$60m project will fund HIV-TB link
10-year effort to be centered in South Africa
A vast South African AIDS research initiative is growing even larger with the launch of a $60 million project to attack the deadly link between HIV and tuberculosis.
At a news conference yesterday in Washington, scientists from the Howard Hughes Medical Institute and the University of KwaZulu-Natal, in Durban, South Africa, announced the 10-year initiative, to be centered in a new research facility on the Durban campus of the university's Nelson Mandela Medical School.
The new project will bolster an effort with deep Boston roots in the AIDS research laboratories of Massachusetts General Hospital and Harvard Medical School. Researchers from MGH and the medical school have worked on AIDS/HIV with Durban colleagues for a decade, led by MGH AIDS researcher Bruce D. Walker. He is also an investigator at the Hughes Institute and is closely involved in the new AIDS-TB project.
Last month Walker's team received a $100 million gift from Cambridge software entrepreneur Phillip Terrence Ragon to create a new institute to develop an AIDS vaccine. That work relies in part on research being conducted in Durban.
The new Howard Hughes-funded project will focus in part on the worsening incidence of patients suffering from both HIV and TB, and especially the outbreak of extensively drug-resistant tuberculosis among HIV victims. That very rare form of TB exploded into an epidemic in Tugela Ferry in KwaZulu-Natal Province in 2006, where more than 200 people were infected in one town alone and most died, along with a number of hospital staffers.
Scientists have long wrestled with the complex problem of multi-drug-resistant tuberculosis. The problem of extensively drug resistant TB is even more vexing because it often occurs in patients who have already contracted and been treated for tuberculosis.
Dr. Salim S. Abdool Karim, who is director of the Center for the AIDS Program of Research in South Africa, said one aspect of the study will be the causes of recurrent tuberculosis, and the extent to which AIDS patients crowded into waiting rooms of clinics are spreading the infection.
He noted that tuberculosis was not as serious in KwaZulu-Natal as elsewhere in the country until the AIDS epidemic erupted in the 1990s. In the past, TB occurred in about 200 of the 100,000 people in the province, but in recent years that number has soared to 800 per 100,000, Karim said in a telephone interview.
What's more, the patient population has changed dramatically because of the convergence of the two infectious diseases, he said. Most TB victims now are much younger and are also infected with HIV, compared with the older villagers who tended to contract TB in the past.
The new $20 million, six-story research institute will include two floors of high-level biosafety labs. The lab will be integrated with the Doris Duke Medical Research Institute that Walker helped establish at the medical school. The other $40 million in Howard Hughes funding will go toward research, training, and related treatment programs over 10 years.
Karim said that in addition to researching the nature of recurrent TB, scientists will study problems in diagnosing TB in AIDS patients, which is especially complex, as well as understanding the genetic factors in drug resistance. Researchers will also study HIV immunology and try to learn why HIV leads to more aggressive tuberculosis.
The research will be combined with patient treatment at three hospitals in the heart of the AIDS crisis in the province as well as extensive training of research and clinical staff.
James F. Smith can be reached at jsmith@globe.com. 