Page 94 - SAMRC AnnualReport 2025-26

TRiAD Study Team.

ADAP-TIV Study Team. ECRS Achievement Award.

The Unit also assessed TM4:GeNL reporter prevention strategies. Key publications during the
mycobacteriophage phenotypic drug-susceptibility period demonstrated that BCG revaccination in
testing in Mycobacterium tuberculosis isolates with HIV-negative adolescents did not prevent sustained
bedaquiline resistance variants, demonstrating Mycobacterium tuberculosis infection, while the
a strong correlation with minimum inhibitory M72/AS01E-4 vaccine candidate was shown to be
concentrations, making it a rapid and cost-effective safe and immunogenic in people living with HIV.
resistance assay. Integrated genomic, spatial, and
epidemiological analyses further showed that more Additional treatment studies demonstrated no
than two-thirds of bedaquiline-resistant TB strains clinical benefit of high-dose rifampicin in TB
resulted from community transmission. meningitis among people living with HIV. Research
on TB-HIV co-treatment further showed that twice-
The ongoing ADAP-TIV study is evaluating patient- daily bictegrivir/emtricitabine/tenofovir alafenamide
centred adherence support interventions for administered with rifampicin-maintained HIV
multidrug-resistant TB (MDR-TB) and HIV to improve treatment efficacy, while tenofovir alafenamide
retention in care, treatment adherence, and clinical remained safe with effective drug exposure. Studies
outcomes. These findings are expected to inform in children weighing 20–35 kg also showed that
differentiated service delivery strategies for high- twice-daily dolutegravir administered with rifampicin
risk populations. was well tolerated and effective.

Prevention-focused research includes evaluating Collectively, these studies provide policy-relevant
novel TB vaccine candidates, including M72/AS01E, evidence to accelerate diagnosis, optimise
BNT 164-01/02, MTBVAC, and ID93+GLA, and treatment, strengthen prevention strategies, and
generating evidence on safety, immunogenicity, improve survival among people affected by HIV
and efficacy to support next-generation TB and TB in high-burden settings.

92 SA M R C A N N U A L R EP O R T 2 0 2 5 / 2 0 2 6