spearheaded ‘Going Viral’, a week-long campaign to raise awareness of blood-borne viruses. [12] The week-long novel campaign offered HIV, Hepatitis B and Hepatitis C testing in emergency departments around the United Kingdom utilising an opt-out testing strategy. The campaign was widely covered in the media [13] and supported by several high profile celebrities, including actor Richard Wilson and DJ Tim Westwood.
She led the first ever phase III clinical trial into the use of injectable anti-retrovirals. [2] After appearing on ITV News [14] to discuss the treatment, she was trolled on social media where many misogynistic and homophobic comments were made about her appearance and sexual identity. [6] [15] This experience led her to take action on gender and sexuality-based discrimination. Shortly after she stood for election and was elected Vice President of the Medical Women's Federation in 2019. [16] Orkin has also served as Chair of the British HIV Association from 2017-2019 [17] and is on the Governing Council for the International AIDS Society. [18]
In 2018, Orkin and the British HIV Association announced their commitment to the Undetectable=Untransmittable (U=U) campaign. [3]
During the first wave of COVID-19 pandemic in the United Kingdom, she led on safe delivery of COVID-19 treatment trials at the 5 Barts Health NHS Trust hospitals including NHS Nightingale London (the first non-hospital, non-military research delivery). Since then she has led the team that created a new clinical trial centre in a community library to deliver a large SARS CoV2 vaccine trials [19] and was appointed as its clinical director. She has also led research into poor health outcomes in ethnically diverse people [20] and on gender disparities in women's academic careers. [21] She is lead investigator for the first COVID-19 vaccine trial in pregnant women.
HIV Anti-retroviral Therapy:
COVID-19 Equality Research:
Blood-borne Virus Testing in UK Emergency Department:
Orkin is a Fellow of the Royal College of Physicians (FRCP).
Orkin is a lesbian. [22] She lives in London with her wife Flick Thorley, who was a highly regarded HIV specialist nurse at Chelsea and Westminster hospital and Charge Nurse at the London Lighthouse. [23] They share a home with their three dogs and two cats.
Reverse-transcriptase inhibitors (RTIs) are a class of antiretroviral drugs used to treat HIV infection or AIDS, and in some cases hepatitis B. RTIs inhibit activity of reverse transcriptase, a viral DNA polymerase that is required for replication of HIV and other retroviruses.
Emtricitabine, with trade name Emtriva, is a nucleoside reverse-transcriptase inhibitor (NRTI) for the prevention and treatment of HIV infection in adults and children. In 2019, it was the 494th most commonly prescribed medication in the United States, with more than 3 thousand prescriptions.
Post-exposure prophylaxis, also known as post-exposure prevention (PEP), is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring.
Gilead Sciences, Inc. is an American biopharmaceutical company headquartered in Foster City, California, that focuses on researching and developing antiviral drugs used in the treatment of HIV/AIDS, hepatitis B, hepatitis C, influenza, and COVID-19, including ledipasvir/sofosbuvir and sofosbuvir. Gilead is a member of the Nasdaq-100 and the S&P 100.
Tenofovir disoproxil, sold under the brand name Viread among others, is a medication used to treat chronic hepatitis B and to prevent and treat HIV/AIDS. It is generally recommended for use with other antiretrovirals. It may be used for prevention of HIV/AIDS among those at high risk before exposure, and after a needlestick injury or other potential exposure. It is sold both by itself and together in combinations such as emtricitabine/tenofovir, efavirenz/emtricitabine/tenofovir, and elvitegravir/cobicistat/emtricitabine/tenofovir. It does not cure HIV/AIDS or hepatitis B. It is available by mouth as a tablet or powder.
Emtricitabine/tenofovir, sold under the brand name Truvada among others, is a fixed-dose combination antiretroviral medication used to treat and prevent HIV/AIDS. It contains the antiretroviral medications emtricitabine and tenofovir disoproxil. For treatment, it must be used in combination with other antiretroviral medications. For prevention before exposure, in those who are at high risk, it is recommended along with safer sex practices. It does not cure HIV/AIDS. Emtricitabine/tenofovir is taken by mouth.
Pre-exposure prophylaxis for HIV prevention, commonly known as PrEP, is the use of antiviral drugs as a strategy for the prevention of HIV/AIDS by people that do not yet have HIV/AIDS. PrEP is one of a number of HIV prevention strategies for people who are HIV negative but who have a higher risk of acquiring HIV, including sexually active adults who are at increased risk of contracting HIV, people who engage in intravenous drug use, and serodiscordant sexually active couples. When used as directed, PrEP for HIV infection has been shown to be highly effective, reducing the risk of acquiring HIV through sexual intercourse by up to 99% and injection drug use by 74%.
