The Botswana Harvard AIDS Institute Partnership (BHP)’s Scientist Dr Kaelo Seatla, a BHP PhD fellow was awarded an HBNU Fogarty Global Health Fellowship commencing 1st July 2020 – 30th June 2021. Dr Seatla’s project under this award aims for World Health Organization (WHO) validation of an ‘in-house’ BHP developed genotyping resistance assay that will detect dolutegravir resistance mutations at a fraction of the current commercial assay costs.
Dr Seatla’s project was selected for presentation to National Institute of Health (NIH) Director, Dr Francis Collins. Dr Seatla was amongst the only four out of 15 new awardees from over 100 Fogarty Global Health fellows who were selected to present their research projects to the Director. The selection of Dr Seatla is demonstration of his immense capabilities as a young clinician and scientist as well as highlighting the overall appeal and significance of the BHP for it’s mentorship and research projects.
Dr Seatla pitched his study on 15thJuly 2020 on performing the WHO validation of his ‘in-house ’ HIV-1 drug resistance assay with plans of implementing it for routine patient care use in Botswana..
In his presentation, Dr Seatla noted that Botswana has a high HIV-1 prevalence of 17.6%. He explained that Dolutegravir (DTG) is a potent anti-HIV-1 drug and that DTG based regimens are recommended as preferred first line ART in many HIV treatment guidelines including Botswana. However, he stated that resistance to DTG could occur especially amongst treatment-experienced patients experiencing virological failure (VF).
He said that resistance to ARVs causes the virus not to be suppressed thereby increasing the chances of onwards transmission of the virus. He revealed that determining for DTG resistance in resource limited settings such as Botswana can be expensive and prohibitive. To address this problem, Dr Seatla has developed a low cost in-house assay that will help in determining DTG resistance.
“As part of my PhD work, we have developed a low cost in-house assay that identifies DTG drug resistance mutations. This in-house assay performs quite well, with similar performance characteristics as compared to current commercial assays- but at about 75% less of the costs of the commercial assays,” he said.
He stated that the low cost assay will increase access to low cost drug resistance testing in Low and Middle Income Countries (LMIC)thus ensuring that people living with HIV (PLWH) in such countries are afforded a right to have drug resistance testing done if experiencing VF while on DTG based regimens and that they are placed on efficacious ARV regimens.
With increased viral load testing, coupled with drug resistance testing, Dr Seatla believes that more people will achieve virological suppression, ensuring that there is no onwards transmission of the virus, and ensuring that the last 95 of the UNAIDS 95-95-95 goals of having 95% of PLWH being virologically suppressed are surpassed.
Dr Seatla expresses his sincere gratitude to his mentors, Dr. Simani Gaseitsiwe, Dr. Shahin Lockman, his Supervisor at the University of Botswana, Prof Ishmael Kasvosve, SANTHE and BHP for their invaluable support and mentorship that has made the award possible.
The Global Health programme for fellows and scholars of the National Institutes of Health(NIH)Fogarty International Center supports collaborative mentored global health research training opportunities in low and middle-income countries. The programme supports seven consortia, including the Harvard University, Boston University, Northwestern University and University of New Mexico (HBNU) Fogarty Global Health training programme which is funding Dr Seatla’s study.
About NIH-Director, Dr Francis Collins
Dr Francis Collins is a physician-geneticist noted for his landmark discoveries of disease genes and his leadership of the international Human Genome Project, which culminated in April 2003 with the completion of a finished sequence of the human DNA instruction book. He has laso served as director of the National Human Genome Research Institute at NIH from 1993-2008.
Dr. Collins oversees and manages the work of the largest supporter of biomedical research in the world, spanning the spectrum from basic to clinical with an annual budget of $ 42 Billion USD per year. He has been awarded a USA Presidential Medal of Freedom, was appointed by Pope Benedict XVI to the Pontifical Academy of Sciences amongst many awards.