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Background

Hannan-Crusaid

The Hannan Crusaid Treatment Centre

The Hannan Crusaid Treatment Centre was established in 2002 by the DTHF in partnership with the Western Cape Provincial Health authorities. With donor support, it was relocated to a purpose-built facility within the grounds of the Gugulethu Community Health Centre in March 2004. Initial funds enabled the treatment of 150 very ill HIV-positive individuals for one year. Since these small beginnings it has grown into one of the largest single antiretroviral delivery centres in the Western Cape, with more than 6500 people on treatment.

Research at the site has included studies on mortality, loss to follow-up, retention and adherence to care and the impact and outcomes of tuberculosis infection as well as TB diagnostics in this cohort. More recently research is being completed on the transition of adolescents into adult care and on maternal to child HIV transmission prevention. Many of these studies have impacted Western Cape and National guidelines. In addition, the research on adolescent transition has led to the development of a youth development programme to facilitate adolescent transition to adult healthcare and provide adolescents with key development skills through provision of a curriculum based programme using cognitive behavioural tools.

The Gugulethu Research Offices (GRO)

Presently, the facility is shared with UCT and houses five studies:

  • Use of ARV Drug Levels in dried blood spots (DBS) to Assess and Manage ART Adherence in South Africa (ADD-ART). This prospective study, funded by DAIDS, will determine the ability of the DBS Tenofovir-Diphosphate (TFV-DP) assay to provide an objective, clinically relevant, and actionable measure of adherence in low-resource settings. Dr Orrell is the local Principal Investigator (PI). The study will run from July 2016 to July 2018.
  • The Antiretroviral (ART) Refusal study is a cohort study funded by the NIH (R34 grant). This study is exploring reasons for adults eligible for ART to refuse to access treatment; and aims to improve treatment acceptability. Dr Orrell is local PI. The study is ongoing, until mid-2018.
  • 2IUDnCT Trial is a randomized controlled Phase IV study being managed by the UCT team, headed by Prof Landon Myer. The study commenced in 2013 and is planned to be completed during 2017.
  • The Measuring Adherence in Early Treatment (META) cohort study is funded by the Bill and Melinda Gates Foundation.  Dr. Orrell is the local PI.  The study is currently actively recruiting and is anticipated to end in October 2017.
  • The Postpartum Adherence Clubs to Enhance Retention (PACER) study is funded by the British Medical Research Council (MRC). Landon Myer is the PI.  The study commenced in 2015 and ended in 2016.

We have a strong research team including well-respected principal investigators, a clinical operations manager, three study coordinators, two data staff and a team of research assistants. Through our research activities, we also offer medical support, data support, infrastructure and additional administrative support to the current provincial health services.  Our team support both the patients and the researchers in recruitment, translation and community activities.  In addition we have a strong focus on adolescents and having them transition to adult ARV services, through our Youth Development Programmes and Youth Adherence Clubs.

The Gugulethu MOU

Research conducted by the Maternal and Child Health Division of the DTHF at the Gugulethu Maternity and Obstetrics Unit (MOU) has driven innovative new strategies in the delivery of antiretroviral medicines to HIV-positive pregnant women in the Western Cape.   This has been shown to reduce the risk of transmission of HIV from mother to child more effectively, while promoting the health of both.

Current Trials

Sponsor: NIH
DTHF PI: Prof Landon Myer
Site: Gugulethu MOU
Status: Active

The Prematurity Immunology in HIV-infected Mothers and their infants Study (PIMS) (2015-2018)

A prospective cohort study following women on ART during pregnancy to examine the association of ART with prematurity and the mechanisms that may be involved in any such association.

Sponsor: NIH
DTHF PI: Prof Landon Myer
Site: Gugulethu MOU
Status: Active

The Two-IUD (‘2IUD’) study (2013-2017)

A randomised controlled trial comparing the effect of two intrauterine devices (IUD) in HIV–infected women.

