Francoise Barre-Sinoussi & Nelleke Langerak

Postdoctoral fellow Dr Nelleke Langerak is one of only five researchers worldwide to be awarded a prestigious CIPHER grant project is entitled “HIV encephalopathy: definition of the natural history, physical characteristics and imaging findings in a group of children with gait abnormalities”. CIPHER, the Collaborative Initiative for Paediatric HIV Education and Research, is a major paediatric research initiative of the International AIDS Society (IAS) aimed at addressing outstanding research gaps related to clinical management and delivery of services to infants, children and adolescents affected by HIV in resource-limited settings. CIPHER was officially launched in 2012 and is supported by an unrestricted grant from the ViiV Healthcare’s Paediatric Innovation Seed Fund.

Dr Langerak received her award at the 5th International Workshop on HIV Pediatrics and 7th IAS 2013 Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) in Kuala Lumpur, Malaysia. Recipients from the USA, Uganda, Ethiopia, Malawi and South Africa (University of Cape Town and Stellenbosch University). The awards were presented by Professor Francoise Barré-Sinoussi*, who won a Nobel Prize for her work in the first identifying HIV and Professor Linda Gail-Bekker, the internationally acclaimed HIV scholar based at the Desmond Tutu HIV Centre in the UCT Institute for Infectious Disease and Molecular Medicine.

Dr Langerak’s research project tackles a problem that confronts Paediatric Neurosurgeons at Red Cross War Memorial Children’s Hospital. With the wider availability of antiretroviral therapy, increasing numbers of children are surviving in good health but some manifest disabling spastcity due to HIV Encephalopathy. This presents with an abnormal gait and physical characteristics very similar to children with spastic diplegic Cerebral Palsy (CP) and the question has arisen whether they would benefit from Selective Dorsal Rhizotomy.

The first step however is to elucidate the pathogenesis and natural history of this condition and Dr Langerak has assembled an impressively multidisciplinary team spanning both UCT and SU. Investigators include Prof Graham Fieggen, Dr Kirsty Donald (Developmental Paediatrics, RCWMCH), Dr Tracy Kilborn (Radiology, RCWMCH); Dr Barbara Laughton (Paediatrics and Child Health/KID-CRU, Tygerberg), and Professor Jacques du Toit (Orthopaedic Surgery, Tygerberg).

This study will lay a foundation for the rational development of effective management options for HIV positive children whose activities are limited by troublesome spasticity.