Candidate: Dr. Jennifer Slyker, PhD, is a Senior Fellow in the Division of Allergy and Infectious Diseases at the University of Washington. Dr. Slyker proposes a K01 Career Development Award to gain mentorship in epidemiology and clinical research which, combined with her rigorous background in immunology, will enable her to pursue a long-term career in molecular epidemiology focusing on women and children at risk for HIV. During the award period, Dr. Slyker will receive training in epidemiology, biostatistics, clinical trials, and CMV research by mentors with considerable expertise in these areas (Drs. John-Stewart, Richardson, Boeckh), all of whom are committed to provide intensive support and have extensive mentorship experience. The proposed research addresses a topic of high public health significance with important potential implications as CMV vaccines and treatments continue to evolve. The research plan will foster opportunities for Dr. Slyker to gain skills in complex analyses, study design and CMV pathogenesis. The candidate and research plan is anticipated to result in Dr. Slyker's development into an independent research scientist. The UW will provide an ideal milieu for Dr. Slyker's career development with access to resources and opportunities that will foster her long-term success. In addition, Dr. Slyker's continued collaboration with Kenyan pediatrician scientists will provide a context for the design of relevant future studies. Research: There is evidence that cytomegalovirus (CMV) infection contributes significantly to morbidity and mortality in HIV-1 infected infants. Several new advances offer hope for improved diagnosis, treatment and prevention of CMV in resource-limited settings. These include CMV diagnosis from dried blood spots, novel anti-CMV drugs with reduced toxicity, and progress toward the development of a CMV vaccine. For this K-application Dr. Slyker will conduct research using a repository of data and specimens from 3 Kenyan randomized controlled trials comprising HIV-infected women and their infants. CMV viral loads will be measured from stored specimens from the three trials.
The aims of the study are 1) To determine the influence of breastfeeding on infant CMV acquisition. Time to CMV will be compared between infants randomized to breastfeeding versus formula feeding. 2) To evaluate the impact of maternal HAART on breast milk CMV viral load and vertical CMV transmission. Breast milk CMV viral loads will be compared at serial time-points during the first year post-partum between HIV-infected women randomized to ZDV/NVP versus HAART. 3) To evaluate the efficacy of maternal valacyclovir therapy during pregnancy and breastfeeding to reduce maternal CMV replication and CMV transmission. Time to CMV will be compared between infants born to HIV-infected women randomized to valacyclovir versus placebo. This complement of studies will provide important new data on the epidemiology of CMV in the setting of HIV-1 and will form a foundation for new interventions that may decrease infant morbidity and mortality. Public Health Relevance: Jennifer Slyker, PhD is a Senior Fellow in the Division of Allergy and Infectious Diseases at the University of Washington. For this K01 award, the career development plan and proposed research studies will pose analytical challenges and opportunities which will be combined with mentorship in epidemiology, statistical analyses, clinical trials design, and CMV virology which will enable the candidate to develop an independent research career in molecular epidemiology. The research findings will be central to the design of interventions to interrupt vertical cytomegalovirus transmission, a strategy aimed at reducing morbidity and mortality in HIV- infected infants.
Jennifer Slyker, PhD is a Senior Fellow in the Division of Allergy and Infectious Diseases at the University of Washington. For this K01 award, the career development plan and proposed research studies will pose analytical challenges and opportunities which will be combined with mentorship in epidemiology, statistical analyses, clinical trials design, and CMV virology which will enable the candidate to develop an independent research career in molecular epidemiology. The research findings will be central to the design of interventions to interrupt vertical cytomegalovirus transmission, a strategy aimed at reducing morbidity and mortality in HIV- infected infants.
|Slyker, Jennifer A; Richardson, Barbra; Chung, Michael H et al. (2017) Maternal Highly Active Antiretroviral Therapy Reduces Vertical Cytomegalovirus Transmission But Does Not Reduce Breast Milk Cytomegalovirus Levels. AIDS Res Hum Retroviruses 33:332-338|
|Wagner, Anjuli D; Wachira, Cyrus M; Njuguna, Irene N et al. (2016) Active referral of children of HIV-positive adults reveals high prevalence of undiagnosed HIV. J Acquir Immune Defic Syndr :|
|Wagner, Anjuli D; Mugo, Cyrus; Njuguna, Irene N et al. (2016) Implementation and Operational Research: Active Referral of Children of HIV-Positive Adults Reveals High Prevalence of Undiagnosed HIV. J Acquir Immune Defic Syndr 73:e83-e89|
|Ásbjörnsdóttir, Kristjana H; Slyker, Jennifer A; Maleche-Obimbo, Elizabeth et al. (2016) Breastfeeding Is Associated with Decreased Risk of Hospitalization among HIV-Exposed, Uninfected Kenyan Infants. J Hum Lact 32:NP61-6|
|Richardson, Barbra A; John-Stewart, Grace; Atkinson, Claire et al. (2016) Vertical Cytomegalovirus Transmission From HIV-Infected Women Randomized to Formula-Feed or Breastfeed Their Infants. J Infect Dis 213:992-8|
|Wagner, Anjuli; Slyker, Jennifer; Langat, Agnes et al. (2015) High mortality in HIV-infected children diagnosed in hospital underscores need for faster diagnostic turnaround time in prevention of mother-to-child transmission of HIV (PMTCT) programs. BMC Pediatr 15:10|
|Slyker, Jennifer; Farquhar, Carey; Atkinson, Claire et al. (2014) Compartmentalized cytomegalovirus replication and transmission in the setting of maternal HIV-1 infection. Clin Infect Dis 58:564-72|
|Roxby, Alison C; Unger, Jennifer A; Slyker, Jennifer A et al. (2014) A lifecycle approach to HIV prevention in African women and children. Curr HIV/AIDS Rep 11:119-27|
|Slyker, Jennifer A; Patterson, Janna; Ambler, Gwen et al. (2014) Correlates and outcomes of preterm birth, low birth weight, and small for gestational age in HIV-exposed uninfected infants. BMC Pregnancy Childbirth 14:7|
|Slyker, Jennifer A; Casper, Corey; Tapia, Kenneth et al. (2014) Accelerated suppression of primary Epstein-Barr virus infection in HIV-infected infants initiating lopinavir/ritonavir-based versus nevirapine-based combination antiretroviral therapy. Clin Infect Dis 58:1333-7|
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