Darunavir (DRV), sold under the brand name Prezista among others, is an antiretroviral medication used to treat and prevent HIV/AIDS. It is generally recommended for use with other antiretrovirals. It is often used with low doses of ritonavir or cobicistat to increase darunavir levels. It may be used for prevention after a needlestick injury or other potential exposure. It is taken by mouth once to twice a day.
Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infection is a multi-faceted, chronic condition that significantly impacts public health. According to the World Health Organization (WHO), 2 to 15% of those infected with HIV are also affected by HCV, increasing their risk of morbidity and mortality due to accelerated liver disease. The burden of co-infection is especially high in certain high-risk groups, such as intravenous drug users and men who have sex with men. These individuals who are HIV-positive are commonly co-infected with HCV due to shared routes of transmission including, but not limited to, exposure to HIV-positive blood, sexual intercourse, and passage of the Hepatitis C virus from mother to infant during childbirth.
Integrase inhibitors (INIs) are a class of antiretroviral drug designed to block the action of integrase, a viral enzyme that inserts the viral genome into the DNA of the host cell. Since integration is a vital step in retroviral replication, blocking it can halt further spread of the virus. Integrase inhibitors were initially developed for the treatment of HIV infection, but have been applied to other retroviruses. The class of integrase inhibitors called integrase strand transfer inhibitors (INSTIs) are in established medical use. Other classes, such as allosteric integrase inhibitors (ALLINIs) or integrase binding inhibitors (INBIs), are still experimental.
Rilpivirine, sold under the brand names Edurant and Rekambys, is a medication, developed by Tibotec, used for the treatment of HIV/AIDS. It is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with higher potency, longer half-life and reduced side-effect profile compared with older NNRTIs such as efavirenz.
Cobicistat, sold under the brand name Tybost, is a medication for use in the treatment of human immunodeficiency virus infection (HIV/AIDS). Its major mechanism of action is through the inhibition of human CYP3A proteins.
Discovery and development of nucleoside and nucleotide reverse-transcriptase inhibitors began in the 1980s when the AIDS epidemic hit Western societies. NRTIs inhibit the reverse transcriptase (RT), an enzyme that controls the replication of the genetic material of the human immunodeficiency virus (HIV). The first NRTI was zidovudine, approved by the U.S. Food and Drug Administration (FDA) in 1987, which was the first step towards treatment of HIV. Six NRTI agents and one NtRTI have followed. The NRTIs and the NtRTI are analogues of endogenous 2´-deoxy-nucleoside and nucleotide. Drug-resistant viruses are an inevitable consequence of prolonged exposure of HIV-1 to anti-HIV drugs.
HIV prevention refers to practices that aim to prevent the spread of the human immunodeficiency virus (HIV). HIV prevention practices may be undertaken by individuals to protect their own health and the health of those in their community, or may be instituted by governments and community-based organizations as public health policies.
Emtricitabine/rilpivirine/tenofovir, sold under the brand name Complera among others, is a fixed-dose combination of antiretroviral drugs for the treatment of HIV/AIDS. The drug was co-developed by Gilead Sciences and Johnson & Johnson's Tibotec division and was approved by the US Food and Drug Administration (FDA) in August 2011, and by the European Medicines Agency in November 2011, for patients who have not previously been treated for HIV. It is available as a once-a-day single tablet.
Tenofovir alafenamide, sold under the brand name Vemlidy, is an antiviral medication used against hepatitis B and HIV. It is used for the treatment of chronic hepatitis B virus (HBV) infection in adults with compensated liver disease and is given in combination with other medications for the prevention and treatment of HIV. It is taken by mouth.
Cabotegravir, sold under the brand name Vocabria among others, is a antiretroviral medication used for the treatment of HIV/AIDS. It is available in the form of tablets and as an intramuscular injection, as well as in an injectable combination with rilpivirine under the brand name Cabenuva.
Bictegravir is a second-generation integrase inhibitor (INSTI) class that was structurally derived from an earlier compound dolutegravir by scientists at Gilead Sciences. In vitro and clinical results were presented by Gilead in the summer of 2016. In 2016, bictegravir was in a Phase 3 trial as part of a single tablet regimen in combination with tenofovir alafenamide (TAF) and emtricitabine (FTC) for the treatment of HIV-1 infection.
HPTN 083 is a 2016 clinical trial which compares cabotegravir injections with oral use of Emtricitabine/tenofovir as pre-exposure prophylaxis ("PrEP") for prevention of HIV/AIDS.
Bictegravir/emtricitabine/tenofovir alafenamide, sold under the brand name Biktarvy, is a fixed-dose combination antiretroviral medication for the treatment of HIV/AIDS. It contains bictegravir, a human immunodeficiency virus type 1 (HIV-1) integrase strand transfer inhibitor; emtricitabine, an HIV-1 nucleoside analog reverse transcriptase inhibitor; and tenofovir alafenamide, an HIV-1 nucleoside analog reverse transcriptase inhibitor.