Abstract

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.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24HD054314-04
Application #
7668420
Study Section
AIDS Clinical Studies and Epidemiology Study Section (ACE)
Program Officer
Ryan, Kevin W
Project Start
2006-09-29
Project End
2011-08-31
Budget Start
2009-09-01
Budget End
2010-08-31
Support Year
4
Fiscal Year
2009
Total Cost
$112,310
Indirect Cost

  Institution

Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195

  Publications

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
Ronen, Keshet; Unger, Jennifer A; Drake, Alison L et al. (2018) SMS messaging to improve ART adherence: perspectives of pregnant HIV-infected women in Kenya on HIV-related message content. AIDS Care 30:500-505
Velonjara, Julia; Crouthamel, Bonnie; O'Malley, Gabrielle et al. (2018) Motherhood increases support for family planning among Kenyan adolescents. Sex Reprod Healthc 16:124-131
LaCourse, Sylvia M; Pavlinac, Patricia B; Cranmer, Lisa M et al. (2018) Stool Xpert MTB/RIF and urine lipoarabinomannan for the diagnosis of tuberculosis in hospitalized HIV-infected children. AIDS 32:69-78
Unger, J A; Ronen, K; Perrier, T et al. (2018) Short message service communication improves exclusive breastfeeding and early postpartum contraception in a low- to middle-income country setting: a randomised trial. BJOG 125:1620-1629
Wagner, Anjuli D; O?Malley, Gabrielle; Firdawsi, Olivia et al. (2018) Brief Report: Disclosure, Consent, Opportunity Costs, and Inaccurate Risk Assessment Deter Pediatric HIV Testing: A Mixed-Methods Study. J Acquir Immune Defic Syndr 77:393-399
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

Showing the most recent 10 out of 213 publications