It is critical to understand the effectiveness of the various interventions on the HIV treatment cascade, HIV incidence and HIV drug resistance. The centre contributed to these areas and provided key laboratory testing that will contribute to the national incidence and drug resistance estimates as well as the development and implementation of a revised protocol that will inform on the treatment cascade in the case of the annual antenatal survey for 2017. 

CD4 count recovery and associated factors among individuals enrolled in the South African antiretroviral therapy programme: An analysis of national labolatory based data

Kufa t, Shubber Z, MacLeod W, Takuva S, Carmona S, Bor J, Gorgens M, Pillay Y, Puren A, Eaton JW, Fraser-Hurt N


We describe CD4 count recovery among HIV positive individuals who initiated antiretroviral therapy (ART) with and without severe immune suppression using complete laboratory data from South Africa’s national HIV treatment programme between 2010 and 2014 and discuss implications for CD4 count monitoring.  Read Publication

Chronic HIV-1 Infection Alters the Cellullar Distribution of FCyllla and the Functional Consequence of the FCyllla- F158V Variant

Phaahla GN, Lassauniere R, Da Costa Dias B, Waja Z, Martinson NA, Tiemessen CT


Chronic HIV-infection modulates the expression of Fc gamma receptors (FcγRs) on immune cells and their antibody-dependent effector function capability. Given the increasingly recognized importance of antibody-dependent cellular cytotoxicity (ADCC) in HIV-specific immunity, we investigated the cellular distribution of FcγRIIIa on cytotoxic lymphocytes—natural killer cells and CD8+ T cells—and the effect of the FcγRIIIa-F158V variant on ADCC capacity in HIV-infected individuals (n = 23) and healthy controls (n = 23).  Read Publication

Cis-regulatory genetic variants in the CCR5 gene and natural HIV – 1 control in black South Africans

Koor GW, Paximadis M, Picton ACP, Karatas F, Lousber SA, He W, Ahuja SK, Chaisson RE, Martinson N, Ebrahim O, Tiesmessen T


Studies have investigated CCR5 haplotypes (HHA, HHB, HHC, HHD, HHE, HHF*1, HHF*2, HHG*1, HHG*2), defined by seven 5′UTR single nucleotide polymorphisms (SNPs), CCR2-V64I and CCR5Δ32, in HIV-1 disease. CCR5 cis-regulatory regions were sequenced, CCR2-V64I and CCR5Δ32 genotyped, and compared in HIV-1-infected black South Africans: 71 HIV-1 controllers (23 elite controllers, 37 viraemic controllers (VCs), 11 high viral load long-term non-progressors) and 74 progressors. Read Publication

Daily Vaginal Swabs and Mobile Phone Sex Report for Assessing HIV Virion Exposure Prospectively Among a Cohort of Young Sexually Active Women in South Africa (HVTN 915)

Lemos MP, Lazarus E, Isaacs A, Dietrich J, Morgan C, Huang Y, Grove D, Andrasik M, Laher F, Hural J, Chung E, Dragavon J, Puren A, Gulati RK, Coombs R, McElrath MJ, Gray G, Kublin JG


Measurements of HIV exposure could help identify subpopulations at highest risk of acquisition and improve the design of HIV prevention efficacy trials and public health interventions. The HVTN 915 study evaluated the feasibility of self-administered vaginal swabs for detection of HIV virions to assess exposure. Read Publication

Evidence for both Intermittent and Persistent Compartmentalization of HIV-1 in the Female Genital Tract

Mabvakure BM, Lambson BE, Ramdayal K, Masson L, Kitchin D, Allam M, Karim SA, Williamson C, Passmore JA, Martin DP, Scheepers C, Moore P L, Harkins GW, Morris L


HIV-1 has been shown to evolve independently in different anatomical compartments, but studies in the female genital tract have been inconclusive. Here, we examined evidence of compartmentalization using HIV-1 subtype C envelope (Env) glycoprotein genes (gp160) obtained from matched cervicovaginal lavage (CVL) and plasma samples over 2 to 3 years of infection. HIV-1 gp160 amplification from CVL was achieved for only 4 of 18 acutely infected women, and this was associated with the presence of proinflammatory cytokines and/or measurable viremia in the CVL. Read Publication

Incidence, Persistence, Clearance, and Correlates of Genital Human Papillomavirus Infection and Anogenital Warts in a Cohort of Men Living with Human Immunodeficiency Virus in South Africa

Chikandiwa A, Pisa PT, Muller EE, Tamalet C, Mayaud P, Chersich MF, Delany-Moretlwe S


Objective To estimate the incidence; persistence and correlates of human papillomavirus (HPV) infection and anogenital warts (AGW) among men living with human immunodeficiency virus (MLHIV). Read Publication

Improvements in the South African HIV care cascade: findings on 90-90-90 targets from successive population-representative surveys in North West Province

Lippman SA, El Ayadi AM, Grignon JS, Puren A, Liegler T, Venter WDF, Ratlhagana MJ, Morris JL, Naidoo E, Agnew E, Barnhart S, Shade SB


