M-PACT

Description

A recent scale-up of antiretroviral therapy (ART) in sub-Saharan Africa has transformed HIV from a lethal to a chronic disease. Studies in high-income settings have shown that HIV-induced residual immune activation during ART is associated with poor immune recovery, AIDS and non-AIDS morbidity, and mortality. However, little is known about its health impact in Africa. We hypothesize that residual immune activation/dysfunction is greatly exacerbated in Africa because of advanced pre-ART immunodeficiency, highly prevalent chronic co-infections (hepatitis B, tuberculosis, o.a.), and faster disease progression in HIV-1 subtype C infections. With millions of Africans accessing chronic care, residual immune activation poses a potential threat to effective life-long ART. This project will explore the effect of immune activation on treatment outcomes as well as novel biomarkers of immune recovery. Such knowledge will be crucial in the development of future adjunctive interventions to curb any detrimental effects of residual inflammation. MicroRNAs present an exciting novel opportunity as potential biomarkers of immune activation and recovery. The research project will be leveraged by the established PASER-M cohort in five African countries.