December 30, 2022

Researchers receive $6.6 million award to generate evidence on biological factors influencing health outcomes in HIV-exposed children

A researcher and a child demonstrating a cognitive assessment. Credit: Sarah Benki-Nugent

Global WACh researchers and collaborators received a milestone National Institutes of Health grant award, totaling nearly $6.7 million, to generate evidence on biological factors that may cause adverse birth and neurodevelopmental outcomes in young children exposed to but uninfected with HIV (HEU). Research shows that HEU children have compromised growth, neurodevelopmental delays, and increased morbidity and mortality compared to that of unexposed, uninfected children (HUU) and Global WACh is currently involved in several studies that are examining pathways that influence these outcomes to help inform future health interventions.

The new five-year Impact of Microbiome, Immune activation and Drug on Neurodevelopment (MIND) Program leverages three existing studies in Kenya that are evaluating the associations between various factors (PrEP exposure in-utero, breast milk and gut-microbiome, cytomegalovirus (CMV) transmission), maternal HIV, and infant health outcomes in Kenya. It will advance this research in the form of three new studies and two ‘Cores’ that provide access to technologies, services, training, and consultation to successfully execute the studies. The studies will synergistically evaluate the roles of 1) dolutegravir (an antiviral HIV medication) exposure in-utero, 2) gut-microbiome and breast milk human milk oligosaccharides (HMOs), and 3) maternal/infant immune activation and CMV on outcomes in HEU and HUU infant cohorts through neurodevelopmental assessments.

The award supports the creation of a Measurement and Analysis Core to guide the successful implementation of the assessments by offering training, providing quality assurance and validity checks and statistical analysis and expertise in pediatrics and neuropsychology to the three studies. The second Core—the Administrative Core—will provide scientific, administrative, mentorship, and logistical support throughout the program.

Drs. Grace John-Stewart (Global WACh Center Director), John Kinuthia (Kenyatta National Hospital), and Dalton Wamalwa (University of Nairobi) serve as multiple Principal Investigators of the MIND program. Project Directors and co-investigators of the three studies include Global WACh faculty Drs. Sarah Benki-Nugent, Christine McGrath, Irene Njuguna, Jillian Pintye, and Jennifer Slyker with collaborators from UW Department of Global Health and multiple partner institutions—Emory University, Fred Hutch, Kenya Medical Research Institute, Makerere University, and University of California, San Francisco.