To achieve epidemic control of HIV by 2030, countries aim to meet 90‐90‐90 targets to increase knowledge of HIV‐positive status, initiation of antiretroviral therapy (ART) and viral suppression by 2020. We assessed the progress towards these targets from 2014 to 2016 in South Africa as expanded treatment policies were introduced using population‐representative surveys. Read Publication

Low frequency Protease Inhibitor Resistance Mutation and Insertions in HIV -1 Subtype C Protease Inhibotor –Naïve Sequences

Ledwaba J, Sayed Y, Pillay Visva, Morris L, Hunt G


Human immunodeficiency virus-1 (HIV-1) protease sequences from 2,225 protease inhibitor (PI)-naïve HIV-1 subtype C-infected individuals collected over a 14-year period were analyzed for polymorphisms. Over 50% of sequences differed from an HIV-1 subtype B consensus sequence at 8 of the 99 amino acids at residues 12, 15, 19, 36, 41, 69, 89, and 93, but not in the functionally important regions. The frequency of primary resistance and accessory mutations occurred in <1% of the sequences. Read Publication

Need must: living donor liver transplantation from and HIV-positive mother to her HIV-negative child in Johannesburg, South Africa

Etheredge HR, Fabian J, Duncan M, Conradie F, Tiemessen C, Botha


The world’s first living donor liver transplant from an HIV-positive mother to her HIV-negative child, performed by our team in Johannesburg, South Africa (SA) in 2017, was necessitated by disease profile and health system challenges. In our country, we have a major shortage of donor organs, which compels us to consider innovative solutions to save lives. Read Publication

 Prevalence of HIV-1 drug resistance amongst newly diagnosed HIV-infected infants age 4-8 weeks, enrolled in three nationally representative PMTCT effectiveness surveys, South Africa: 2010, 2011-12 and 2012-13. 

Hunt GM, Ledwaba J, Salimo A, et al.


South Africa (SA) has expanded efforts to reduce mother-to-child transmission of HIV (MTCT) to less than 2% at six weeks after birth and to less than 5% at 18 months postpartum by 2016. Despite improved antiretroviral regimens and coverage between 2001 and 2016, there is little data on infant HIV drug resistance. This paper tracks the prevalence of HIV drug resistance patterns amongst HIV infected infants from three nationally representative studies that assessed the effectiveness of national programs to prevent MTCT (PMTCT). Read Publication

Prime-Boost Immunisations with DNA, Modified Vaccinia Virus Ankara, and Protein-Based Vaccines Elicit Robust HIV-1 Tier 2 Neutralizing Antibodies against the CAP256 Superinfecting Virus

van Diepen MT, Chapman R, Douglass N, Galant S, Moore PL, Margolin E, Ximba P, Morris L, Rybicki EP, Williamson AL


A vaccine regimen that elicits broadly neutralizing antibodies (bNAbs) is a major goal in HIV-1 vaccine research. In this study, we assessed the immunogenicity of the CAP256 superinfecting viral envelope (CAP256 SU) protein delivered by modified vaccinia virus Ankara (MVA) and DNA vaccines in different prime-boost combinations followed by a soluble protein (P) boost. Read Publication

Recommendations for analytical antiretroviral treatment interruptions in HIV research trials-report of a consensus meeting

Julg B, Dee L, Ananworanich J, Barouch DH, Bar K, Caskey M, Colby DJ, Dawson L, Dong KL, Dubé K, Eron J, Frater J, Gandhi RT, Geleziunas R, Goulder P, Hanna GJ, Jefferys R, Johnston R, Kuritzkes D, Li JZ, Likhitwonnawut U, van Lunzen J, Martinez-Picado J, Miller V, Montaner LJ, Nixon DF, Palm D, Pantaleo G, Peay H, Persaud D, Salzwedel J, Salzwedel K, Schacker T, Sheikh V, Søgaard OS, Spudich S, Stephenson K, Sugarman J, Taylor J, Tebas P, Tiemessen CT, Tressler R, Weiss CD, Zheng L, Robb ML, Michael NL, Mellors JW, Deeks SG, Walker BD


Analytical antiretroviral treatment interruption (ATI) is an important feature of HIV research, seeking to achieve sustained viral suppression in the absence of antiretroviral therapy (ART) when the goal is to measure effects of novel therapeutic interventions on time to viral load rebound or altered viral setpoint. Trials with ATIs also intend to determine host, virological, and immunological markers that are predictive of sustained viral control off ART. Read Publication

Understanding hepatitis C and HIV among people who inject drugs in South Africa: finding from a three-city cross-sectional survey

Scheibe A, Young K, Moses L, Basson RL, Versfeld A, Spearman WC, Sonderup MW, Prabdial-Sing N, Manamela J, Puren AJ, Rebe K, Hausler H


People who inject drugs (PWID) are at high risk for hepatitis C (HCV), hepatitis B (HBV) and HIV without accessible harm reduction programmes. Coverage of needle and syringe and opioid substitution therapy (OST) services in South Africa is below global recommendations and no hepatitis services exist for PWID. We assessed HCV, HBV and HIV prevalence and risk factors among PWID accessing harm reduction services in Cape Town, Durban and Pretoria to inform policy and programming. Read Publication

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