Triple Therapy Trial

Lead Research Organisation: MRC Unit, The Gambia

Abstract

A great deal has been learned about the way HIV-1 behaves in an infected person from studies of how much virus can be found in the blood over time after the start of effective drug therapy with several antiviral drugs. Much less is known about the second strain of HIV, HIV-2, which is largely found in West Africa and is associated with a lower rate of progression to disease. In this study we will compare what happens to the amount of virus in the blood between people infected with HIV-1 or HIV-2 or both viruses when they start anti-HIV drug therapy.

Technical Summary

This is a clinical research study with the aim of comparing the viral dynamics in patients with HIV-1, HIV-2 and dual HIV-1/2 infection when these patients start combination anti-retroviral therapy (ART). Patients eligible for ART will be recruited from the GUM clinic in Fajara and admitted to the adult ward for intensive monitoring of their plasma viral load before and after the initiation of therapy and subsequently followed with further blood samples as an outpatient. The intention is to recruit 20 patients from each group into the study. The principal laboratory study will be on the viral load decay over time after therapy starts, but the virus-specific immune response will also be studied.
 
Description Drafted national HIV treatment guidelines and Global Fund application
Geographic Reach Africa 
Policy Influence Type Participation in a national consultation
Impact The experiences of treatment of HIV-2 and HIV-1 in MRC Gambia laid the basis for the development of hte national programme there. I drafted most of the treatment section for the national programme and wrote the grant proposal which was successful a obtaining funding from Global Fund for Gambia to set up HIs treatment. This led to widespread treatment availability for HIV in Gambia.
 
Title HIV-2 quantitative viral load assay 
Description PCR based measure of HIV-2 viral load. This assay was improved, made more robuse, and standardise as part of this project , with also funds from EDCTP, a personal fellowship for Dr Abraham Alabi. 
Type Of Material Technology assay or reagent 
Year Produced 2006 
Provided To Others? Yes  
Impact better HIV-2 viral load assay 
 
Description IDS 
Organisation University of Sussex
Department School of Global Studies Sussex
Country United Kingdom 
Sector Academic/University 
PI Contribution co-suppervision of student
Collaborator Contribution A joint MRC/ESRC PhD studentship was proposed, saught, and successfully won, which led to a successful PhD award. The student was jointly supervised by myself and by a co-supervisor at U of Sussex. Ths has led to 3 book chapters, as well as the thesis.
Impact PhD thesis, and award 3 book chapters better understanding of Gambia and MRC
 
Description Mathematical modelling analysis A Neumann 
Organisation Bar-Ilan University
Department The Mina and Everard Goodman Faculty of Life Sciences
Country Israel 
Sector Academic/University 
PI Contribution WE designed the study, organised the study, collected the data, wrote up the material, and presented it.
Collaborator Contribution The helped to analyse the numberical data.
Impact Poster presented at HIV dynamics conference, and paper in preparation
 
Description Modelling HIV-2 viral dynamics on treatment 
Organisation Bar-Ilan University
Department The Mina and Everard Goodman Faculty of Life Sciences
Country Israel 
Sector Academic/University 
PI Contribution Design study, recruit patients,
Collaborator Contribution analysis of HIV-2 viral dynamics presentation of a poster at a retroviral dynamics meeting
Impact presentation of a poster at an international meeting on retrovirus dynamics
 
Description Prince Leopold institute, Antwerp 
Organisation Institute of Tropical Medicine Antwerp
Department Microbiology
Country Belgium 
Sector Academic/University 
PI Contribution We hosted the laboratory work, performed the sample collection, supervised and trained the doctoral student
Collaborator Contribution brought the oligo-nucleotide assay technology
Impact A succesful PhD scholarship
 
Description RCSI 
Organisation Royal College of Surgeons in Ireland
Department Department of International Health and Tropical Medicine
Country Ireland 
Sector Academic/University 
PI Contribution designed and executed the project
Collaborator Contribution Estabilshed a National Malaria Surveillance system in Gambia, and evaluated it.
Impact Hosted a 2h workshop at American Society of Tropical Medicine and Hygiene in Washington DC in 2010, Late-breaker abstract for ASTMH meeting in Philadelphia 2011 paper in preparation