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Professor Clive Gray MSc PhD (WITS) ASSAf

HIV Immunology Group

Clive Gray

Professor of Immunology & Chair and Head, Division of Immunology, Institute of Infectious Disease and Molecular Medicine and Department of Pathology, University of Cape Town; Director, Laboratory of Tissue Immunology, National Health Laboratory Services and Groote Schuur Hospital; Adjunct Professor, Department of Immunology, Duke University, North Carolina, USA; Secretary-General, Federation of African Immunology Societies; Vice-Chair, Education Committee of the IUIS.

Clive Gray currently has six active grants from the NIH; one from the National Institute of Health Research, UK; one from the EDCTP, and a competitive rated NRF grant. His research interests revolve around investigating immune regulation and dysregulation and biological risk for HIV infection in two scenarios: a) HIV exposed uninfected pre-term and term newborn children (born to HIV infected mothers) and b) epithelial immune regulation in foreskin tissue of adolescent and young males who elect to undergo medical male circumcision (MMC). The following is a brief scientific synopsis of his current research:

Immune ontogeny in HIV exposed infants. Due to the efficacy of ARV prevention of mother to child transmission, it is rare that we now see HIV infected children in our clinics and hence my focus on the exposed infant. The central question is why these infants do poorly. We hypothesise that HIV-induced inflammation from the mother results in perturbed immunity in the neonate and weakened immunity. We focus on the balance between Th17 and Treg kinetics and function at birth in exposed and unexposed infants. Coupled to this, we are measuring the ontogeny of NK and T cell populations (in collaboration with Stanford University, USA) using a CyTOF 39 antibody panel to identify multiple novel populations emerging after birth. It is envisaged that the outcomes of these investigations will provide a foundation for treatment interventions that will correct immune dysfunction in these infants.

Placental investigations and pre-term birth. We are looking at the impact of antiretroviral (ARV) treatment timing on adverse birth outcomes in HIV infected mothers, with the hypothesis that initiation of ARV drugs during gestation causes inflammation in the placenta and precipitates pre-term birth. We are measuring placenta pathology along with markers of inflammation and the different populations of Treg cells along with macrophage polarization using multiparameter flow cytometry and tissue imaging. He is a member of the PRIME group (a collaboration with the University of Sheffield, UK) which is a collaborative consortia investigating pre-term birth across South Africa, Bangladesh and Nigeria and understanding how infections in the placenta cause adverse birth outcomes. 

Epithelial immunity in the foreskin. Medical Male Circumcision (MMC) has shown 60% efficacy in preventing male acquisition of HIV. Consequently, it has been rolled out as a national standard of HIV prevention-care across South Africa. We are seeking to understand the mechanisms of MMC and gain insight into how HIV is acquired in the male genital tract (in collaboration with Northwestern University). The premise is that epithelial foreskin tissue, being richly endowed with HIV target cells, is a major site for HIV acquisition in the uncircumcised male. We are investigating tissue-resident CD4-bearing cells (including T cells, macrophages and Langerhan’s cells) for evidence of increased density in relation to poor epithelial barrier integrity.

In 2004, he received the International Leadership Award from the Elizabeth Glaser Pediatric AIDS Foundation for developing Immunopaedia, an on-line learning website to simplify immunology for paediatricians and clinicians in general. The site is endorsed by the International Union of Immunology Societies (IUIS) and has been used to train students in immunology in Africa, Latin America, India and Iran. He will be the co-Chair of the 18th IUIS International Conference on Immunology in 2022, to be held in Cape Town.


