Pilot Award Recipient: Adeline Koay, MBBS, MSc

The advancement and scale up of antiretroviral treatment (ART) among pregnant and breastfeeding women globally has led to the increase in child survival and decrease in mother-to-child HIV transmission. Pregnant women with HIV routinely receive antiretroviral drugs (ARVs), and infants born to women with HIV (HEU infants) are also started on ARVs for several weeks to prevent the transmission of HIV. As a result, there is a growing global population of infants who are exposed to maternal HIV and antiretroviral drugs (ARVs). Although majority of these infants remain uninfected with HIV, they have increased mortality, more severe infections and hospitalizations, and have poorer growth compared infants born to women without HIV (HUU infants). Bacteria living in the infant’s gut may be responsible for the development of a healthy immune system. In fact, changes in the gut bacteria may be related to the risk of acquiring certain immune and allergic diseases. The researchers hypothesize that the poorer health outcomes observed in HEU infants may be partly due to exposure to maternal HIV infection and ARVs. This study will examine if there are differences between the gut bacteria of HEU infants with HUU infants, as changes in the gut bacteria may account for the poorer health outcomes in infants born to women with HIV. They will also measure blood levels of inflammation and the function of the gut, as this could be different in infants born to women with HIV compared to infants born to women without HIV. If differences are found between HEU and HUU infants, researchers would be better equipped to study methods that will improve the health of HEU infants. Research findings will be shared with patients when they are seen in clinic. With ~5,000 women with HIV giving birth annually in the United States, and 100-150 HEU infants seen in our clinic at Children’s National Medical Center annually, this research has the potential to affect and improve the health of hundreds to thousands of children born locally and nationally.