By the spring of 2020, the urgency of the COVID-19 pandemic caused many researchers affiliated with UNC’s Institute for Global Health and Infectious Diseases to pivot their studies to focus on testing, treatment and prevention of the SARS-CoV-2 virus. Here, a look at some of the projects underway in the last two years.
Development of syphilis vaccine
Arlene Sena, Jonathan Parr
The National Institute of Allergy and Infectious Diseases has funded four cooperative research centers to develop vaccines for chlamydia, syphilis, and gonorrhea. Working on an $11 million project to identify a syphilis vaccine candidate are Arlene Sena, MD, MPH, associate professor of medicine; and Jonathan Parr, MD, MPH, assistant professor of medicine; Jonathan Juliano, associate professor, Division of Infectious Diseases, UNC; David Smajs, professor, Masaryk University; Dr. Joseph Tucker, associate professor, Division of Infectious Diseases, UNC; Irving Hoffman, Division of Infectious Diseases, UNC; Heping Zheng, vice director, Dermatology Hospital of Southern Medical University, Guangzhou; Dr. Bin Yang, chief, Dermatology Hospital of Southern Medical University, Guangzhou; Michael Weiner, vice president of molecular sciences. Read more
Revealing and reactivating latent HIV virus, pointing to developing a cure
Overcoming HIV latency – induction of HIV in CD4+ T cells that lay dormant throughout the body – is a major step toward creating a cure for HIV. For the first time, scientists at UNC-Chapel Hill, Emory University, and Qura Therapeutics (a partnership between UNC and ViiV Healthcare) showed that a new approach can expose latent HIV to attack in two different animal model systems with little or no toxicity. Read more
Creating a long-acting drug delivery system to prevent HIV transmission
J. Victor Garcia
HIV clinical trials have shown that the protective efficacy of daily antiretroviral drugs for prevention of HIV transmission correlates with adherence — whether an uninfected person takes the prescribed medication at proper times. But nonadherence is a major roadblock toward decreasing the spread of HIV. One solution to the adherence problem is to make drug delivery less frequent but no less effective. UNC School of Medicine investigators and colleagues were awarded $2.91 million over three years by the Bill & Melinda Gates Foundation to create an ultra-long-acting formulation based on phase inversion implant technology. The principal investigator is J. Victor Garcia, PhD, professor of medicine. Read more
Improving treatment and survival of teens with lymphoma
Studying rituximab for Castleman Disease
Westmoreland and Painschab each won 2019 Fogarty research development funding for studies in Malawi. Fogarty rarely awards funding to two people working at the same site.
As only the second pediatric hematology oncology physician in all of Malawi, Westmoreland is focusing on optimizing treatment outcomes for adolescent and young adult patients with Burkitt Lymphoma through a Methotrexate dose escalation phase I clinical trial. Read more.
Painschab will lead a phase II clinical study for people in Malawi with multicentric Castleman disease (MCD). This disease is more prevalent in sub-Saharan Africa because of a higher prevalence of infections with two viruses that can cause it to develop: Kaposi sarcoma herpes virus and HIV. Rituximab, which targets certain immune cells, has been shown to be effective in controlling the disease in small studies in high-income countries. The researchers will now investigate whether they can safely administer this treatment in a Malawian environment where patients often have limited supportive care and live great distances from health care services. Read more
Combating HIV comorbidities
The National Institutes of Health selected UNC in 2019 as one of 13 sites for its Multicenter AIDS Cohort Study / Women’s Interagency HIV Study Combined Cohort Study. UNC researchers, led by principal investigator Adaora Adimora, MD, MPH, are continuing their research on chronic illnesses that often accompany HIV infection with the seven-year, $19.4 million NIH funding. The consolidated study will include previously underrepresented populations, with a special focus on African American and Hispanic populations and residents of southern states.
Improving pregnancy outcomes in Zambia and South Africa using wearable technology
With $14 million from the Bill and Melinda Gates Foundation, Jeff Stringer, MD, is leading two studies designed to improve pregnancy outcomes in the world’s poorest countries. “In many parts of the world, the days surrounding childbirth are the riskiest period a mother and her newborn will ever face,” says Stringer. “These studies will develop resource-appropriate technologies to make that time much safer.” His team will evaluate 15,000 women at high-volume clinical sites in Zambia and South Africa by providing wearable physiologic sensors to monitor laboring mothers and their fetuses and carefully document their clinical course and birth outcomes. Read more
Training women’s health researchers in Zambia
Carla Chibwesha and Benjamin Chi
Carla Chibwesha, MD, and Benjamin Chi, MD, are leading an NIH Fogarty study to train promising Zambian investigators in HIV and women’s reproductive health research. Their program will provide Ph.D. training for five Zambian investigators from the University of Zambia’s Schools of Medicine and Public Health. Trainees will complete doctoral coursework at the University of the Witwatersrand in Johannesburg, South Africam and then return to Zambia for dissertation research. The program will also support five postdoctoral positions, as well as professional development opportunities for junior and midcareer Zambian faculty.
Reading slides from Malawi and Zambia on specialized microscopes in Chapel Hill
African countries suffer from a critical shortage of pathology services. Cancer registries from the region reflect this problem. In a recent registry from Malawi, for example, fewer than 20 percent of cancer cases were pathologically confirmed, forcing clinicians and patients to make medical decisions without the benefit of a tissue diagnosis. Yuri Fedoriw, MD, works closely with collaborators in Malawi on telepathology, examining slides sent to him with a focus on lymphoproliferative disorders primarily associated with HIV infection. Read more
Studying the safety and efficacy of antibodies in preventing HIV infection in high-risk women in Africa.
Myron Cohen with Larry Corey
Globally, women make up half of the 36.7 million people living with HIV. Eighty percent of infected women live in sub-Saharan Africa, the region hardest hit by the pandemic. Young women ages 15 to 24 are at particular risk and are two to eight times more likely to be infected than their male peers. Institute Director Myron Cohen, MD, co-leads two parallel studies along with Larry Corey, MD. One study in the U.S., Peru and Brazil is testing whether intravenous infusions of neutralizing antibodies can prevent HIV infection in men and transgender people who have sex with men. The second study being conducted in Botswana, Kenya, Malawi, Mozambique, South Africa, Tanzania and Zimbabwe is testing whether an antibody infusion works in women. Read more
How malaria parasite evades rapid test detection
Jonathan Parr, Jonathan Juliano
The Democratic Republic of the Congo has one of the highest rates of people living with malaria. Rapid diagnostic tests account for more than 70 percent of diagnostic testing for malaria in Africa. Most rapid test diagnostics rely on the detection of histidine-rich protein 2, an antigen specific to Plasmodium falciparum malaria. However, one of every 15 children infected with Plasmodium falciparum malaria parasites in the DRC is infected by a pfhrp2-deleted mutant, producing a false-negative result when an RDT is used, investigators from the University of North Carolina at Chapel Hill found. Their results were published in the Journal of Infectious Diseases. Read more
Study finds three strains of resistant bacteria, identifying greater diversity
David van Duin
A study led by David van Duin, MD, PhD, has found that strains of carbapenem-resistant enterobacterales (CRE), a major threat to vulnerable patient populations, are more diverse than previously thought. Analyzing patient samples from 49 U.S. hospitals, the Multi-Drug-Resistant Organism Network of the Antibacterial Resistance Leadership Group identified three subsets of CRE, suggesting that interventions to control the spread of the bacteria should be tailored to the specific strain. Enterobacterales are a class of bacteria that cause common diseases including E.coli. The Centers for Disease Control has identified CRE as one of the nation’s top five most urgent antibiotic resistance threats. Read more