Head of Division: Professor Carolyn Williamson
The Division of Medical Virology is comprised of a diagnostic laboratory which serves as a regional reference centre providing a clinical and diagnostic service to local teaching hospitals and surrounding public health clinics; together with a research programme which focuses on viral diseases of key importance to South Africa. The division is committed to undergraduate and postgraduate teaching. Currently there are 38 members of staff, and 36 post-graduate students registered for MMed, MSc or PhD degrees. Much of the research is performed within the Institute of Infectious Disease and Molecular Medicine. In 2010, Professor Carolyn Williamson was appointed Head of Division.
The diagnostic laboratory under Dr Diana Hardie continues to provide a comprehensive service to Groote Schuur Hospital and Red Cross Childrens Hospital. In addition it is the referral laboratory for a large proportion of the regional virology testing in the province. It offers a wide repertoire of tests in the fields of viral serology and molecular diagnostics. The Virology diagnostic laboratory has maintained its SANAS accreditation status according to ISO15189. The laboratory has a special interest in molecular diagnosis of human viral diseases and performs an extensive range of in-house and commercial molecular assays. To respond to the measles epidemic that hit the Western Cape in 2010, a diagnostic measles PCR was set up to assist in the diagnosis of complicated cases. Using this assay, sub-acute measles encephalitis was confirmed on brain biopsy or CSF in 8 HIV-infected patients with rapidly progressive grey matter disease. In another study, parechovirus was found to be the commonest viral isolate in infants with SIDS, highlighting the potential pathogenicity of this virus in young infants. As a result of this study, an in house multiplex PCR assay to detect both enteroviruses and parechoviruses has been set up and will be introduced soon as a routine diagnostic test.
2010 saw the establishment of a National Institute for Communicable Diseases (NICD) Molecular Epidemiology Satellite Unit in the virology and microbiology diagnostic laboratories in GSH. The purpose of this unit is to investigate nosocomial outbreaks of viral and bacterial infections, to support the activities of the HPV WHO Labnet laboratory, and to identify novel or emerging pathogens and investigate their epidemiology in the local population.
HIV is having a devastating impact on health in South Africa and is a focus of research in the division. A major achievement of the division was the co-development of two candidate vaccines, SAAVI MVA-C and SAAVI DNA-C2, as part of the UCT SAAVI vaccine development programme (Director AL Williamson). These vaccines, which entered into Phase I clinical testing in 2009, were shown to be immunogenic and expanded trials are planned for 2011. HIV vaccine development projects continue in Professor Anna-Lise Williamsons laboratory with Dr Gerald Chege testing BCG vaccines constructed by Dr Ros Chapman in non-human primates. Dr Niki Douglas and PhD student Olivia Carulei continue to work on avipoxviruses as HIV vaccine vectors. In collaboration with Centre for AIDS Programme for Research in South Africa (CAPRISA), there has been a multi-pronged approach to elucidating the effect of viral and immunological dynamics in very early HIV infection, on subsequent disease progression. Analysis of full length HIV genomes have shown that early infection is typified by severe genetic bottleneck where 80% of cases only a single virus establishes infection followed by rapid viral escape from immune detection. Some of these mutations are important in setting the speed at which individuals subsequently progress to disease (C Williamsons research group). In collaboration with researchers at the Vaccine Research Center at the NIH, W. Burgers group discovered that immune activation during early HIV infection was associated with the rate of disease progression in a cohort of South African women. This had previously been shown in chronic HIV infection and these results imply that aberrant activation in the first few weeks of infection sets the course of disease progression. In line with Dr Burgers findings, Jo-Ann Passmores group have shown that certain key inflammatory cytokines present in blood during acute HIV infection also predicted the course of HIV-associated disease progression. At the genital mucosa, they showed that genital tract inflammation was associated with release of infectious HIV particles into the vaginal lumen making women more infectious to their sexual partners. Although anti-retroviral therapy was very effective at suppressing HIV replication in blood, certain HIV-infected women on therapy continued to release HIV into their vaginal secretions and maintained significantly higher genital tract immunity to HIV, indicating inadequate suppression of genital viraemia. Professor Anna-Lise Williamsons group continued to work on the impact of HIV infection on Human Papillomavirus (HPV). In a study done on heterosexual couples HIV infection was found to impact on the prevalence of human papillomavirus infection in both men and women. HIV discordant couples were more likely to share HPV types if the female partner was HIV positive than if the male partner was HIV positive.
Members of the division continue to play a role on national and international committees and policy forum: Professor Carolyn Williamson is a member of the Global HIV Vaccine Enterprise working group on viral diversity and host genetics; PRF Scientific Advisory Panel; and is on the Scientific Advisory Committee of the UK Vaccine Consortium. Professor Anna-Lise Williamson is a member of the Global HIV Vaccine Enterprise Science Committee, and a member of the New Viral Vector Vaccines Safety Working Group (V3SWG) of the Brighton Collaboration. The Brighton Collaboration is an international voluntary collaboration created in 2000 to facilitate the development of high-quality information about the safety of human vaccines. She is also a member of the SA Human Papillomavirus Advisory Board. Dr Jo-Ann Passmore was the co-organiser for the Mucosal Immunology Workshop at the MRC in Durban in August 2010.
Members of the division continue to play a role in undergraduate and honours teaching. In addition, the division hosts 36 post-graduate students. In 2010, five students were awarded PhDs (Yen-Ju Shen, Koushik Chatterjee, Florette Treurnicht, Pam Gumbi and Alfred Bere); and 4 students were awarded MSc degrees (Anna Salimo, Nai-Chung Hu, Mankgopo Kgatle and Agano Kiravu), with Mr Kiravu being awarded his degree with distinction. Andile Nofemela was awarded an AIDS International Training and Research Program Fogarty Scholarship; five students received Clinical Infectious Diseases Research Initiative (CIDRI) fellowships (Alfred Bere, Nonhlanhla Mhkize, Zizipho Mbulawa, Olivia Carulei, Cobus Olivier and Nobubelo Ngandu), and five students were awarded Carnegie fellowships (Lindi Roberts, Marcel Tongo, Shameem Jaumdally, Gama Bandawe and Shivan Chetty). Ms Andreia Soares was awarded a Carnegie postdoctoral fellowship.
The research groups have both national and international funding including funding from HIV Vaccine Trials Network (HVTN); SHARP (DST/LifeLab); Centre for HIV/AIDS Vaccine Immunology (CHAVI); Collaborative Programme for Vaccine Development (CAVD); National Institutes of Health (USA); Wellcome Trust (UK); European and Developing Countries Clinical Trials Platform (EDCTP); European Union; National Research Foundation (SA); South African AIDS Vaccine Initiative (SAAVI); the Cancer Association of South Africa (CANSA); Swedish International Development Cooperation Agency (SIDA); Polio Research Foundation (PRF); Medical Research Council, (SA); and South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation.
Special awards / honours / promotions
Nonhlanhla Mhkize got the LOreal Women in Science award.
Dr Jo-Ann Passmore received the UCT College of Fellows Young Researcher award
Professor Anna-Lise Williamson was awarded the Cancer Association of South Africa (CANSA) AG Oettlé Memorial Medal for work on the human papillomavirus, the leading cause of cervical cancer.
Dr Wendy Burgers was awarded a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine
Professor Bert Jacobs, Biodesign Arizona State University