Sponsor: NIH
DTHF PI: Prof Landon Myer
Site: Hannan Crusaid Treatment Centre
Status: Active

Postpartum Adherence Clubs to Enhance Retention (PACER) (2015-2016

A substudy of MCH-ART examining the feasibility and acceptability of the ‘adherence club’ model of care for women on ART during the postpartum period.

Sponsor: NIH
DTHF PI: Prof Landon Myer
Site: Gugulethu MOU
Status: Active

Maternal and Child Health – Antiretroviral Therapy (MCH-ART)

This  multicomponent implementation science study (2013-2016) is examining the delivery of antiretroviral therapy during pregnancy and the postpartum period, including the role of health service integration in improving outcomes for HIV-infected mothers and HIV-exposed infants during the postpartum period.

Sponsor: EGPAF
DTHF PI: Prof Landon Myer
Site: Gugulethu MOU
Status: Completed

Strategies for the Rapid Initiation of Antiretroviral Therapy in Pregnancy (2011-2014).

This operations research study examined the implementation and effect of various service delivery models to improve ART initiation, including point-of-care CD4 testing and service integration.

Sponsor: NIH
DTHF PI: Professor Linda-Gail Bekker
Site: Hannan Crusaid Treatment Centre
Status: Recruiting

The Cape Town Adolescent AIDS Cohort study (CTAAC)

The Cape Town Adolescent AIDS Cohort study (CTAAC), led by Heather Zar in collaboration with a multidisciplinary primarily UCT-based team aims to investigate markers of chronic disease processes and progression in perinatally HIV-infected SA adolescents in four key areas (general adolescent development; neurocognitive function; pulmonary disease; cardiovascular function). This is a prospective, descriptive cohort study of 520 HIV+ve
adolescents on ART, aged 9 to 14 years, followed for 3 years.

Sponsor: EDCTP
DTHF PI: Assoc. Prof Catherine Orrell
Site: Hannan Crusaid Treatment Centre
Status: Completed

The TAP study

A randomised controlled Trial to explore Adherence-failure relationships in a South African antiretroviral delivery site, using an electronic adherence device and sparse Pharmacokinetic sampling (2012-2014): This randomised study on adherence was completed in 2014. 230 people were enrolled 1:1 to either receive a text message reminder, sent only when dosing was late, and recorded by real-time electronic adherence monitoring device (Wisepill®), or to standard of care. The aim was to examine whether this would improve adherence and HIV viral suppression over 48 weeks. Text messages did reduce the number of prolonged treatment interruptions, but did not significantly improve overall adherence or HIV viral suppression. Pharmacokinetic and pharmacogenetic data are pending.

Sponsor: Bill and Melinda Gates Foundation
DTHF PI: Assoc. Prof Catherine Orrell
Site: Hannan Crusaid Treatment Centre
Status: Not Yet Recruiting

META study

Measuring Early Treatment Adherence: implications for an AIDS-free generation. A cohort study to examine adherence and retention in care of those ill with HIV (CD4<200) compared to those who are starting ART when still well (CD4>350).

Sponsor: NIH
DTHF PI: Assoc. Prof Catherine Orrell
Site: Hannan Crusaid Treatment Centre
Status: Recruiting

ART Refusal Study

Examining the Correlates and Outcomes of HIV Treatment Refusal in an Adult South Africa Cohort. A study to determine the characteristics of individuals who refuse to start ART.

People

Linda-Gail Bekker

Principal Investigator

Catherine Orrell
Catherine Orrell

Principal Investigator

Millicent Atujuna

Behavioural Scientist

Anna Cross

Sub-investigator

Nicky Kelly

Study Coordinator

Ingrid Courtney

Study Coordinator

Landon Myer

Principal Investigator

Contact

Sr. Colleen Herman

Email: colleen.herman@hiv-research.org.za
Telephone:  +27 21 007 2275/6

Physical Address
Gugulethu Research Offices
Scouts Hall
Corner NY79
Gugulethu
Cape Town