Meet the CIPHER grantees

Gabriel Loni Ekali

Year awarded: 2016
Institution: Biotechnology Center
Research site: Biotechnology Center Immunology Laboratory, Cameroon
Primary mentor: Gilbert Tene, CDC/National AIDS Control Committee, Cameroon

Gabriel Loni Ekali is a physician research scientist and epidemiologist. He is a Fogarty fellow at the Yaounde 1 University-Cameroon/University of Hawaii at Manoa-USA and Senior Program Manager at the National AIDS Control Committee, Cameroon.

More information on Gabriel | Email

“Due to the grant, a collaborator donated new technology to ease blood collection from babies (VeinViewer) at clinics … It enables staff to visualize superficial veins and thus greatly ease infant blood collection for renal toxicity biomarkers, reducing maternal stress and infant discomfort. The gift was an encouragement to me and a support to our team.”

Research project: Impact of in utero and breastfeeding exposure to TDF on renal function in HIV-exposed uninfected children in Cameroon

The issue

There is a growing use of tenofovir (TDF) in sub-Saharan Africa with Option B+ for prevention of mother-to-child HIV transmission (MTCT). However, TDF has been associated with renal function abnormalities. TDF crosses the placenta, exposing the foetus to relatively high concentrations in utero and during breastfeeding. In children living with HIV treated with TDF, elevated serum creatinine (Cr), proteinuria and hypophosphatemia have been reported. There are growing concerns about the impact of this exposure on renal function of HIV-exposed uninfected (HEU) infants. However, data is very sparse.

The CIPHER project

The goal of this study is to assess whether TDF use in pregnancy and breastfeeding affects the kidney function of HEU infants. It is intended that results will:

  • Confirm/infirm renal safety of TDF in pregnancy
  • Contribute to promoting development of routine rapid diagnostic tests for acute renal tubular injury.
  • Improve prevention of long-term renal injury through early detection.

Dr Loni Ekali seeks to use more appropriate and more sensitive markers of renal tubular function to assess TDF-associated renal injury in HEU infants. The overall hypothesis is that exposure in utero and during breastfeeding to TDF-containing regimens within the context of Option B+ leads to subclinical renal tubular dysfunction at birth and during breastfeeding in HEU infants compared with non-TDF-exposed controls.

The impact

Trainings carried out in clinics have raised awareness of general practitioners, paediatricians and nurses working in postnatal care and infant welfare clinics on the health of HEU infants. “Before, they had thought that health outcomes for HEU were not different from unexposed uninfected children,” Dr Loni Ekali explains.

The grant is also contributing to build local research capacity. Two PhD students and a Masters student are working with Dr Loni Ekali on the cohort he has set up. He also recently obtained Fogarty funding for further research on HEU infants in Cameroon.