The placenta plays a central role in pregnancy, acting as the interface between mother and child and regulating critical immune interactions that support foetal development. For Dr Carine Kunsevi-Kilola, a researcher from the Democratic Republic of Congo, understanding how this delicate system functions and how it is affected by disease and treatment is at the core of her work. 

Dr Kunsevi-Kilola is a postdoctoral research fellow at Stellenbosch University in South Africa, working within the Reproductive Immunology Research Consortium in Africa. Her research focuses on maternal HIV and the effects of antiretroviral therapy (ART) on placental function and pregnancy outcomes. 

While ART has been instrumental in reducing mother-to-child transmission of HIV across Africa, emerging evidence suggests that treatment may also be associated with complications such as placental dysfunction, preterm delivery, and maternal vascular malperfusion. Dr Kunsevi-Kilola’s work seeks to better understand these associations, with particular attention to how the timing of treatment before or after conception may influence outcomes. 

“Reducing transmission has been a major public health success,” she explains. “The next step is to ensure that both mothers and infants remain healthy throughout pregnancy and beyond.” 

Through the African Postdoctoral Training Initiative (APTI), implemented by the African Academy of Sciences (AAS), Dr Kunsevi-Kilola is undertaking advanced research at the National Institute of Allergy and Infectious Diseases (NIAID) in the United States. Under the mentorship of Dr Michal Fried, she is investigating how immune cells are organised and function within the placenta under different conditions. 

Her work applies to a combination of advanced laboratory techniques, including spatial tissue transcriptomics and mass spectrometry, to map gene expression and identify how immune responses differ depending on when HIV treatment is initiated. This approach allows for a more precise understanding of the biological mechanisms that underpin pregnancy complications. 

The research is particularly relevant in the African context. According to the World Health Organization, more than 1.3 million pregnancies affected by HIV occur annually, the majority in low- and middle-income countries. While progress in reducing transmission has been significant, improving broader maternal and infant health outcomes remains a critical priority. 

As part of her study, Dr Kunsevi-Kilola is establishing a cohort of approximately 200 women, generating data that will contribute to a more comprehensive understanding of maternal and infant health in settings where HIV remains prevalent. 

Her long-term research aims to identify the molecular and cellular mechanisms that regulate immune tolerance during pregnancy, and to understand how disruptions in these processes contribute to conditions such as pre-eclampsia, poor foetal development, and other complications linked to immune dysregulation. 

Ultimately, she hopes this work will inform the development of targeted interventions that can improve pregnancy outcomes and support healthier beginnings for children across Africa. 

“The placenta is a critical but still underexplored organ,” she says. “By understanding how it functions in different disease contexts, we can begin to design more effective strategies to protect both mother and child.” 

Dr Kunsevi-Kilola holds a PhD in Molecular Biology from Stellenbosch University and has received several international recognitions, including the L’Oréal-UNESCO For Women in Science Young Talent Award for Sub-Saharan Africa. Her work has also been supported by the National Research Foundation and the Bill & Melinda Gates Foundation. 

Reflecting on her APTI fellowship, she notes the importance of sustained support for African scientists. 

“This programme has strengthened my ability to lead independent research that is directly relevant to Africa,” she says. “It is an investment not only in individuals, but in the future of science on the continent.” 

As her research progresses, the next phase will focus on validating key biomarkers identified in her study in larger populations advancing the translation of scientific discovery into practical health solutions.