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Researcher Spotlight: Dr Thuy Le

2 Nov, 2015

Dr Thuy Le is the Deputy Group Head of the Central Nervous System and HIV Infection Group based at the Wellcome Trust’s Major Overseas Programme in Vietnam. Her work focuses on the neglected fungal infection Penicilliosis, and she is interested in exploring the pathogen’s epidemiology, from both clinical and environmental perspectives.

Dr They Le

Dr Thuy Le

What are you working on?

I run a research programme in Penicillium marneffei infection at the Oxford University Clinical Research Unit in Vietnam. Penicilliosis is a common, yet relatively neglected, fungal infection in HIV-positive people living in or traveling to Southeast Asia.

My research aims to understand the epidemiology of this pathogen, both from the clinical perspectives of what constitute severe disease and how we can improve the diagnosis and the management of patients, but also from the environmental perspectives of what exposure factors put patients at higher risk for infection and how we can prevent disease in susceptible people.

The Wellcome Trust, as part of the Global Health Trial Grant funder, is supporting a multi-centre clinical trial that I am conducting in Vietnam to see whether itraconazole, a cheap widely available oral antifungal drug, is at least as good as amphotericin B, an expensive intravenous drug that has lots of side effects and is not widely available in Southeast Asia, for the treatment of penicilliosis. The trial is recruiting patients in five major hospitals throughout Vietnam and will provide the answer that potentially can change the way penicilliosis is being managed in resource-limited settings.

What does your average day involve?
Thun and daughterMy average day involves seeing patients, attending conferences, supervising clinical and laboratory staff, lots of reading and writing (emails and more), and every three months traveling to northern Vietnam to visit the study sites.

The best part of my day is in the evening, when I come home and recharge mentally with my 7 year-old daughter.

Why is your work important?

Penicilliosis is emerging from a rare disease to one of the leading HIV-associated opportunistic infections in Southeast Asia. Critical questions about the natural reservoir of disease and risk factors for infection remain poorly understood. Despite antifungal therapy, mortality is up to 20%. There has not been a randomised clinical trial conducted to evaluate treatment options for penicilliosis.

What do you hope the impact of your work will be?

My work will increase knowledge and hopefully will directly lead to improve diagnosis, management, and outcomes of patients with penicilliosis.

How did you come to be working on this topic/in this field?

I came to Vietnam to work on HIV drug resistance, and penicilliosis came to me from my clinical rounds in the Hospital for Tropical Diseases in Ho Chi Minh City.

I was very fortunate to meet, very much by serendipity, Prof. Jeremy Farrar, then Director of the Oxford University Clinical Research Unit in Vietnam, now Director of the Wellcome Trust, who opened the door and gave me the opportunity to pursue my research questions.

How has Wellcome funding helped you/your research/your career?

I would not be writing about penicilliosis without the support of the Wellcome Trust-funded Oxford Clinical Research Unit in Vietnam which has a deep-rooted relationship with the Hospital for Tropical Diseases and provides tremendous clinical research infrastructure for young investigators like myself. The partly Trust-funded Global Health Trial Grant has enabled the first-ever conducted clinical trial (440 patients) in the treatment of penicilliosis. I am grateful to be supported by the Trust to work on this neglected but important fungal pathogen.

What’s the most frequently asked question about your work?

“What is penicilliosis?”

(My answer: penicilliosis is a systemic infection caused by a fungus called Penicillium marneffei that is endemic in Southeast Asia. In patients who are immunocompromised, such as those with HIV, the fungus causes a disseminated infection involving the lung, liver, spleen, gut, lymph nodes, blood stream, and skin. Up to 70% of patients will develop multiple skin lesions on the face, chest, back, arms and legs, as seen on the photos. The infection is diagnosed by visualisation of typical features of the fungus in clinical specimens under the microscope (see photo below) and by the isolation of the fungus by culturing in the laboratory for 4 to 14 days. The infection can be treated with antifungal drugs; however HIV-infected patients need to be maintained on antifungal drug until their immune system improves on antiretroviral therapy.)      thun pics Which question about your work do you most dread – and why?

I really cannot think of one!

Tell us something about you that might surprise us…

I wanted to be a writer when I was young.

I wrote six ‘novels’ (in Vietnamese) between the ages of 14 and 15, both under the table during class and under a candle at night. This dream was quickly abandoned when I came to the US at 17 and needed to learn English from ‘scratch’.

What keeps you awake at night?

Internal conflicts, but mostly I sleep like a log!

What’s the best piece of advice you’ve been given?

Be endearing first.

The “Chain reaction” question, posed by our previous spotlight-ee Dr Angela Cassidy is this, “Do you have any tips, tricks and hints for doing collaborative research, either within or across disciplines?”

Successful collaboration rests on finding/maintaining the win-win situation.

You can find out more about the Oxford University Clinical Research Unit (OUCRU) in Vietnam, and the Wellcome Trust’s other Major Overseas Programmes.

One Comment leave one →
  1. Cara @ Business Watch Group permalink
    3 Nov, 2015 12:42 pm

    Doing truly fantastic work out there. All research is valuable.

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