Report back on 2nd EMBO Conference on AIDS-Related Mycoses held at the IDM, 13 to 15 July 2016
Professor Graeme Meintjes, Dr Claire Hoving and Professor Gordon Brown from the IDM represented UCT on the organizing committee of this international meeting that focused on fungal infections that cause disease in people living with HIV infection. This conference followed on the success of the first meeting held in 2013 which was also held at the IDM.
As part of an ongoing effort to stem the tide of opportunistic fungal infections that continue to take a heavy toll on the most disadvantaged living with HIV-AIDS, over 100 researchers from Africa, Asia, North and South America, Europe and Australasia attended the conference to discuss current progress in the field and future priorities. Scholarships were awarded to 9 students from African universities outside South Africa and 20 students from South African universities, to cover all expenses to attend the workshop.
The programme included plenary sessions on Epidemiology and Public Health, Improving Diagnostics, Host-Pathogen Interactions, Immunology, Drug resistance, Treatment Strategies and new Antifungal Drugs and Vaccines. Detailed updates were given on epidemiology and public health aspects of the major AIDS-related Mycoses such as cryptococcosis, pneumocystosis, histoplasmosis and penicilliosis. Newly recognized HIV-associated invasive fungal infections due to Emmonsia spp were also highlighted. A major concern was that while antiviral rollout appears to have had some impact on the incidence of cryptococcal meningitis in sub-Saharan Africa in recent years, there is an ongoing epidemic of cryptococcal meningitis due to health system factors, patients being diagnosed with HIV late and some patients disengaging from ART care or failing ART. Access to available antifungal drugs and the development of novel drugs is an urgent priority due to the emergence of resistance to triazoles in Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus.
A further meeting is planned for 2019 and key goals over the next 3 years are:
Better collaborative working structures for basic scientists and clinical researchers to accelerate translational medicine in this field.
Better diagnostics and improved surveillance to identify infections earlier when treatment outcomes have better success rates.
Access to established drugs, as well as development of new drugs and vaccines, especially in low- and middle-income countries with the highest burden of disease.
Consolidation and extension of consortia for the delivery of multi-centre clinical trials.
Extension of current advocacy groups and public engagement as major funding from governmental and non-governmental organizations is urgently needed.
Groundbreaking study published by R Wilkinson & collaborators
Message from IDM Director Prof Valerie Mizrahi »
I’d like to draw your attention to an important new paper from a team led by Robert Wilkinson, which was published yesterday in Nature Medicine.
This study provides key insights into the progression of TB infection.
Please join me in warmly congratulating Hanif Esmail, Katalin Wilkinson, Clif Barry, Robert and colleagues from Imperial College, the Francis Crick Institute, the NIH and the IDM on their ground-breaking work.
Better views of TB lungs may save lives and stop spread
A special TB session was held prior to the 21st International AIDS Conference in Durban, South Africa in July 2016. Researchers suggest new ways, using CT and PET scans, to evaluate whether treatment has cured an infection.
Latest TB research from the Francis Crick Institute in London in collaboration with Robert J Wilkinson
Bacteria that cause tuberculosis can live in the walls of lymph vessels. The discovery, made by scientists at the Francis Crick Institute, could explain why people can be treated for TB hiding outside the lungs, recover and then get it again.
A team led by Dr Max Gutierrez found Mycobacterium tuberculosis bacteria intact inside cells taken from samples of human lymph tissue.
TB bugs attached to lymph cells. This electron micrograph image
shows the long, thin bacteria.
These TB bacteria can live inside lymph node cells.
The number of people affected by TB that takes hold outside of the lungs - extrapulmonary TB - has increased dramatically in the past decade. Lymph nodes are the most common site of infection. Almost one in five people who are HIV positive experience extrapulmonary TB.
This is the first time that endothelial cells, that line the walls of the lymph vessels, have been shown to have a role in TB.
The study was performed using tissue samples from people living in South Africa whose lymph nodes were sampled to diagnose extrapulmonary TB. However, the problem exists worldwide.
The team infected endothelial cells taken from human lymph vessels with TB bacteria in the lab. They followed their progress using microscopic imaging to find out exactly where within the cell the bacteria multiply. Most of the bacteria were discovered in the fluid inside the lymph cells, but some were found growing in autophagosomes - a sort of cell bag that usually swallows and destroys bacteria.
Dr Gutierrez said: "Depending on how active the immune system is, the cells forming the walls of lymph vessels can actually provide a reservoir for TB bacteria that allows them to multiply as well as hide. If the cells are properly activated by the immune system the bacteria are destroyed, if not, they can grow."
"This is the first time we have been able to show that TB bacteria can live in these cells in the lymph nodes and suggests they are a source of re-infection even after treatment."