The starting point for this story is the discovery of Human Immunodeficiency Virus (HIV). This virus significantly weakens the immune system, making individuals more susceptible to develop active tuberculosis (TB). TB is one of the leading causes of death among people living with HIV, as the compromised immune system struggles to combat Mycobacterium tuberculosis.
The co-infection of HIV and TB presents a major public health challenge globally, requiring integrated treatment and prevention strategies to manage both diseases effectively. GHTM & IHMT-NOVA researchers have been at the forefront of HIV & TB research in Portugal and at a global level.
Crucial Role in Understanding the Virus and the Discovery of HIV-2
In 1984, Dr. Kamal Mansinho and Dr. Jaime Nina, under the leadership of Professor Champalimaud at Egas Moniz Hospital, made groundbreaking strides in HIV research. Their diligent collection of samples from immunocompromised patients who tested negative for HIV (later redignated as HIV-1) was crucial in the discovery and isolation of HIV-2.
Continuing this legacy, researcher Anne-Mieke Vandamme has advanced our understanding of the virus’s zoonotic origins. Kamal Mansinho, Ricardo Camacho and Ana Abecasis, on the other hand, have focused on the impact of conflicts in Portuguese-speaking African countries on the spread of HIV-2.
Professor Ana Abecasis, specialist in Molecular Epidemiology, highlights the contributions of her team in studying the emergence and ignition of HIV-1 epidemic in Angola. Their research identified Angola as one of the three initial epicenters of the HIV-1 pandemic. This pivotal finding has opened new avenues for exploring the phylogenetic history of HIV and the potential development of antiretroviral drug resistance.
Addressing Tuberculosis Outbreaks
The surge in HIV cases led to a corresponding increase in TB prevalence, with Portugal being notably affected. The Institute of Hygiene and Tropical Medicine (IHMT) and its research unit, responded by investing in infrastructures for the early and accurate diagnosis of tuberculosis and its resistant forms, using newly developed molecular biology assays for direct detection and rapid liquid culture, which was critical for a systematic approach to this dual epidemic.
Professor Miguel Viveiros, GHTM Scientific Coordinator and leading expert in the field, emphasized the essential role of GHTM researchers in combating TB in Portugal and globally. They described and characterized hundreds of cases of extensively drug-resistant tuberculosis and their intrinsic mutations for resistance in hundreds of antibiotic targets. These were basis for the WHO catalogue for M. tuberculosis antibiotic resistance mutations. It was in our laboratory that the transmission chain of the highly virulent and resistant “Lisboa strain” was identified, which has since become a global reference point in M/XDR-TB research.
A fight in multiple fronts
These combined efforts have significantly advanced our understanding of HIV and its intersection with tuberculosis. Their pioneering work continues to influence global health strategies and offers hope for more effective treatments and interventions.