The Goulder Group focuses on the South African HIV epidemic. The group studies the inter-related roles in HIV infection of CTL escape, viral replicative capacity, the impact of HLA and non-HLA genes on disease outcome, and the evolutionary consequences of these events. A key research interest is in the paediatric HIV epidemic, with the unique insights this presents into mechanisms underlying HIV Cure and HIV Non-Pathogenesis.
HIV infects CD4+ T-cells, causes a decline in CD4 count and immunodeficiency, ultimately resulting in AIDS. An estimated >70 million people have been infected with HIV to date, of whom ~36m are living with HIV today. Approximately one-seventh of HIV infections are in children.
Our research work aims to:
- Define the adaptive immune responses that are successful in controlling HIV (see Payne et al PNAS 2014; and reviews: Kloverpris et al, Front Immunol 2015; Prendergast et al Nat Rev Immunol 2012, Goulder & Walker, Immunity, 2012)
- Understand the innate immune responses that allow HIV to replicate at high levels without causing disease. This we see in a small subset – approximately 2% - of HIV-infected children who are healthy and indistinguishable from age-matched uninfected children apart from running persistently high viral loads (see Paediatric Non-Progressor Study);
- Investigate the potential for HIV Cure in specific groups of HIV-infected children: newborns in whom ART is initiated on the first day of life (see Baby Cure Study); HIV-infected children in whom ART was initiated in the first 12 months of life; and the paediatric non-progressors;
- Define changes in the innate and adaptive immune response that arise over the course of normal development (see Muenchhoff et al, Front Immunol, 2014), that give rise to the so-called honeymoon period of infectious diseases in childhood, with high morbidity and mortality in the first 1-2yrs, reduced in childhood, increasing again towards older childhood and adolescence (an example being TB infection versus TB disease); and to define the sex differences in the immune response that arise pre-puberty in children that give rise to the striking disease outcomes from a range of infections in male and female children through childhood (see Muenchhoff & Goulder, JID 2014). To this end we are conducting a longitudinal study of 40 sets of twins we have enrolled in Oxford and 20 sets we have enrolled in Kimberley South Africa.
highlighted Current Studies
'Baby Cure' study team at Stanger Hospital Clinic
Paediatric HIV Research Clinic Team, Ithembalabanthu Clinic, Umlazi
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Goulder has received funding from the Wellcome Trust from 2002-2015 through Senior Clinical Fellowships and since 2015 through a Wellcome Trust Investigator Award, 2015-2020. He has also received RO1 support from the National Institutes of Health since 2000 (most recent RO1 award 2011-2016).
Thumbi Ndung’u - Principal Investigator, Durban, South Africa
Pat Mbatha - Clinical Coordinator, Durban, South Africa
Manjeetha Jaggernath - Research Clinician, Durban, South Africa
Pieter Jooste - Principal Investigator, Kimberley, South Africa
Samantha Daniels - Research Technician, Kimberley, South Africa
Thea Brits - Research Technician, Kimberley, South Africa
Joris Hemelaar - Clinical Lecturer, Nuffield Department of Obstetrics and Gynaecology, University of Oxford