During the past 5 years of her K24 award, the candidate has provided mentoring to 55 clinical research trainees, including 30 physician/nurse research trainees. For this K24 renewal application, Dr. John- Stewart proposes to mentor a new cadre of clinician-researchers focused on pediatric HIV-1 infected and exposed children. She has already identified 15 trainees, including pediatricians, internists, epidemiologists, and nurses for long-term mentorship in the K24 renewal. Using one-on-one in person meetings, group mentoring (formal weekly analyses meetings), distance-mentoring (for trainees in Nairobi) and peer and co- mentoring, Dr. John-Stewart anticipates investing 20% FTE in mentoring a cadre of clinical researchers committed to translational global pediatric HIV-1-related research. Research: During the 5 years of her K24 award, Dr. John-Stewart has been extremely productive, increasing from 43 to >120 publications in peer-reviewed journals and leads several research grants focused on women and children. For the K24 renewal, research will utilize existing cohorts to focus on pediatric HIV-1 in 3 inter- related domains - immunology, growth, and cognition. She proposes to extend follow-up of a cohort of children who received treatment during infancy >3 years, including previous randomization to interrupted vs. continued therapy. Extending this cohort will enable long-term comparisons of immune recovery and identification of immune correlates of more prolonged immune sustenance during interruption to inform potential future therapeutic vaccine strategies. This and other ongoing or historical cohorts will be used for analyses of growth, micronutrient levels, and nutritional supplementation in HIV-1 exposed and infected treated children. In ongoing cohorts, cognitive assessments will be incorporated for all participating children at annual intervals to identify prevalence and cofactor of cognitive delay and develop future studies. Research strategies used by mentored trainees will range from molecular epidemiology to implementation science and provide inter-disciplinary translational impact.
Africa is home to >90% of pediatric HIV-1 infected children who require life-long therapy and may face growth and cognitive challenges. This K24 award will enable the candidate to mentor new leaders to contribute research advances in this area.
|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|
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