Prendergast, Andrew

Andrew Prendergast

Andrew Prendergast

Title: Dr
MA DPhil MRCPCH DTM&H
Clinical Senior Lecturer in Paediatric Infection and Immunity

Andrew Prendergast graduated from Cambridge and Imperial College, and undertook his paediatric training in London, specialising in paediatric infectious diseases and immunology.  After undertaking his DPhil in Oxford, investigating immunological and clinical aspects of paediatric HIV infection, he was an Academic Clinical Lecturer in the Department of Paediatrics, University of Oxford, where he continued research into paediatric HIV infection.  He was subsequently awarded a Wellcome Trust Intermediate Clinical Fellowship and appointed as Senior Lecturer in Paediatric Infection and Immunity at Queen Mary, University of London.  He divides his time between London, where he is based at the Blizard Institute, and Zimbabwe.

Bio

 

My research interests focus on the interaction between infection, immunity and malnutrition, particularly in the context of HIV infection.  Specifically, I am investigating the role of microbial translocation, a pathological process that underlies two conditions of global public health importance: childhood malnutrition and HIV infection.  Children in developing countries almost universally have environmental enteropathy, a condition characterized by reduced absorptive capacity, chronic inflammation and increased intestinal permeability.  Passage of normally innocuous gut organisms into the systemic circulation causes chronic immune activation, which leads to reduced growth during childhood and underlies morbidity and mortality in HIV infection.  

In Zimbabwe, we are undertaking a cluster-randomized trial of improved sanitation/hygiene in two rural districts, to reduce environmental enteropathy and improve growth and anaemia in early life.  We are investigating the biomedical pathway linking poor sanitation/hygiene and impaired growth in infancy and exploring the link between the gut microbiota and growth.  In parallel, we are exploring the impact of enteropathy on the developing immune system, in particular the phenomenon of ‘immunosenescence’ (or premature ageing of the immune system), which results from constant immune activation, and the impact of enteropathy on vaccination responses.  

I also work on large, pragmatic HIV trials in Africa through the MRC Clinical Trials Unit, including the ARROW trial (www.arrowtrial.org), which is investigating monitoring strategies in 1200 children starting antiretroviral therapy (ART) in Uganda and Zimbabwe, and REALITY, a randomized trial of nutritional and antimicrobial interventions to reduce the high early mortality among HIV-infected children and adults starting ART.

In parallel laboratory work, we are investigating the causes and consequences of chronic inflammation in HIV-infected children, focusing particularly on the role of co-infections (such as CMV and EBV), malnutrition and microbial translocation. A long-standing and ongoing interest is the investigation of immune control of HIV, trying to better understand the factors that impact host control of HIV infection in childhood.

 

Research

Paediatric infectious diseases and immunology; HIV; malnutrition; international child health

Recent and ongoing research projects:

  • Randomized trial of improved sanitation/hygiene and/or nutrition in Zimbabwean infants (with Jean Humphrey, Johns Hopkins Bloomberg School of Public Health; funded by DFID and Bill & Melinda Gates Foundation)
  • The impact of microbial translocation on the health of Zimbabwean children (Wellcome Trust Intermediate Clinical Fellowship)
  • The causes and consequences of immune activation in HIV-infected children on antiretroviral therapy (with Professor Nigel Klein, UCL Institute of Child Health; funded by MRC UK)

 

Publications

Key Publications

Prendergast A, Goodliffe H, Clapson M, Cross R, Tudor-Williams G, Riddell A, Daniels J, Williams A, Goulder P.  Gag-specific CD4+ T-cell reponses are associated with virological control of paediatric HIV-1 infection.  AIDS 2011; 25(10):1329-31.

Prendergast A, Walker AS, Mulenga V, Chintu C, Gibb DM.  Improved growth and anaemia in HIV-infected African children taking cotrimoxazole prophylaxis.  Clin Infect Dis 2011; 52(7):953-6.

