Honorary lecturer at UKZN and scientist at the Centre for the AIDS Programme of Research in South Africa (CAPRISA) Dr Sinaye Ngcapu has been awarded the prestigious National Institutes of Health (NIH) R01 grant.

The award will fund a five-year novel study to determine whether specific vaginal anaerobic microbes and associated inflammation can influence preterm deliveries or the acquisition of HIV infections.

Born in the rural village of Mdolomba near King Williams Town in the Eastern Cape, Ngcapu is an infectious diseases immunologist and teaches immunology at UKZN to Medical students in their honours year. His research focuses on understanding the role of the microbiome at the female genital tract in modulating the immune response, with HIV as the primary outcome as well as susceptibility to other sexually transmitted infections as a secondary analysis.

The participants of the study are HIV-uninfected pregnant women and their infants – including those actively taking Pre-Exposure Prophylaxis (PrEP) – from townships in the Durban metropolitan area. These cohorts provide a unique platform to first assess whether vaginal microbial taxa or cytokines during gestation predict risk of preterm labour and delivery in women at high risk for HIV, secondly, to determine whether increased vaginal microbial diversity and/or inflammation could explain the higher HIV risk during late pregnancy and early postpartum, and lastly, to determine the effects of antiretroviral exposure during gestation and breastfeeding on infant glucose metabolism and innate immunity.

Ngcapu said: ‘Pre-exposure Prophylaxis is being used more frequently during pregnancy due to the high risk of HIV during this time period. Indeed, prevention of maternal seroconversion during pregnancy, which comes with a high risk of mother to child transmission, is paramount. Yet we do not know the full implications these interventions have on the vaginal bacteria, genital inflammation and the developing foetus and young infant. This study has the ability to measure the effects of maternal ARVs on the female genital microenvironment, infant immunology and metabolism in the absence of HIV-exposure.

‘This is a critical area of HIV research as this has the potential to lead to more refined interventions to mitigate risks of adverse birth outcomes, HIV acquisition and neonatal morbidity, which is particularly important in the South African population where HIV is highly prevalent,’ he said.

Ngcapu has a doctoral degree in Medical Virology and is a visiting postdoctoral fellow at the Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, Harvard University in the United States, and at the University of Cape Town. He has presented extensively at national and international conferences and supervised UKZN honours and masters students.

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Words: MaryAnn Francis

Photograph: Supplied