Wits professor granted R46m for Aids research

There could be light at the end of the tunnel for people with HIV/Aids in Africa after a Wits professor received a R46m grant for research that focuses on reducing deaths from bacterial and fungal infections in people living with the diseases.

This comes after Prof Nelesh Govender of Wits University was awarded one of seven prestigious five-year UK National Institute for Health and Care Research (NIHR) global research professorships.

The professorship scheme funds research that aims to specifically and primarily benefit people in low- and middle-income countries.

Recipients of the professorship scheme receive five-year awards of up to £2m (R46m) and Govender will collaborate with colleagues and partners in SA, Tanzania, the Democratic Republic of Congo (DRC), Mozambique and Guinea.

His research topic is “Refining Interventions to Reduce Aids Mortality from Bacterial and Fungal Infections in Africa”.

“With the £2m NIHR award, I can work full time on this research for five years. A team of postdoctoral and PhD students will also boost the Wits mycology research division’s work,” Govender said.

Govender is a medical microbiologist/epidemiologist in the school of pathology at Wits and his proposed research on bacterial and fungal infections in people with advanced HIV disease (or Aids) will now, with the help of the NIHR funding, be applied to assess a World Health Organisation (WHO) package of care.

“Some Aids-related infections are unique to Southern Africa. We first described a fungus — emergomyces africanus — causing a life-threatening infection in people with Aids in 2013. Histoplasmosis, although found worldwide, is underdiagnosed in Africa because there is no access to simple accurate diagnostic tests,” he said.

He said they used to see Aids-related infections in people who were newly diagnosed with HIV.

Now, he said, they were increasingly seeing these infections in people who were previously diagnosed with HIV and started antiretroviral therapy (ART) but then disengaged from care and stopped their ART.

The work will be divided into three broad areas. A three-tiered cohort of adults with advanced HIV disease will be set up in SA to document the incidence, causes and outcomes of serious bacterial and fungal infections compared with tuberculosis.

The second phase of the research will include HIV-positive patients participating for researchers to understand their lived experience of being diagnosed and treated for serious bacterial and fungal infections.

That is to help researchers answer questions about the acceptability and feasibility of a combination antifungal treatment regimen for cryptococcal disease being tested in the Effect clinical trial in SA and Tanzania.

The last phase of the research comprises new laboratory tests, which detect traces of bacterial and fungal pathogens in body fluids and will be applied to cohort study patient samples and evaluated as diagnostic tools for serious infections among people living with advanced HIV disease.

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