37 results match your criteria: "Center for the AIDS Program of Research in South Africa (CAPRISA)[Affiliation]"

Background: CD4+ T cells expressing α4β7 are optimal targets for HIV infections, with higher pre-HIV α4β7hi expression linked to increased HIV acquisition and progression in South African women. However, similar associations were not observed in men who have sex with men (MSM) or people who inject drugs (PWID) in the Americas, indicating need for further research.

Methods: This retrospective case-control study enrolled heterosexual men and women from South Africa (HIV Vaccine Trials Network; HVTN 503) and East Africa (Partners Pre-Exposure Prophylaxis/Couples' Observational Study; PP/COS), quantifying α4β7 expression on CD4+ T cells as a predictor of subsequent HIV risk using flow cytometry analyses.

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Purpose Of Review: Women in Africa bear the burden of the HIV epidemic, which has been associated with the high prevalence of bacterial vaginosis (BV) in the region. However, little progress has been made in finding an effective cure for BV. Drawing on advances in microbiome-directed therapies for gastrointestinal disorders, similar live-biotherapeutic based approaches for BV treatment are being evaluated.

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Background: The COVID-19 pandemic has caused a large mortality and morbidity burden globally. For individuals, a strong immune response is the most effective means to block SARS-CoV-2 infection. To inform clinical case management of COVID-19, development of improved vaccines, and public health policy, a better understanding of antibody response dynamics and duration following SARS-CoV-2 infection and after vaccination is imperatively needed.

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SARS-CoV-2 humoral immunity in people living with HIV-1.

Trends Immunol

July 2024

South African Medical Research Council Antibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; HIV Virology Section, Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Services, Johannesburg, South Africa; Centre for the AIDS Program of Research in South Africa (CAPRISA), University of KwaZulu Natal, Durban, South Africa. Electronic address:

The effect of COVID-19 on the high number of immunocompromised people living with HIV-1 (PLWH), particularly in Africa, remains a critical concern. Here, we identify key areas that still require further investigation, by examining COVID-19 vaccine effectiveness, and understanding antibody responses in SARS-CoV-2 infection and vaccination in comparison with people without HIV-1 (PWOH). We also assess the potential impact of pre-existing immunity against endemic human coronaviruses on SARS-CoV-2 responses in these individuals.

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Article Synopsis
  • There is a high rate of asymptomatic sexually transmitted infections (STIs) among pregnant adolescent girls and young women in Africa, which is linked to pregnancy outcomes in HIV-affected regions.
  • The study involved HIV-negative pregnant women in South Africa, who were tested for various STIs at the beginning and later stages of their pregnancy, with a focus on how these infections might affect their outcomes.
  • Results showed that certain STIs like Mycoplasma genitalium and Trichomonas vaginalis were significantly associated with low birth weight and preterm births, suggesting a need for further research on STI testing and treatment during pregnancy.
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  • The STREAM study assessed risk factors for HIV viraemia and retention in care 18 months after starting antiretroviral therapy in 390 participants in Durban, South Africa.
  • Approximately 11.5% of participants lost care and 11.8% had viraemia 18 months after treatment, with those having CD4 counts <200 or previous viraemia at higher risk of ongoing viraemia and care issues.
  • Early indicators like initial viraemia are crucial for targeting interventions to assist individuals likely to face ongoing health challenges in managing their HIV.
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Broadening access to tenofovir alafenamide for the treatment and prevention of HIV-1 infection.

Expert Rev Clin Pharmacol

November 2023

Center for the AIDS Program of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa.

Introduction: Tenofovir alafenamide (TAF), a prodrug of tenofovir, achieves higher intracellular concentrations of tenofovir-diphosphate and 90% lower plasma concentrations of tenofovir compared to tenofovir disoproxil fumarate (TDF). TAF is associated with improved renal and bone safety outcomes.

Areas Covered: We review the efficacy and safety of TAF-containing regimens in adults and pediatrics.

