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James Porterfield, MD, PhD

GHES U.S. Fellow 2018-2019

FELLOWSHIP SITE: African Health Research Institute University of KwaZulu-Natal in Durban, South Africa
U.S. INSTITUTION: YALE UNIVERSITY

Project Title: The Role of T-follicular Helper Cells in Antibody Response to HIV and in HIV Latency

Most HIV replication occurs within CD4+ T-cells. The vast majority of these cells are found in the secondary lymphoid tissues while only ~2% of the total CD4+ T-cells in the body are found in the peripheral blood. However, HIV has historically been studied in the blood because of ease of obtaining these samples. Lymphatic tissue from HIV infected patients is difficult to obtain from logistical, ethical, and prevalence standpoints. However, the next major steps in our understanding of HIV, both for cure and vaccination purposes, may very well come from studies of HIV in these sanctuary sites. 

Given his long history of clinical and research work in South Africa, Dr. Porterfield has been able to facilitate the connection between a team of HIV researchers at the Africa Health Research Institute (AHRI) with ENT surgeons from across the province of KwaZulu-Natal in South Africa to supply tonsils (a secondary lymphoid organ) from medically-indicated tonsillectomies in both HIV infected and uninfected adults and children. This offers a very unique opportunity to study HIV in a way that likely would be impossible nearly anywhere else in the world given both the prevalence of HIV in the region and the extensive research infrastructure available at AHRI. 

Dr. Porterfield with be working with Dr. Alasdair Leslie and the research team at AHRI to probe this tissue to better understand the immune response of CD4+ T-cells within secondary lymphoid organs and their susceptibility to HIV infection. He will specifically be addressing T-follicular helper (T FH) cells and analyzing the neutralization breadth as a function of TFH activity as well as examining their susceptibility to HIV infection as a function of receptor and co-receptor expression. Taken together, this project takes advantage of a unique confluence of resources to explore critical aspects of HIV vaccine and cure efforts.