FUNCTIONS

The Section is a globally accredited laboratory responsible for performing validated end-point antibody for vaccine trials, including passive and active vaccination regimens. The overall focus of the Section is on characterising humoral immune responses to viral pathogens of public health relevance. The Section initially focused on HIV and understanding how broadly neutralizing antibodies to HIV develop (including virology, immunology and immunogenetics), as such antibodies are crucial for the development of an effective HIV vaccine. However, the longer-term vision was to expand to other pathogens.

This vision was urgently realised with the emergence of SARS-CoV-2 and major contributions were made by the Section to the national COVID-19 response. In parallel, the unit continues to make valuable contributions to HIV research and has expanded at a smaller scale into influenza, RSV, cytomegalovirus and Ebola. The Section has three focus areas of research that have been applied to these various pathogens: the identification of antibody correlates on vaccine protection and the examination of infection mediated correlates of immunity, uncovering genetic diversity in the African antibody repertoire and isolating and engineering antibodies for passive immunity.

The Section is also engaged in virus surveillance and have made key contributions to showing that HIV is increasingly evolving toward resistance to broadly neutralizing antibodies, with implications for vaccine design. A major focus is training, with the Section hosting many students, post-doctoral fellows and collaborators

A major focus of this research group is the study of natural resistance models which include maternal-infant HIV-1 transmission for understanding protective immunity to HIV-1, and long term nonprogressors and elite controllers to understand natural attenuation of disease progression. A more recent focus of research efforts is in the field of paediatric HIV cure. This encompasses studies of the viral reservoir and host biomarkers in the context of very early antiretroviral treatment of infants as part of the LEOPARD clinical trial being conducted in Johannesburg, and detailed exploration of the recent case of the HIV-infected South African child in long-term remission. This case offers a unique opportunity to find clues as to what might make long-term remission possible for more individuals, and could help inform the search for the more challenging goal of a complete cure for HIV.

The section focuses on the implementation of HIV surveillance for prevalence, incidence and drug surveillance including the Annual Antenatal HIV survey. South Africa has the world’s largest antiretroviral treatment programme with 4.3 million PLHIV on treatment. Monitoring of HIV drug resistance is thus a key part of the sections activities. Paediatric HIV surveillance and monitoring provides critical dashboards for monitoring and key weekly action reports to reduce missed opportunities for diagnosis and treatment. The section takes advantage of the “Big Data” opportunities. Linking patient-level CD4 and viral load test result data from the NHLS corporate data warehouse and data from the health information system enabled a new analysis of immune recovery. The section supports the monitoring of HIV rapid test quality through a post-market programme. The section has a well-developed sero-molecular diagnostic section in support of its activities including the evaluation of diagnostic technologies and introducing cutting edge and relevant technologies including point of care testing. The section provides the endpoint diagnostic HIV infection results for the major HIV prevention vaccine trials in South Africa and the African region.  The section provides technical expert support in various areas and staff are part of national and international expert committees.

The STI Reference section is responsible for providing intelligence on the aetiology of major STI syndromes, as well as antimicrobial resistance data related to gonococcal infections. Findings are communicated annually to the national and relevant provincial health departments in South Africa as well as to those working in public health and directly with STI patients. The STI Reference section undertakes teaching and training activities, assisting with training of medical scientists, doctors, nurses and other healthcare staff. The STI section undertakes operational research relevant to public health and to that end, it has established several international links with STI researchers overseas.