Fogarty International Center Emerging Global Leader award for Associate Prof. Jonny Peter

23 Oct 2018
Image of capsules and tablets on a metal tray; via Unsplash
23 Oct 2018

Image of capsules and tablets on a metal tray
Jonny Peter’s goal is to improve the safety and effectiveness of treatments for TB and HIV in African populations through the identification of biomarkers and treatments that enable a personalized clinical approach.

While effective treatments for TB and HIV are available, some 13% of people receiving first-line TB drugs, and 8% of those taking non-nucleoside reverse transcriptase inhibitors for HIV may develop cutaneous adverse drug reactions; some of these are severe and life-threatening. Severe cutaneous adverse reactions (SCAR) in African TB and HIV endemic settings is a neglected research topic, despite the high rate of occurrence during treatment.

The most common types of SCAR are Stevens Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) and Drug Reaction Eosinophilia and Systemic Symptoms (DRESS). There are limited means to predict who will develop SCAR and no targeted therapies available to treat or prevent TB and HIV-associated immune-mediated adverse drug reactions.

During the course of the Immune-Mediated Adverse Drug Reactions in African HIV Endemic Setting (IMARI-SA) study, Prof. Peter and his team will pursue three aims:

  1. define the characteristics of the drug reactions, and of specific immune cells, involved in SCAR in HIV-uninfected, HIV-infected and HIV-TB co-infected populations in South Africa;
  2. define genetic risk factors associated with SCAR in HIV-uninfected, HIV-infected and HIV-TB co-infected populations in South Africa; and 
  3. define the molecular and cellular signatures of drug-specific immune cells at the site of SCAR reactions.

Prof. Peter hopes that the data and conclusions drawn from the study will inform the eventual development of a screening tool to identify safe treatment options for individual patients, as well as improved tools to diagnose and treat SCAR. He will work with two other HATTP colleagues—Profs Lehloenya and Dlamini—and will also have both a United States mentor (Prof. Phillips) and a South African mentor (Prof. Meintjes, PI of the HATTP programme) to support him with this award.

IMARI-SA will be nested in the drug allergy clinic at Groote Schuur Hospital. This clinic was started by Profs Peter, Lehloenya and Dlamini in 2015, and is the first such clinic on the continent. Three or four patients with SCAR (usually in response to first-line TB drugs, nevirapine/efavirenz, or cotrimoxazole) are admitted to the tertiary dermatology ward associated with the clinic every month.

 

About the Fogarty International Center Emerging Global Leader award

The Fogarty Emerging Global Leader award—also known by the code K43—provides support to early career researchers in low and middle income countries. The award covers salary and research costs, and facilitates capacity development in areas such as advanced research methodology, analysis and data management, and manuscript and grant writing.