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Article Synopsis
  • The study investigates how certain genetic features of SARS-CoV-2 might make the virus resistant to the Ad26.COV2.S vaccine, which had an overall efficacy of 56% in preventing moderate to severe COVID-19.
  • Data from 484 vaccinated and 1,067 placebo participants revealed that the vaccine was less effective against the Lambda variant, particularly in regions like Latin America where the virus's genetic diversity was high.
  • The research also found that vaccine efficacy decreased with genetic differences between the virus and the vaccine strain, particularly at specific amino acid positions and based on the virus’s neutralization resistance level.
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  • The study examined the impact of South Africa’s CCMDD program on the clinical outcomes of HIV patients, focusing on viral load suppression and patient retention in care compared to traditional clinic-based care.
  • Out of 390 patients assessed for the program, 116 participated, demonstrating high levels of adherence and timely ART distribution at 93% of visits.
  • Results showed no significant differences in viral load suppression and retention between those who participated in the CCMDD program and those who did not, suggesting the community-based model is effective for maintaining HIV care outcomes.
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Most cervicovaginal microbiome-immunology studies to date have relied on 16S rDNA microbial profiling which does not resolve the molecular subgroups of , believed to be central to the pathogenesis of bacterial vaginosis (BV) and subsequent risk of HIV acquisition. Here we used the 60 universal target which in addition to other microbial taxa, resolves four subgroups, for cervicovaginal microbial profiling in a longitudinal cohort of Kenyan women to examine associations with cellular and soluble markers of inflammation and HIV susceptibility. Participants (N = 41) were sampled, contributing 362 samples for microbiome analysis.

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Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities.

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Baseline host determinants of robust human HIV-1 vaccine-induced immune responses: A meta-analysis of 26 vaccine regimens.

EBioMedicine

October 2022

Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States of America. Electronic address:

Background: The identification of baseline host determinants that associate with robust HIV-1 vaccine-induced immune responses could aid HIV-1 vaccine development. We aimed to assess both the collective and relative performance of baseline characteristics in classifying individual participants in nine different Phase 1-2 HIV-1 vaccine clinical trials (26 vaccine regimens, conducted in Africa and in the Americas) as High HIV-1 vaccine responders.

Methods: This was a meta-analysis of individual participant data, with studies chosen based on participant-level (vs.

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We piloted the combined effectiveness of point-of-care viral load monitoring plus motivational enhanced adherence counseling (intervention) compared with routine care (control) in women identified at risk of virologic failure in the PROMOTE study in Zimbabwe. In an unblinded randomized study, consenting women with last viral load ≥200 copies/ml and/or pill count outside 90-110% range were randomized 1 : 1 to receive the intervention or continue routine care, comprising laboratory-based VL monitoring and standard EAC, from trained nurses and counsellors. Viral load was measured 0, 3, 6, and 12 months after enrolment.

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Objective: Given the roll out of maternal antiretroviral therapy (ART) for prevention-of-perinatal-HIV-transmission, increasing numbers of children are perinatally HIV/antiretroviral exposed but uninfected (CAHEU). Some studies suggest CAHEU may be at increased risk for neurodevelopmental (ND) deficits. We aimed to assess ND performance among preschool CAHEU.

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People living with HIV have a higher risk of developing tuberculosis, and tuberculosis is one of the leading causes of death among people living with HIV globally. Treating HIV and tuberculosis concurrently has morbidity and mortality benefits. However, HIV and tuberculosis co-treatment is challenging due to drug-drug interactions, overlapping toxicities, tuberculosis-associated immune reconstitution syndrome, and concerns for treatment failure or drug resistance.

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Safe practices for dispensing investigational product (IP) during clinical trials are not standardized and information in this regard is often limited. ASPIRE was a Phase 3 safety and effectiveness trial of a vaginal matrix ring containing 25 mg of dapivirine for the prevention of HIV-1 in women. The study enrolled 2629 women at 15 clinical research sites in Malawi, Uganda, South Africa and Zimbabwe who were randomized in a 1:1 ratio to receive either a vaginal ring containing 25 mg of dapivirine or a matching placebo vaginal ring.

