A short summary of Roland`s research: 

South Africa has the biggest burden of HIV in the world, but also the largest antiretroviral therapy (ART) programme globally. People with HIV (PWH) are at a 2-fold higher risk of developing non-communicable diseases (NCDs) such as cardiovascular disease and metabolic disorders compared to their HIV-negative counterparts, despite having the HIV virus suppressed with ART (termed viral suppression). Increased NCDs are purportedly driven by underlying inflammation, leading to damage and dysfunction of the inner lining of blood vessels (called endothelial dysfunction).

A major contributor to ongoing inflammation is residual viraemia, a persistence of viral replication below the detectable threshold of current viral load assays. Modern ART can lead to viral suppression with adherence rates as low as 80%, but imperfect adherence is known to cause residual viraemia, likely driving HIV-associated NCDs. In clinical practice imperfect (<100%) ART adherence is prevalent, occurring in 24%-57% of PWH, and presents a modifiable factor to reduce residual viraemia and subsequent NCDs.

I am fascinated by the field, and through my research am interested in finding out how imperfect adherence to ART contributes to HIV-associated NCDs, as it has the potential to influence millions of lives.

Research for Impact is one of the core strategic themes in SU`s Vision 2040. Can you describe the (potential) impact of your research?

My research stands to add valuable data on NCD associations in virally suppressed PWH. In addition, enhancing our understanding of endothelial dysfunction in PWH on suppressive ART will generate important data for future targets for NCD treatment and prevention. This is of particular importance given the rapidly growing incidence of HIV-associated NCDs despite viral suppression.

The research findings have the potential to impact communities by enhancing their understanding of HIV-associated NCDs through dissemination of research findings to participants directly and to the communities at large.

In the ever-changing environment of academia, what are some of the obstacles early career researchers are faced with?

Early career researchers in the medical field often face severe time constraints, as the pressures of providing clinical care to patients need to be weighed up with academic and research responsibilities. These clinician-scientists are expected to develop rapid task-shifting abilities and to think outside the box to find solutions for clinical and research problems, but we stand to make deep inroads in care advancements through our research in the same populations that we serve in our clinical capacities.

What would you regard as the most important aspects to consider to effectively support early career researchers?

The space to develop and increase capacity as you develop through your early career. Time will always be limited, and knowledge can only take you so far, but an ever-increasing capacity to navigate academic and personal spheres will contribute greatly to effectively support early career researchers for the rest of their career.

What excites you about your work? 

The opportunity to work alongside my patients to try and find solutions to that which matters to us both excites me. Research in South Africa is a very exciting space to be in, as the potential for growth and community engagement is vast.

When you're not in the lab, library or in the field conducting research, what do you do to unwind?

I absolutely love time with my wife and kids, and making and savouring good coffee.

How has the ECAD programme of SU contributed to your research career?  

The support and mentoring from the ECAD programme has been immeasurable. Being able to learn from an established academic - not just on research matters but also about navigating life in the academic space - has been incredibly valuable. The constant stream of support and career development opportunities is simply wonderful.

What advice, if any, would you look to impart to future early career academics?

Find and actively learn from established academic, especially those who align with your work ethic and principles.
Waiting until all your ducks are in a row is often unrealistic, so consider to simply start even before you are ready.

Connect with Roland and his work!

ResearchGate: https://www.researchgate.net/profile/Roland-Van-Rensburg