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New study explores link between HIV and tuberculosis
Massachusetts attorney Thomas M. Kiley, http://www.tomkileylaw.com, concentrates on legal issues affecting children’s health. A new research initiative will bolster efforts of AIDS research laboratories at Massachusetts General Hospital, Harvard Medical School, and tie this research with South African researchers to explore the link between HIV and tuberculosis.
According to an article in the Boston Globe, the research initiative is a 10-year project, to be centered in a new research facility at the the University of KwaZulu-Natal and the Nelson Mandela Medical School in Durban, South Africa. The $60 million project is funded by the Howard Hughes Institute. Researchers from MGH and the medical school have worked on AIDS/HIV with Durban colleagues for the past 10 years. MGH AIDS researcher Bruce D. Walker has led this research and 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 focuses on an increasing number of patients suffering from both HIV and TB. There has been an outbreak of extensively drug-resistant tuberculosis among HIV victims that became an epidemic in Tugela Ferry in KwaZulu-Natal Province in 2006. There were more than 200 people infected in one town and most died, including hospital staffers.
Researchers have been concerned with the complicated problem of multi-drug-resistant tuberculosis. The problem of extensively drug resistant TB 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 the study will look at the causes of recurrent tuberculosis. Researchers will study the extent to which AIDS patients crowded into waiting rooms of clinics are spreading tuberculosis.
Tuberculosis became a problem in KwaZulu-Natal in the 1990s when there was an AIDS epidemic. In the past, TB occurred in about 200 of the 100,000 people in the province, but in recent years that number has increased to 800 per 100,000, according to the article.
The patient population has changed since the two infectious disease have converged. 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.
