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Motswana woman enhancing HIV/AIDS cure research

Publishing Date : 23 April, 2018


Thirty years on, the cure for HIV/AIDS remains elusive, but researchers from various corners of the world are making enormous efforts and as the quest ensues, one Motswana woman, Dr Catherine Koofhethile, an immunologist, is in the thick of things and among those in the forefront to enhancing HIV/AIDS Cure research, ANGELA MDLALANI writes.

Despite the fact that both the vaccine and cure for the Human Immunodeficiency Virus (HIV) have eluded the researchers’ inquisitive eye for three decades now, Dr. Catherine Koofhethile believes that a breakthrough for an HIV cure is nigh.
Having spent almost all her career life in HIV research, Koofhethile is of the strong view that more focus should be placed on cure research.

During her PhD studies, her research focussed more on the understanding  of the mechanisms of HIV control during the chronic stage of infection but the turning point was in 2014 when she was nominated to attend the 64th Lindau Nobel Laureate (Medicine and Physiology) meeting in Germany. There, she met and interviewed the esteemed Professor Barré-Sinoussi who received a Nobel Prize for co-discovery of HIV.

“That was big for me, as I was fortunate enough to be meeting this woman who has taken great strides in HIV work. We discussed a variety of topics with regards to HIV research. And when she gave her talk, she encouraged work towards cure research. Her talk motivated me and pushed me to think about having my post-PhD career be focused on cure research.” 

Further, she was propelled by revelations by Prof Barre-Sinoussi’s assertion that she had interacted with HIV infected people who had revealed that they were tired of taking medication and wanted to be cured. Today, Koofhethile is based in the United States in Boston, Massachussets at the Harvard T. H. Chan School of Public Health. Under the mentorship of Professor Max Essex and Dr. Vladimir Novitsky, she still researches on HIV.

Prof. Essex is among HIV experts who have been researching on HIV since the beginning of the epidemic. Currently, Koofhethile’s research focuses on understanding the architecture; size and structure of the proviral reservoir in HIV infected individuals undertaking antiretroviral treatment (ART) in Botswana.

She uses a combination of Immunological and Virological assays to monitor proviral reservoir in HIV infected individuals. She works in collaboration with a local Investigator, Dr. Sikhulile Moyo, a Virologist based at Botswana Havard AIDS Institute Partnership (BHP) in Botswana where she also holds a Research Associate position. Here, she is actively involved with research and also mentors and supervises some of the upcoming researchers and students who are attached at the lab.

“When HIV infects the cells, mostly CD4+ T cells, the majority of these infected cells eventually die but only a small proportion go in to a ‘resting state’ creating what we call ‘reservoir’. This is a situation where by the virus can sort of hide in different parts of the body. The reservoir sites can be in tissues such as the lymph nodes and spread across the body including central nervous system and the gastrointestinal track. This reservoir is the major obstacle to finding a cure for HIV,” she revealed.

“My current research therefore is focused on trying to understand this reservoir. In order to completely eradicate the virus from the body, we must eliminate the reservoir but in order to get rid of the reservoir, there is need to understand its dynamics.” 

Just last month, Koofhethile flew into the country and gave her first ever Public Lecture at the University of Botswana. And fittingly, it was hosted in her homeland. The Public Lecture addressed her previous PhD and current post doctoral research work, which she revealed to this publication, was going well. She also gave a summary of the current global HIV cure research – an update of where we are in terms of finding a cure.

The public lecture was well attended, including by her family who got to see firsthand the kind of work she does, since she is not based in Botswana. “It was very humbling to see my family and friends in the audience; they have greatly supported me throughout my career. And for them to see my progress meant a lot to me. They now understand the kind of work I am involved in and are very proud.”

The current study, she and Dr. Moyo started last year November will be completed hopefully at the end of this year (2018). The study involves teenagers who were born with HIV, started ART soon after diagnosis and have been on therapy for many years. “It is a very important project that will give us a better understanding of  the HIV reservoir and enhance HIV cure research. We are still recruiting for this study but already I am hopeful about it,” she said.