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Article Synopsis
  • - Regulatory T cells (Tregs) are crucial for maintaining tissue balance, with a study in Nairobi revealing a significant correlation between Treg levels in the endocervix and blood in women, highlighting a higher frequency of Tregs in the endocervix.
  • - Most Tregs in both tissues expressed the FOXP3 marker, and endocervical Tregs showed higher CTLA-4 levels compared to blood, which might indicate enhanced functionality in this area.
  • - The study suggests that increasing endocervical Treg proportions could potentially help lower inflammation in the genital tract, as higher Treg levels were linked to decreased pro-inflammatory cytokines and lower CD4+ T cell abundance in the endocervix
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Resting CD4 T cells are primary targets of early HIV infection events , but do not readily support HIV replication . This barrier to infection can be overcome by exposing resting CD4 T cells to endothelial cells (ECs). ECs line blood vessels and direct T cell trafficking into inflamed tissues.

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Residual T cell activation and skewed CD8+ T cell memory differentiation despite antiretroviral therapy-induced HIV suppression.

Clin Immunol

October 2018

Institute of Infectious Disease and Molecular Medicine and Department of Pathology, Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, South Africa. Electronic address:

HIV infection results in excessive T cell activation and dysfunction which may persist even during effective antiretroviral therapy (ART). The dynamics of immune 'deactivation' and extent to which T cell memory subsets normalize after ART are unclear. We longitudinally assessed the influence of 1 year of ART on the phenotype of T cells in HIV-infected African women, relative to matched HIV-uninfected women, using activation (CD38, HLA-DR) and differentiation markers (CD27, CD45RO).

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HIV-1 superinfection can occur in the presence of broadly neutralizing antibodies.

Vaccine

January 2018

MRC/UVRI Uganda Research Unit on AIDS, c/o Uganda Virus Research Institute, Entebbe, Uganda; London School of Hygiene and Tropical Medicine, Department of Clinical Research, London, UK.

Background: Superinfection of individuals already infected with HIV-1 suggests that pre-existing immune responses may not adequately protect against re-infection. We assessed high-risk female sex workers initially infected with HIV-1 clades A, D or A/D recombinants, to determine if HIV-1 broadly neutralizing antibodies were lacking prior to superinfection.

Methods: Six superinfected female sex workers previously stratified by HIV-1 high-risk behavior, infecting virus clade and volunteer CD4 counts were evaluated at baseline (n = 5) and at 350 days post-superinfection (n = 6); one superinfected volunteer lacked pre-superinfection plasma.

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Neutralization tiers of HIV-1.

Curr Opin HIV AIDS

March 2018

Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts, USA.

Purpose Of Review: HIV-1 isolates are often classified on the basis of neutralization 'tier' phenotype. Tier classification has important implications for the monitoring and interpretation of vaccine-elicited neutralizing antibody responses. The molecular basis that distinguishes the multiple neutralization phenotypes of HIV-1 has been unclear.

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HIV-1-specific cytotoxic T cells (CTLs) play an important role in the control of HIV-1 subtype B or C infection. However, the role of CTLs in HIV-1 subtype A/E infection still remains unclear. Here we investigated the association of HLA class I alleles with clinical outcomes in treatment-naive Vietnamese infected with subtype A/E virus.

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Mycobacterium tuberculosis strains induce strain-specific cytokine and chemokine response in pulmonary epithelial cells.

Cytokine

April 2018

Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, 719 Umbilo Road, South Africa. Electronic address:

M. tuberculosis F15/LAM4/KZN has been associated with high transmission rates of drug resistant tuberculosis in the KwaZulu-Natal province of South Africa. The current study elucidated the cytokine/chemokine responses induced by representatives of the F15/LAM4/KZN and other dominant strain families in pulmonary epithelial cells.

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