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Prof Hapgood's field is broadly in intracellular molecular mechanisms of action of steroid receptors, in particular the glucocorticoid receptor (GR). Research is focussed on ligand-selectivity, regulation of gene expression as well as cross talk between steroid receptors and other signalling pathways, which allows functional integration between stress, reproduction and immune function. This research is conducted in the broad context of reproduction, inflammation, contraception and infectious disease, in particular HIV-1. Different progestins are used in contraception. MPA, widely used as an injectable contraceptive in Sub-Saharan Africa, has been reported in observational clinical studies to increase HIV-1 acquisition, unlike another injectable contraceptive NET-EN. The Hapgood lab is investigating the molecular basis for this difference. Broadly, the lab is investigating the mechanisms and effects on immune function and HIV-1 pathogenesis of different progestin contraceptives via the GR, as well as cross talk between the GR and other receptors, and the role of the unliganded GR. The effects of different progestins via different steroid receptors, as well as their metabolism, are also being investigated. Reciprocal modulation of progestins and ARVs is another area of interest, with a view to choice of combination therapies to inhibit both HIV-1 acquisition and pregnancy. The work on HIV and contraceptives is highly relevant to women’s choice of contraception in areas of high risk of HIV-1 infection in Sub-Saharan Africa and South Africa in particular. 

Selected publications

  1. Komane, M., Avenant, C., Louw-du Toit, R., Africander, D.J. and Hapgood, J.P. (2022). Differential off-target glucocorticoid activity of progestins used in endocrine therapy. Steroids. 182, 108998.  doi: 10.1016/j.steroids.2022.108998
  2. Bick, A. J., Louw-du Toit, R., Skosana, S. B., Africander, D. and Hapgood, J. P. (2021). Pharmacokinetics, metabolism and serum concentrations of progestins used in contraception. Pharmacol. Ther. 222, 107789
  3. Enfield, K., Dlamini, S., Avenant, C., Kuipa, M., and Hapgood, J.P. (2020). Maraviroc, tenofovir disoproxil fumarate and dapivirine, activate progesterone receptor B in the absence of progestogens. Biochem. Biophys. Res. Commun. 533, 1027-1033
  4. Enfield, K., Cartwright, M., Louw-du Toit, R., Avenant, C., Africander, D. and Hapgood, J.P. (2020). Characterisation of progestins used in hormonal contraception and progesterone via the progesterone receptor. Biochem. Biophys. Res. Commun. 533, 879-885
  5. Louw-du Toit, R., Hapgood, J.P. and Africander, D. (2020). A direct comparison of the transcriptional activities of progestins used in contraception and menopausal hormone therapy via the mineralocorticoid receptor. Biochem. Biophys. Res. Commun. 526(2), 466-471
  6. Hapgood J. (2020). Is the injectable contraceptive Depo-medroxyprogesterone acetate (DMPA-IM) associated with an increased risk for HIV acquisition? The jury is still out. AIDS Res. Hum. Retroviruses. 36(5), 357-366
  7. Hapgood, J.P. (2020). ECHO: context and limitations. The Lancet 395(10222), e22
  8. Dlamini, S., Kuipa, M., Enfield, K., Skosana, S., Woodland, J.G., Moliki, J.M., Bick, A.J., van der Spuy, Z., Maritz, M.F., Avenant, C. and Hapgood, J.P. (2019). Reciprocal modulation of antiretroviral drug and steroid receptor function in vitro. Antimicrob. Agents Chemother. 64(1), e01890-01819
  9. Skosana, S. B., Woodland, J. G., Cartwright, M., Enfield, K., Komane, M., Louw-du Toit, R., van der Spuy, Z., Avenant, C., Africander, D., Storbeck, K. H. and Hapgood, J. P. (2019). Differential metabolism of clinically-relevant progestogens in cell lines and tissue: Implications for biological mechanisms. J. Steroid Biochem. Mol. Biol. 189, 145-153
  10. Ray, R. M., Maritz, M. F., Avenant, C., Tomasicchio, M., Dlamini, S., van der Spuy, Z.., and Hapgood, J. P. (2019). The contraceptive medroxyprogesterone acetate, unlike norethisterone, directly increases R5 HIV-1 infection in human cervical explant tissue at physiologically relevant concentrations. Sci. Rep. 9, 4334
  11. Heffron, R., Achilles, S.L., Dorflinger, L.J., Hapgood, J.P., Kiarie, J., Polis, C.B., Steyn, P.S. (2019). Pharmacokinetic, biologic, and epidemiologic differences in MPA- and NET-based progestin-only injectable contraceptives relative to the potential impact on HIV acquisition in women. Contraception. 99, 199-204
  12. Tomasicchio, M., Davids, M., Pooran, A., Theron, G., Smith, L., Semple, L., Meldau, R., Hapgood, J., Dheda, K. (2018). The injectable contraceptive medroxyprogesterone acetate attenuates Mycobacterium tuberculosis-specific host immunity through the glucocorticoid receptor. J. Infect. Dis. 2018 Nov 19. doi: 10.1093/infdis/jiy657. [Epub ahead of print]
  13. Bick A.J., Hapgood J.P. (2018). HIV-1 Latency Is Maintained by the Estrogen Receptor. Trends Microbiol. 26, 891-892
  14. Maritz, M. F., Ray, R. M., Bick, A. J., Tomasicchio, M., Woodland, J. G., Govender, Y., Avenant, C., and Hapgood, J. P. (2018). Medroxyprogesterone acetate, unlike norethisterone, increases HIV-1 replication in human peripheral blood mononuclear cells and an indicator cell line, via mechanisms involving the glucocorticoid receptor, increased CD4/CD8 ratios and CCR5 levels. PLoS One. 13, e0196043
  15. Hapgood, J. P., Kaushic, C., and Hel, Z. (2018). Hormonal Contraception and HIV-1 Acquisition: Biological Mechanisms. Endocr Rev. 39, 36-78
  16. Polis, C. B., Achilles, S. L., Hel, Z., and Hapgood, J. P. (2018). Is a lower-dose, subcutaneous contraceptive injectable containing depot medroxyprogesterone acetate likely to impact women's risk of HIV? Contraception, 97, 191-197