The making of the great Doctor

Koofhethile has almost always known she would end up in science. She grew up at a time when HIV had just been discovered, and the stigma and fear of AIDS was rife. She would go on to hear more about this monstrosity at school, although not much was known about the disease then. So curious was the young Koofhethile that she at that young age took a life decision that she would grow up to one day help end that epidemic.

Fast forward to some years later, now a qualified microbiologist and immunologist, the Harvard Post-doc Fellow is among those at the forefront of the worldwide effort working towards HIV cure research. Right from her primary school days, she had always performed well in Mathematics and Science, it was no surprise then when after the Junior Certificate she went on to do Pure Sciences and Add Maths.

She proceeded to do her Tirelo Sechaba (National Service) at the Botswana National Youth Council as an Admin Assistant and occassional peer educator on HIV/AIDS before proceeding to do her first year at the University of Botswana. She spent only her foundation year (formely known as BSc Part 1) at UB and she was then offered a scholarship for a four-year Bachelor of Science Degree with Honours in Medical Microbiology at the University of Surrey in the United Kingdom.

Upon graduating, she returned home and was offered a job at BHP as a Fogarty Fellow. After 2 years, she decided to go back to read for her Masters Degree in Immunology at the University of Birmingham, still in the UK, albeit this time as a self sponsored student. “My family contributed a lot towards my school fees and upkeep and I’ll forever be grateful for their unconditional support,” said Koofhethile.

All along, she was itching to get her hands on HIV research, but there were no dedicated research projects on HIV. Eventually, after her second degree, she decided to contact a Professor at Oxford University who was only impressed she would want to work with HIV research. The Professor in question is Phillip Goulder, whose work has had a major impact in the field of HIV research throughout the world. A renowned paediatrician and researcher, he is lauded for his great contributions towards HIV research.

Dr. Koofhethile spent 2 and half years at Prof. Goulder’s lab, working as a Graduate Research Assistant. “My time at the Goulder lab was fulfilling in many ways. Most of my research techniques I employ in my HIV research were learnt from the Goulder lab,” she said in an interview. She would want to continue studying under Goulder’s mentorship, but this time in Africa, at the “at the epi-centre of the epidemic”.

“During my time at Oxford, I already knew I wanted to proceed to a PhD and that I wanted to study in South Africa under the mentorship of both Prof. Goulder and Prof. Thumbi Ndung’u who used to work in Botswana. And I knew both professors would be fantastic mentors since they are experts in the field of HIV research.” In 1998, Goulder and some colleagues founded a state-of-the-art lab at the University of Kwazulu Natal (UKZN), in Durban South Africa, the university Koofhethile had in mind for her PhD.

“It really made sense for me to study in Africa than elsewhere because we are the hardest hit by HIV. When at home, you get to experience how people affected relate with the research,” she highlighted further. So, she decided to take up her studies, focusing on the Immunology of HIV. “I was basically trying to understand why some people get infected and do not fall sick and while some get infected and their health deteriorates very fast.”

Her PhD research entitled “Protective HLA Class I Alleles: Investigation of Viral Control and Lack of Control in Chronic HIV-1 Subtype C infection,” in fact, has brought scientists a step closer to understanding the phenomenon whereby a rare group of individuals control HIV-1 infection without antiretroviral therapy.

Her PhD studies were supported through scholarship from the Organisation for Women in Science for the Developing World (OWSD) and partly by some of Prof. Ndung’u’s grants. The OWSD is a non-profit making entity whose objective is to strengthen women scientists’ role in the development process and promoting their representation in scientific and technological leadership. 

Returning home?

As fulfilling as her work has been thus far, Koofhethile harbours plans to return home and do more with regards to HIV research, women’s development and science development. However, she believes that there is a great number of women involved in science and research in Botswana, but they are not celebrated enough. So, we need to celebrate these wonderful women in science in order to make science careers more attractive to the young girls.

This will increase the Global numbers of women in science. We also need our government to direct funding towards basic science research in Botswana to allow us to do research in our own country as Batswana and solve problems affecting us as a nation,” she asserted. She envisions an Africa that would be the hub of research, science and technology and be able to attract more research funding.



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