The Peter Wall Institute for Advanced Studies (PWIAS) at the University of British Columbia (UBC) has awarded a Major Thematic Grant of $500 000 CAD (R3,5 million) over three years for a project to identify the immunological explanation for the increased infectious morbidity and mortality of HIV-Exposed but Uninfected (HEU) babies. A team of researchers from UBC, lead by principal investigator Prof David Speert, will join forces in this project at Tygerberg Hospital with researchers from the Health Sciences Faculty at Stellenbosch University, including Dr Monika Esser and Prof Mark Cotton and their research teams.
This project has grown from an initiative resulting from a Fellowship awarded by the Stellenbosch Institute for Advanced Study (STIAS) to Prof Speert in 2008, and the subsequent MOA established between STIAS and PWIAS. In November 2009 the HEU project was the focus of a 3 day PWIAS Colloquium Abroad co-hosted by STIAS at its Wallenberg Research Centre.
Effective strategies have already been introduced to prevent the spread of HIV infection from mothers to their babies. Of the one million births annually in South Africa, a third are babies born to HIV-infected mothers — however the vast majority of these are not infected themselves, even in the absence of prevention of transmission programs. Nevertheless HEU babies are at greatly increased risk of death during the first year of life and appear to suffer from a weakness in their immune defenses.
While several theories have been offered to explain the very poor health of these HEU babies, none has been proven to be the sole one responsible. As a result there is no effective intervention to prevent the many deaths that occur annually. South Africa has the highest burden of HIV/AIDS in the world, and with an antenatal HIV prevalence rate of around 30% a very large proportion of HEU babies.
The research team will study 100 HIV-exposed babies and 100 babies born to womenwho are not HIV infected, all born at Tygerberg Hospital. Blood samples will be obtained, prepared and partially analysed at Tygerberg Hospital NHLS and Stellenbosch University laboratories and also evaluated at the CFI Centre for Understanding and Preventing Infections in Children, BC Children’s Hospital in Vancouver. The team will study the innate (present from birth) and the adaptive (learned) immune system of all babies at several time points from 2 weeks of age to 24 months. These studies will be guided by the results of a small pilot study conducted in 2009 and 2010 in which 60 babies were investigated. With information gained from these studies, and future major studies arising from them, it should be possible to suggest interventions to protect these very vulnerable children during the first year of life, when most of the fatal infections occur.
In her grant award letter Prof Dianne Newell, Director of PWIAS, confirmed their long term commitment to this fundamental project and described it as an exciting development. Prof Hendrik Geyer, Director of STIAS, said that he was very pleased that STIAS had been able to play an early coordinating role and act as catalyst for the project; “being able to provide the space and opportunity for interdisciplinary interaction in the neutral environment of STIAS has often proven to be crucial in establishing major projects”. Prof Speert will continue his STIAS Fellowship in November 2010 to coordinate further planning and implementation of the HEU project.