A/Prof Donita J. Africander (Dept of Biochemistry, Stellenbosch University)
Dr Charles Morrison (FHI 360, North Carolina, USA)
Dr Pai-Lien Chen (FHI 360, North Carolina, USA)
Dr Karl Storbeck (Dept of Biochemistry, Stellenbosch University)
Dr Léanie Kleynhans (Dept of Biomedical Sciences, Stellenbosch University)
Dr Mandisa Singata-Madliki (Co-director Effective Care Research Unit, University of the Witwatersrand)
Prof Zephne van der Spuy (Dept of Obstetrics and Gynaecology, Groote Schuur Hospital)
Dr Michele Tomasicchio (Centre for Lung Infection & Immunity, Division of Pulmonology and UCT Lung Institute, Dept of Medicine, UCT)
Prof Justus Hofmeyr (Dept of Obstetrics and Gynaecology, Frere and Cecilia Makiwane Hospitals; Effective Care Research Unit, University of the Witwatersrand; Dept of Obstetrics and Gynaecology, University of Botswana)
A/Prof Jenni Smit (MatCH Research Unit, Dept of Obstetrics and Gynaecology, University of the Witwatersrand)
Dr Mags Beksinska (MatCH Research Unit, Dept of Obstetrics and Gynaecology, University of the Witwatersrand) 

Lab members
Dr Chanel Avenant
Research Officer
Dr Alexis Bick
Post-doctoral Fellow
Dr Johnson Mosoko Moliki
Post-doctoral Fellow
Sigcinile (Gcina) Dlamini
Scientific Officer
Karen van der Merwe
Research Administrative Assistant
Calvin Kemp
PhD Student
Maleshigo Komane
PhD Student
Nxalati Mkhombo
PhD Student
Carole Capitaine
MSc Student
Prettysha Appadoo
MSc Student

Also see Prof. Hapgood's IDM site

News: archived article