Candidate: Dr. Grace John-Stewart has had a highly productive research career focusing on international HIV-1 studies in Africa, particularly focused on mother-to-child transmission of HIV-1. She has mentored over 20 clinician-researchers, and 3 individuals who have received K-awards. For the K24 Mid-Career Investigator Award, the candidate, Dr. John-Stewart, proposes to develop a research program on pediatric HIV-1 treatment in Africa using historical and new research cohorts. The candidate has excellent research support that will provide many opportunities for new clinical-research trainees. Research: Pediatric HIV-1 treatment lags considerably behind adult treatment in newly expanded programs in Africa, in part because of insufficient experience and data. HIV-1 infected infants have staggeringly high mortality with >50% of untreated infants dying before 2 years of age. Infant immune development, HAART adherence, and the use of surrogate markers for therapeutic decision-making are key areas requiring further research to guide pediatric HIV-1 treatment programs.
The aims proposed for the K24 are: 1. To determine effects of HIV-1 on the developing infant immune system by comparing immunologic parameters in infants who are HIV-1 uninfected, HIV-1 infected treated with early HAART, and HIV-1 infected untreated. 2. To determine adherence and rates of viral suppression among infants initiating HAART in the first few months of life. 3. To determine sensitivity, specificity, and predictive value of clinical markers, CD4%, and HIV-1 RNA for guiding therapeutic change during infancy in African HIV-1 infected infants. Relevance: The new studies will provide opportunities for trainees interested in pediatrics, immunology, HAART adherence, and HIV-1 treatment. Dr. John-Stewart's familiarity with conducting research in Africa and breadth of experience will contribute to excellent mentorship. The K24 will allow Dr. John-Stewart to develop new pediatric HIV-1 research and to mentor a new cadre of clinical researchers. Currently, about 90% of HIV-1 infected children worldwide reside in Africa. The proposed studies will be relevant to pediatric HIV-1 treatment programs and will contribute to improved health-care and child survival in Africa. ? ? ?
|LaCourse, Sylvia M; Cranmer, Lisa M; Njuguna, Irene N et al. (2018) Urine Tuberculosis Lipoarabinomannan Predicts Mortality in Hospitalized Human Immunodeficiency Virus-Infected Children. Clin Infect Dis 66:1798-1801|
|Bosire, Rose; Farquhar, Carey; Nduati, Ruth et al. (2018) Higher Transplacental Pathogen-Specific Antibody Transfer Among Pregnant Women Randomized to Triple Antiretroviral Treatment Versus Short Course Zidovudine. Pediatr Infect Dis J 37:246-252|
|Suter, Megan K; Karr, Catherine J; John-Stewart, Grace C et al. (2018) Implications of Combined Exposure to Household Air Pollution and HIV on Neurocognition in Children. Int J Environ Res Public Health 15:|
|Greene, Sharon A; McGrath, Christine J; Lehman, Dara A et al. (2018) Increased Cervical Human Immunodeficiency Virus (HIV) RNA Shedding Among HIV-Infected Women Randomized to Loop Electrosurgical Excision Procedure Compared to Cryotherapy for Cervical Intraepithelial Neoplasia 2/3. Clin Infect Dis 66:1778-1784|
|Lohman-Payne, Barbara; Gabriel, Benjamin; Park, Sangshin et al. (2018) HIV-exposed uninfected infants: elevated cord blood Interleukin 8 (IL-8) is significantly associated with maternal HIV infection and systemic IL-8 in a Kenyan cohort. Clin Transl Med 7:26|
|Beima-Sofie, Kristin; Wamalwa, Dalton; Maleche-Obimbo, Elizabeth et al. (2018) Toll-like receptor 9 polymorphism is associated with increased Epstein-Barr virus and Cytomegalovirus acquisition in HIV-exposed infants. AIDS 32:267-270|
|Achwoka, Dunstan; Pintye, Jillian; McGrath, Christine J et al. (2018) Uptake and correlates of contraception among postpartum women in Kenya: results from a national cross-sectional survey. Contraception 97:227-235|
|Pankau, Mark D; Wamalwa, Dalton; Benki-Nugent, Sarah et al. (2018) Decay of HIV DNA in the Reservoir and the Impact of Short Treatment Interruption in Kenyan Infants. Open Forum Infect Dis 5:ofx268|
|Gómez, Laurén A; Crowell, Claudia S; Njuguna, Irene et al. (2018) Improved Neurodevelopment After Initiation of Antiretroviral Therapy in Human Immunodeficiency Virus-infected Children. Pediatr Infect Dis J 37:916-922|
|McGrath, Christine J; Singa, Benson; Langat, Agnes et al. (2018) Non-disclosure to male partners and incomplete PMTCT regimens associated with higher risk of mother-to-child HIV transmission: a national survey in Kenya. AIDS Care 30:765-773|
Showing the most recent 10 out of 213 publications