Alexander Pym, M.D., Ph.D.

Associate Investigator

Soon after earning his medical degree, Alexander Pym left his home in London to work in a rural hospital in KwaZulu-Natal. From 1992 to 1994, he was in charge of tuberculosis (TB) control for the hospital’s district of Nqutu. He also launched the hospital’s first voluntary HIV testing program.

“I was there just as the HIV/TB epidemic was launching off,” Pym says. At the time, only about 2% of the patients were infected with HIV. Today, he says, hospitals in KwaZulu-Natal face HIV infection rates more like 35% to 40%. And TB and HIV are tightly intertwined. Pym and his research colleagues at K-RITH will be studying the deadly intersection between these two infectious diseases.

When Pym returned to London in 1994 to continue his medical training, he worked on some of the first clinical trials of triple therapy for HIV. Until then, HIV was treated with a combination of two drugs. “It worked a bit, but it essentially failed to suppress HIV,” he says. “With triple therapy, for the first time we could see patients actually getting better and remaining well. That showed me that clinical trials and clinical medicine could really have a big impact on treatment.” Pym went on for a Ph.D. at the Institut Pasteur in Paris, where he continued his focus on TB, studying the tuberculosis vaccine BCG and the genetic mutations that make the bacterium that causes TB, Mycobacterium tuberculosis, resistant to antibiotics.

Pym was drawn back to South Africa in 2006, where he worked at the Tuberculosis Research Unit of the South African Medical Research Council in Durban. “I really felt I wanted to study HIV/TB in an area of the world that was worst affected,” he says. Things were much worse than in the early 90s. “I was astonished to find quite how dramatic the TB/HIV epidemic had become.” Durban has some of the highest rates of TB and HIV infection in the world.

Pym’s aim is to improve treatment for TB and HIV, by testing new drugs and finding better ways of combining existing drugs. People infected with HIV take three drugs for the rest of their lives. TB treatment lasts six months and includes four drugs. When people with both infections are taking seven drugs a day, they face difficulties adhering to the drug regimen as well as an unhealthy pile up of side effects and dangerous drug-drug interactions.

At K-RITH, Pym will continue working on clinical trials and will delve into the basic biology of TB infection. He wants to know why it takes multiple drugs six months to kill M. tuberculosis. All but a handful of TB cells are killed in the first couple of weeks of treatment, but a tiny number of cells hold on for another five and a half months before the drugs take effect.

“I’m very excited to join K-RITH because now I can really focus on understanding why it takes six months to treat TB,” Pym says. He also hopes to develop better ways to determine if treatment is working. Today, clinical trials must run for two or three years before researchers can be sure a treatment has an effect; using the new facilities at K-RITH, Pym hopes to find a way to speed those studies along.

“Being part of a state-of-the-art scientific institute equipped with cutting-edge technology [in South Africa] enables someone like me to really study the human biology and its relation to TB and HIV at the site of the problem,” he says. “There’s no real parallel for K-RITH anywhere in the world.”

Interested in working with Dr. Pym as a postdoctoral fellow? E-mail alex.pym@k-rith.org.
 

EDUCATION: 
  • B.A., Trinity College, Cambridge University
  • MRCP, Imperial College School of Medicine
  • MB BChir., University College Hospital School of Medicine
  • Ph.D., University of Liverpool
MEMBER: 
  • Rifabutin Pharmacokinetic Trials Scientific Advisory Board (Chairperson)
  • TMC207 expanded access and compassionate release program Advisory Board (Member)
  • NIAID/DAIDS Co-Infections and Complications Data and Safety Monitoring Board (Member)
AWARDS: 

SIGNIFICANT PUBLICATIONS: 
  • Systematic genetic nomenclature for type VII secretion systems. PLoS Pathogens
  • The diarylquinoline TMC207 for multidrug-resistant tuberculosis. New England Journal of Medicine
  • Are survey based estimates of the burden of drug resistant TB too low? Insight from a simulation study. PLoS ONE
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PUB MED: 
Pym, Alexander