Prendergast A, Bwakura-Dangarembizi M, Cook A, Bakeera-Kitaka S, Natukunda E, Nahirya P, Nathoo K, Karungi C, Lutaakome J, Kekitiinwa A, Gibb DM.  Hospitalisation for severe malnutrition amongst HIV-infected children starting antiretroviral therapy.  AIDS 2011; 25(7):951-6.

Prendergast A, Prado JG, Kang YH, Chen F, Riddell LA, Luzzi G, Goulder P, Klenerman P.  HIV-1 infection is characterized by profound depletion of CD161+ Th17 cells and gradual decline in regulatory T cells.  AIDS 2010, 24(4):491-502.

Prado JG, Prendergast A, Thobakgale C, Juarez C, Tudor-Williams G, Ndung’u T, Walker BD, Goulder P.  Replicative capacity of human immunodeficiency virus type 1 transmitted from mother to child is associated with pediatric disease progression rate.  J Virol 2010; 84(1):492-502.

Thobakgale CF, Prendergast A, Crawford H, Mkhwanazi N, Ramduth D, Reddy S, Molina C, Mncube Z, Leslie A, Prado J, Chonco F, Mphatswe W, Tudor-Williams G, Jeena P, Blanckenberg N, Dong K, Kiepiela P, Coovadia H, Ndung’u T, Walker BD, Goulder P.  Impact of HLA in mother and child on disease progression of pediatric human immunodeficiency virus type 1 infection.  J Virol 2009; 83(19):10234-44.

Kawashima Y, Pfafferott K, Frater J, Matthews P, Payne R, Addo M, Gatanga H, Fujiwara M, Hachiya A, Koizumi H, Kuse N, Oka S, Duda A, Prendergast A, Crawford H, Leslie A, Brumme Z, Brumme C, Allen T, Brander C, Kaslow R, Tang J, Hunter E, Allen S, Mulenga J, Branch S, Roach T, John M, Mallal S, Ogwu A, Shapiro R, Prado JG, Fidler S, Weber J, Pybus OG, Klenerman P, Ndung’u T, Phillips R, Heckerman D, Harrigan PR, Walker BD, Takiguchi M, Goulder P.  Adaptation of HIV-1 to human leucocyte antigen class I.  Nature 2009; 458(7238):641-5.

Matthews P, Prendergast A (joint first), Leslie A, Crawford H, Payne R, Rousseau C, Rolland M, Honeyborne I, Carlson J, Kadie C, Brander C, Bishop K, Mlotshwa N, Mullins J, Coovadia H, Ndung’u T, Walker BD, Heckerman D, Goulder PJR.  Central role of reverting mutations in HLA associations with human immunodeficiency virus set point. J Virol 2008; 82(17):8548-59.

Prendergast A, Mphatswe W, Tudor-Williams G, Rakgotho M, PIllay V, Thobakgale C, McCarthy N, Morris L, Walker BD, Goulder P.  Early virological suppression with three-class antiretroviral therapy in HIV-infected African infants.  AIDS 2008; 22(11):1333-43.

Prendergast A, Cotton M, Gibb DM.  When should antiretroviral therapy be started for HIV-infected infants in resource-limited settings?  Future HIV Ther 2008;2(3):201-208 (Editorial).

Prendergast A, Tudor-Williams G, Jeena P, Burchett S, Goulder P.  International perspectives, progress, and future challenges of paediatric HIV infection.  Lancet. 2007; 370(9581):68-80.


All publications from PubLists

 

Teaching

Undergraduate Paediatrics

Topics for PhD supervision:

HIV and malnutrition; interactions between the gut and the immune system; cellular immunology of HIV; severe acute malnutrition

Contact

Centre for Paediatrics
 Blizard Institute
Barts and The London School of Medicine and Dentistry
Blizard Building
4 Newark Street
London
E1 2AT

020 7882 2615
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