Meet the CIPHER grantees

Steve Innes

Year awarded: 2013
Institution: Stellenbosch University, South Africa
Research site: Family Infectious Diseases Clinical Research Unit, Tygerberg Children’s Hospital and Stellenbosch University
Primary mentor: Dr Richard Haubrich and Dr Sara H Browne, University of California, San Diego

Steve Innes is a clinician-researcher who develops and implements new research to provide sound, scientifically robust evidence to generate effective and feasible guidelines for management of an aging paediatric HIV-positive population in resource-constrained settings in southern Africa.

More information on Steve | Email

“Funding that was secured as a direct result of the CIPHER project has allowed us to expand and prolong this cohort study to provide substantial additional longitudinal understanding that will be vital to guide national healthcare guideline committees around the world on how to manage children living with perinatally acquired HIV.”

Research project: Novel methods for detecting and minimizing chronic cardiovascular, metabolic, respiratory, renal and bone disease in children living with HIV treated with antiretroviral therapy in Southern Africa

The issue

An estimated 750,000 of sub-Saharan Africa’s 1.9 million HIV-positive children under 15 years of age are on ART (2016 data). Two-thirds of them are living in southern Africa. The chronic non-infectious diseases commonly associated with aging (cardiovascular, metabolic, respiratory, renal and bone disease) are markedly accelerated in adults on ART, but very little was known about these risks in children on ART. With very few primary healthcare-level surveillance programmes in sub-Saharan Africa for HIV-related chronic diseases in children, these diseases may go unnoticed until they are severe and result in major disability.

The CIPHER project

Dr Innes’ project investigated the long-term consequences of HIV-related persistent immune activation and ART. It was aimed at providing novel epidemiological data about the primary sources of long-term morbidity in ART-treated HIV-positive children whose viral load has been adequately suppressed by ART.

It aims to provide the high-quality data needed to target those outcomes by identifying and validating simple screening tests that are easily implementable as a country-wide surveillance strategy. This was intended to allow the design of simple, pragmatic, evidence-based surveillance programmes that would detect the most common ART- and HIV-related complications and co-morbidities, therefore allowing earlier intervention to limit disease progression and minimize the impact on long-term survival, quality of life and socio-economic functioning.

The impact

The project provided pilot data showing feasibility and preliminary differences between HIV positive and HIV uninfected, which led to him being awarded an R01 grant of $1.64 million over five years for a cohort study entitled “Screening for atherosclerotic vascular disease in HIV-infected children”. In extending Dr Innes’ ability to remain self-funded, the CIPHER grant directly facilitated him attaining the rank of associate professor at his institution.

The CIPHER project built upon local infrastructure and resources, which facilitated significant expansion of local research capacity and specialized skills for future work. In directly mentoring 11 young researchers locally and four internationally, Dr Innes continues building towards securing a critical mass of world-class scientists needed to address the region’s extensive HIV-related problems.