THE STORY OF CLAIRE WHITAKER AND NOBHONGO GXOLO. PHOTO CIDRI-AFRICA.
The HIATUS study, a research program being launched by the Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa) at the University of Cape Town (UCT), will investigate the interaction between the COVID-19 pandemic and common endemic infectious diseases in Africa. The South African context.
CIDRI-Africa will launch a program of projects focused on understanding and providing information on the clinical presentation and pathogenesis of COVID-19 in the South African population. COVID-19 is the disease caused by the recently emerged severe acute respiratory syndrome virus (SARS-CoV-2).
The "health center-based observational studies to investigate the interaction and overlap between SARS-CoV-2, M. tuberculosis infection and HIV-1" will be conducted at Groote Schuur Hospital and Community Health Centre Site B in Khayelitsha, Cape Town, and Livingstone Hospital in Port Elizabeth.
Principal investigator Professor Robert J Wilkinson, a member of the Institute of Infectious Diseases and Molecular Medicine and director of CIDRI-Africa, said: “It is important to understand not only the COVID-19 infection itself, but also its potential for interaction with common endemic infectious diseases in South Africa, which are HIV-1 and tuberculosis [TB].”
As part of the HIATUS study, researchers in the program of four related projects will invite hospitalized COVID-19 patients to donate small additional samples of blood and cerebrospinal fluid during routine care procedures. From these samples, researchers hope to gain a wealth of information about the pathology and immune response to SARS-CoV-2 in people with and without HIV or TB coinfection.
The study will begin once feedback is received from the Institutional Biosafety Committee.
TB and HIV in South Africa
According to the World Health Organization's (WHO) 2019 Global Tuberculosis Report , South Africa accounts for approximately 3% of the global incidence of tuberculosis. A 2019 profile of South Africa, developed by the Joint United Nations Programme on HIV/AIDS, stated that 20% of the world's HIV prevalence occurs in South Africa.
TB in 2018
| G | Global | South Africa |
| Cases | 10 000 000 | 301 000 |
| Deaths from seropositive TB | 251 000 | 42 000 |
| HIV/TB cases | 862 000 | 177 000 |
HIV in 2018
| G | Global | South Africa |
| Predominance | 37 900 000 | 7 700 000 |
| New infections | 1 700 000 | 240 000 |
| AIDS deaths | 770 000 | 71 000 |
As reported in the WHO COVID-19 Dashboard , to date there have been 6,040,609 cases of COVID-19 worldwide. Of these, 32,683 (0.5%) have occurred in South Africa , according to the National Institute for Communicable Diseases.
There are serious concerns about the potential impact of COVID-19 in South Africa due to existing epidemics such as HIV and TB, which can increase vulnerability and the severity of COVID-19 infection. However, the consequences of SARS-CoV-2 coinfection with HIV and tuberculosis are currently unknown.
It is urgent that we better understand the clinical manifestations and pathogenesis of SARS-CoV-2 to develop tools, strategies, and interventions to halt the spread of the disease and improve treatment within our unique population. CIDRI-Africa will contribute to meeting this need through the various projects of the HIATUS study.
"We anticipate that these studies will provide important information on COVID-19 infection that will be directly relevant to African populations."
HIATUS Projects
In the first HIATUS project, the team will investigate the SARS-CoV-2-specific response of immune cells called T cells and determine whether these responses correlate with disease outcomes. The results of this study could also provide the basis for a simplified test to assess viral immunity.
In the second project, CIDRI-Africa researchers will examine the role of specific pathological phenomena, such as coagulation and cytokine storms, in COVID-19. Cytokine storms are severe and potentially fatal hyperinflammatory immune reactions in which the body releases a flood of cell-signaling molecules.
Although COVID-19 is primarily a respiratory illness, it is becoming increasingly clear that there are also neurological effects, such as anosmia (loss of smell), suggesting that the virus can infect the nerves and brain. Therefore, the CIDRI-Africa team will describe and characterize the prevalence, clinical presentation, biochemistry, and severity of neurological COVID-19 in their third project.
In their latest project, researchers will extend an existing close contact TB study by including screening and COVID-19 testing in future clinical visits.
"We anticipate that these studies will provide important information about COVID-19 infection that will be directly relevant to African populations," Wilkinson said.
In: https://www.news.uct.ac.za/article/-2020-06-02-covid-19s-interaction-with-hiv-and-tb-investigated