universit y of kw azulu-na tal research repor t 2008/2009 - UKZN ...

HIV and AIDSRESEARCH FOCUS AREASAs the pre-eminent academic institution at the epicentre of the HIV epidemic in South Africa, UKZNhas taken up the challenge of providing leadership in response to HIV and AIDS, and of undertakingresearch to enhance and strengthen the broader societal response to the epidemic. The leadershiprole in research and a groundbreaking comprehensive AIDS programme for students and staff serve ascornerstones of UKZN’s AIDS Plan.Partnerships include networking and collaborating with AIDS researchers within UKZN, at otherSouth African academic institutions and around the world. In developing partnerships at a global level,UKZN strives to nurture international institutional partnerships such as the long-standing relationshipwith Columbia University and Harvard University in the United States. The world-class research centresin HIV and AIDS and TB have managed to attract funding from international organisations such asthe Howard Hughes Medical Institute, the Wellcome Trust and National Institutes of Health (NIH),the European Union (EU) and DfID. UKZN’s AIDS Strategic Research Focus includes several wellestablishedHIV research groups and projects, including the following:HIV Pathogenesis Programme (HPP)The HIV Pathogenisis Programme (HPP) comprises a leading researchgroup in the Doris Duke Medical Research Institute led by virologistProfessor Thumbi Ndung’u, who holds the DST/NRF Research Chair inSystems Biology of HIV/AIDS. Key international collaborators includeProfessor Bruce Walker of Harvard Medical School in the United Statesand Professor Philip Goulder of the University of Oxford in England.This programme conducts research into HIV immunology, virology andpathogenesis. HPP has a vibrant post-graduate training programme.Over the past three years, members of the group have co-authoredover 30 articles which have appeared in leading journals such as Nature,New England Journal of Medicine, Journal of Virologyand the Journalof Infectious Diseases. There are four local principal investigators in thegroup, three postdoctoral fellows and about 20 postgraduate students.Centre for the AIDS Programme of Research inSouth Africa (Caprisa)high rates of HIV infection in young people as a prelude to thecurrent Reducing HIV in Adolescents (RHIVA) trial of an innovativeconditional cash transfer strategy to prevent HIV in this importantgroup.❉ Microbiocides. In the CAPRISA 004 trial, an antiretroviralmicrobiocide, Tenofovir, was investigated to assess its potential inpreventing HIV infection in women during sexual intercourse. Resultsreleased to a world wide audience in 2010 were highly encouragingand received international applause. Follow up action is takingplace at present to map out the way forward for the use of theTenofovir microbiocide❉ HIV pathogenesis and vaccines: Acute HIV infection (Caprisa002) is being investigated to generate new knowledge on how viraland host factors impact on the risk of HIV and its natural progressionas a key contribution to vaccine development and testing.❉ HIV and TB treatment. Clinical trials such as the SAPiT trial arebeing conducted to address the key questions and challengesfacing co-treatment of HIV and TB.Caprisa is a multi-institutional team led by Professor Salim Abdool Karim,undertaking research on HIV epidemiology, pathogenesis, preventionand treatment. The Centre was established in 2002 under the NIHfundedComprehensive International Programme of Research on AIDS(CIPRA) by five partner institutions – the University of KwaZulu-Natal,University of Cape Town, University of the Western Cape, the NationalInstitute for Communicable Diseases, and Columbia University inNew York. Caprisa is a designated UNAIDS Collaborating Centre forHIV Prevention Research. The CIPRA grant served as an importantcatalyst for Caprisa which enabled it to become one of the leadingAIDS research organisations in South Africa.Caprisa’s main goal is to undertake globally relevant andlocally responsive research which contributes to understandingHIV pathogenesis, prevention and epidemiology as well as the linksbetween tuberculosis and AIDS care.To achieve this goal, Caprisa conducts research in four mainscientific programmes: HIV pathogenesis and vaccines; HIV and TBtreatment; microbiocides, and prevention and epidemiology, each witha focused set of projects and at least one pivotal study:❉ Prevention and Epidemiology. Several descriptive studies havebeen undertaken at the Vulindlela Research Centre near Howick tobetter understand epidemiology, risk factors and vulnerability toA fifth area of research on the prevention of mother-to-child transmissionis conducted mainly in partnership with other Centres.Africa CentreBased in Hlabisa in rural northern KwaZulu-Natal and the DorisDuke Medical Research Institute in Durban, this Centre conductscommunity-based research on HIV epidemiology, prevention andtreatment. Major areas of research at the Africa Centre, led by ProfessorMarie-Louise Newell, are demographic surveillance and the role ofbreast feeding in mother-to-child transmission of HIV. The Centre,with core funding from the Wellcome Trust, hosts a large demographicand health surveillance system with annual household and individualsurveillance of 90 000 members of 11 000 households.The Africa Centre partners with the local Department of Health inthe Hlabisa HIV Treatment and Prevention Programme – since 2004more than 11 000 people have been initiated on treatment in one of 17primary health care clinics.Comprehensive antiretroviral therapy (ART) coverage aims toreverse the substantial increase in HIV-related deaths in populationswith high HIV prevalence.Using the data from its demographic surveillance system, the10 UKZN Research Report // 2008/2009 UKZN Research Report // 2008/2009 11