Recent publications:

Anna-Lise Williamson, Clive M Gray. Human Leukocyte Antigen (HLA) class II -DRB1 and -DQB1 alleles association between HIV/HPV co-infection and cervical cancer disease in South African women. In Press. Journal of Cancer

Michael Zulu, Fernando Martinez, Siamon Gordon, Clive Maurice Gray. The Elusive role of Placental Macrophages: The Hofbauer Cell.  In Press. J Innate Immunity

Chambuso R, Gray CM, Kaambo E, Rebello G, Ramesar R. Impact of Host Molecular Genetic Variations and HIV/HPV Co-infection on Cervical Cancer Progression: A Systematic review. Oncomedicine 2018; 3:82-93. doi:10.7150/oncm.25573. Available from http://www.oncm.org/v03p0082.htm

Dzanibe S, Jaspan HB, Zulu MZ, Kiravu A, Gray CM. Impact of maternal HIV exposure, feeding status, and microbiome on infant cellular immunity. J Leukoc Biol. 2019 Feb;105(2):281-289. doi: 10.1002/JLB.MR0318-120R. Epub 2018 Dec 21. Review. PubMed PMID: 30577072.

Ferrian S, Ross M, Conradie F, Vally Omar S, Ismail N, Little F, Kaplan G, Fallows G and Gray CM. Frequency of Circulating CD4+Ki67+HLA-DR− T Regulatory Cells Prior to Treatment for Multidrug Resistant Tuberculosis Can Differentiate the Severity of Disease and Predict Time to Culture Conversion. Front. Immunol. 2018; https://doi.org/10.3389/fimmu.2018.02438

Malaba TR, Newell ML, Madlala H, Perez A, Gray C, Myer L. Methods of gestational age assessment influence the observed association between antiretroviral therapy exposure, preterm delivery, and small-for-gestational age infants: a prospective study in Cape Town, South Africa. Ann Epidemiol. 2018 Aug 29. pii: S1047-2797(18)30329-6. doi: 10.1016/j.annepidem.

Tchakoute CT, Sainani KL, Osawe S, Datong P, Kiravu A, Rosenthal KL, Gray CM, Cameron DW, Abimiku A, Jaspan HB; INFANT study team. Breastfeeding mitigates the effects of maternal HIV on infant infectious morbidity in the Option B+ era: A multicenter prospective cohort study. AIDS. 2018 Aug 20. doi: 10.1097/QAD.0000000000001974

All publications


Contact details:

Division of Immunology
Department of Pathology
Falmouth Building
Institute of Infectious Disease and Molecular Medicine
UCT Faculty of Health Sciences
Anzio Road, Observatory 7925
South Africa

Tel:  +27 21 406 6356
Fax: +27 21 406 6029
Email: Clive.Gray@uct.ac.za

Alternate sites: www.immunology.uct.ac.za/imm/people/staff




 Group members:

Name Surname Position
Dhuraiyah Abdullatief Administrator
Nyaradzo Chigorimbo-Tsikiwa Early Career Fellow
Sue Ford Repository Manager
Berenice Allinde Lab Manager
Nobomi Dontsha Lab Technologist
Bangani Nonzwakazi Lab Technologist
Euan Johnston Lab Technologist
Goitsiane Thame Lab Technologist
Sonwabile Dzanibe Postdoctoral Fellow
Kyle O'Hagan Postdoctoral Fellow
Nadia Ikumi Postdoctoral Fellow
Agano Kiravu PhD student
Michael Zulu PhD student
Lerato Rametse PhD student
Yamkela Qumbela MSc student
Christen De Costa MSc student
Bonamy Holtak Communications Officer
Michael Mndini Study Coordinator
Sibulele Mollie Nurse/recruiter



Name Institution
Guido Ferrari Duke University, USA
Thomas Hope Northwestern University, USA
Catherine Blish Stanford University, USA
Dilly Anumba University of Sheffield, UK
Julie Fox Kings College London, UK
Carolina Herrera Imperial College London, UK
Heather Jaspan UCT and Seattle Children's Research Institute, USA
Landon Myer UCT
Mushi Matjila UCT
Priya Soma-Pillay University of Pretoria
Neil Martinson Perinatal HIV Research Institute
Linda-Gail Bekker UCT/Desmond Tutu HIV Foundation
Elmi Muller UCT
Dieter Kabelitz Kiel University
Faith Osier KEMRI-WELLCOME Trust, Kilifi, Kenya