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UKZN


Highly Specialized Team to Tackle HIV Drug Resistance Problem in Southern Africa

UKZN - 2012-02-22

DURBAN, SOUTH AFRICA, 24-26 FEB 2012 - A small, highly specialized multidisciplinary team of doctors and statisticians from South Africa, Botswana, the USA and the UK will meet in Durban this weekend with the express purpose of pooling their resources, knowledge and expertise in an attempt to improve understanding the problem of HIV drug resistance in southern Africa.

Resistance to HIV drug treatment threatens to undermine the success of South Africa's ARV (Antiretroviral) campaign and should thus be handled with the utmost urgency. To this end, collaboration is essential; this meeting is a response to this need. The meeting is coordinated by SATuRN (Southern African Treatment and Resistance Network), a non-profit network devoted to developing innovative means of collaborating and sharing data in response to anti- HIV and TB treatment in southern Africa.

The following southern African institutions are represented in the meeting: KwaZulu-Natal Research Institute for TB and HIV (K-RITH at UKZN), Africa Centre for Health and Population Studies (UKZN), Computer Science Department at UKZN, University of Stellenbosch Medical School, University of the Free State Medical School, University of Pretoria School of Medicine, National Institute of Communicable Diseases (NICD), National Health Laboratory Services (NHLS), Jembi health Systems, Medical Research Council, Botswana Ministry of Health, Aurum Institute. International participants are from the following institutions: John Hopkins School of Medicine, London School of Hygiene and Tropical Medicine and Stanford University.

In this first SATuRN Comprehensive Analysis Meeting, the focus will be on analyzing the vast amount of data that has recently become available from several independent surveys of drug resistance in the region. This group will use these data to learn more about the current situation and to suggest ways that treatment programmes could be improved. Their responsibility as scientists and doctors is to analyze and interpret this data rigorously and then share that information as widely as possible, most importantly with the policy makers at the Department of Health, so that the information can be used to improve care for people living with HIV in this region. Thus far, results from these independent surveys show both good and bad news for the region. The good news is that ARV treatment has expanded very fast and now includes over 1,3 million individuals, it has saved 1000s of lives and there is little evidence that transmission of drug resistant viruses from people on treatment to uninfected people is a problem (<5%). The bad news, however, is that a growing number of HIV infected individuals on treatment start to develop high-level resistance after only a few years on life-long ARV therapy.

SATuRN's first Analysis Meeting comes after years of preparation and a sustained and collaborative effort to collate the largest drug resistance dataset ever produced in southern Africa. 'The data contains over 7,000 genetic (i.e. DNA) codes of drug resistance viruses in the region, and detailed clinical, and in some cases social information, on the patients failing treatment' says Dr. Tulio de Oliveira, a bioinformatician from the Africa Centre for Health and Population Studies at UKZN and the co-director of SATuRN. He continues 'The genetic code of the virus is used to estimate the presence of drug resistance and, if combined with other associated data, it can shed light on the reasons for the development of resistance, which, in many cases, may be social rather than clinical.'

'All patient information is anonymous and has been collected following stringent academic ethics reviews. It is made available on what are considered to be the two best drug resistance databases in the world.' says Dr. Cloete Van Vurren, a specialized HIV physician and researcher from the University of the Free State. He continues 'It is a great opportunity to work together with some of best scientists and professional statisticians in the region in order to properly analyze the data'. Two internationally renowned statisticians, Dr. Nuala McGrath (London School of Hygiene and Tropical Medicine, U.K. and the Africa Centre, UKZN) and Dr. George Melikian (Stanford University, U.S.) will be present at the meeting and will not only provide analytical support but also specialized training in data analysis, training which will continue after the meeting ends, so that the participants develop the necessary skills to independently, and as a multi-disciplinary team, survey resistance levels in the region.

Links:

http://www.ukzn.ac.za/news.aspx?id=445

Publication cited

Public Database for HIV Drug Resistance in southern Africa. de Oliveira T, Shafer WR, Seebregts C, for SATuRN, Nature (2010), 464(7289):673.

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