Our group’s work is focused on the South African HIV epidemic. Although the group is based in Oxford, we have over the past 20 years developed strong collaborations in Durban and Kimberley, South Africa. Our group’s major focus is on HIV-infected children; specifically: (1) the impact of differences in the immune response in adults and children on HIV disease and HIV cure/remission potential in children; and (2) the impact of sex differences in the immune response, from conception through adolescence, on HIV disease and HIV cure/remission potential in children.
HIV infects CD4+ T-cells, causes a decline in CD4 count and immunodeficiency, ultimately resulting in AIDS. An estimated 78 million people have been infected with HIV to date, of whom ~36m are living with HIV today. Approximately 15% of HIV infections are in children. So far, only two people with HIV infection have been cured.
Our group is based in the Peter Medawar Building for Pathogen Research at the University of Oxford. The primary focus of this work is the South African HIV epidemic where we have worked since 1998 in collaborations with colleagues in Durban, KwaZulu-Natal and in Kimberley in the Northern Cape.
The overarching aim of this work is to achieve cure in HIV infection.
Alongside this initiative are studies designed to define the mechanisms that underpin the impact of age and sex differences on the immune response. Unexpectedly, our work in the BabyCure study showed that immune sex differences arise prenatally and result in a 2-3-fold increased risk of mother-to-child transmission of HIV in utero. The impact of age and sex differences on outcome from a range of infections beyond HIV, have until SARS-CoV-2 been relatively underestimated and understudied. HIV provides a model by which to study these immune differences, in addition to furthering our understanding of HIV and HIV cure mechanisms.
Ucwaningo Lwabantwana: BabyCure study
The BabyCure study headed by Jane Millar investigates cure potential in HIV-infected newborns initiated on ART in the first 48hrs of life in KwaZulu-Natal, South Africa. We are following over 200 in-utero infected infants and their mothers enrolled onto this study. This allows us to characterise in detail: the early life innate and adaptive immune responses in these children and their mothers, the virus transmitted from mother-to-child, and the impact of non-structured ART-interruptions. There is a strikingly high frequency of ART non-adherence amongst these in-utero infected children for reasons that we and others are investigating (Millar et al., PIDJ 2019; Millar et al., EClinMed 2020).
Innate immune sex differences in utero result in type I interferon-resistant viruses being more readily transmitted to females (Adland et al Nat Comm, 2020).
In the media
Research Clinic Team
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
Goulder has received funding from the Wellcome Trust from 2002-2015 through Senior Clinical Fellowships and since 2015 through a Wellcome Trust Investigator Award, 2015-2021. He has also received RO1 support from the National Institutes of Health since 2000 (most recent RO1 award 2017-2022).