Dr. Burgener’s innovative research seeks to understand the biology of HIV transmission in woman and it’s made him an international leader in the HIV/AIDS scientific community.
HIV for women is a major global health problem that is resulting in nearly 1,000 new infections each day in young women – mostly through sexual intercourse. This is particularly true in areas of sub-Saharan Africa.
It’s really staggering if you do the math,” said Dr. Adam Burgener. “This is almost one young woman being infected every single minute.
Dr. Burgener’s groundbreaking work at the Public Health Agency of Canada seeks to understand the biology of HIV transmission in women. His “exploding productivity and substantial impact on the field through his innovative research” are among several reasons Dr. Burgener was selected for the 2018 CAHR-CANFAR Excellence in Research Award for Basic Sciences.
His publications include 28 peer reviewed articles in the past five years, with many appearing in high impact journals like, Science, Plos Pathogens and OXFORD Academic’s The Journal of Infectious Diseases. His recent publication in Science has resulted in a paradigm shift that will help advance Canadian and global efforts to end HIV.
To date, pre-exposure prophylaxis – or PrEP has been highly successful at preventing new HIV infections in men, but in women the clinical trials have had variable success. It’s been observed that adherence is really important for these drugs to work in women – more so than in men.
This led Dr. Burgener to ask whether there are biological factors that are different in women than in men, which may be contributing to the variable success of HIV prevention products.
Burgener’s research revealed that vaginal microbiome (naturally occurring microorganisms) reduces the effectiveness of treatment with topical PrEP for HIV prevention – even in women with the highest adherence to treatment. Follow up work showed that bacteria could metabolize antiretrovirals.
This finding has huge clinical and public health significance. It challenges the generally accepted dogma that failing to stick to treatment is the only reason why certain forms of PrEP has had little success at preventing new HIV infections in women.
“What we’re finding is that women who do not have Lactobacillus are at much higher risk of acquiring HIV,” said Burgener. “They have other diverse microbial communities and this is really associated with the higher risk of HIV. Not only this, but in these women topical PrEP is not effective.”
Burgener says this can cause up to a six-fold increase risk of HIV infection and that research has found that many women in South Africa and sub-Saharan Africa have these diverse microbial communities in their vaginas.
We’re trying to understand ‘what is it about these bacteria that are causing an increased risk of infection?’ and a broader question is, ‘are these bacteria important for HIV prevention strategies?’
Currently, plans are under development to provide PrEP to millions of women in Africa. Burgener’s research could influence health policy, as well as clinical implications and the roll-out of certain types of PrEP to young women throughout the African continent.
“Dr. Burgener’s recent data has shown that more research in the genital tract microbiome and inflammation is needed,” said Dr. Gita Ramjee, Director of HIV Prevention Research at the South African Medical Research Council. “There has been little research in terms of how these factors might affect other HIV prevention strategies.”
Ramjee says Dr. Burgener’s research identifies new biological factors that contribute to HIV infection risk and impact the effectiveness of prevention technology.
In his first five years as faculty at the University of Manitoba and scientist at the Public Health Agency of Canada, Burgener has demonstrated a commitment to passing on what he has learned and to advancing the knowledge of HIV researchers.
“The only way we’re going to beat this disease is if we train and ensure that the next generation of scientists are really focussed on this disease because we can’t carry the mantle forever,” he said. “We need to pass on this knowledge so that brighter and younger people can figure this out.”
Dr. Ramjee calls Burgener’s work “exceptional in creativity and scientific rigor” and that his findings are easily among the Top 10 most interesting stories in the HIV world last year.