Access to antiretroviral therapy (ART) is becoming available to children in India for the first time through an initiative from the National AIDS Control Organization (NACO). The mandate for treating HIV infected children <15 years of age will be followed in major centers, including the Tuberculosis Research Institute (PI, Dr S Swaminathan) which is a major pediatric HIV center in South India. This project, between a US pediatric immunologist (S. Pahwa) and the Indian PI proposes to provide insights into HIV disease pathogenesis that have implications for future management of HIV infected subjects world wide. These studies will also lay the groundwork for subsequent challenging and innovative treatment protocols, clinical trials and future vaccine studies.
Our specific aims are centered around the following hypotheses: 1. The nadir of NaTve CD4 T cells prior to starting ART predicts capacity for CD4 T Cell reconstitution; 2. Loss of CD127+ CDS T Cells or expansion of CD127-CD8 T Cells is associated with aberrant immune activation and disease progression, 3. Reconstitution of Dendritic Cell function is essential for functional immune reconstitution. These studies will apply novel and most current immunologic evaluations by flow cytometry and real time PCR in assays that require minimal blood volumes to characterize immunological status of HIV infected children, including those who initiate treatment with ART and those who have not progressed to reach eligibility standards for antiretroviral treatment. All new immunologic assays will be performed prospectively and the results analyzed in the context of current established indicators of disease progression, i.e. CD4 counts and virus load. The proposed investigations will provide insights into HIV disease pathogenesis that have implications for future management of HIV infected subjects world wide. These studies will also lay the groundwork for subsequent challenging and innovative treatment protocols, and future vaccine studies. ? ? ? ?

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Small Research Grants (R03)
Project #
5R03HD052154-02
Application #
7234852
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Ryan, Kevin W
Project Start
2006-06-01
Project End
2010-05-31
Budget Start
2007-06-01
Budget End
2010-05-31
Support Year
2
Fiscal Year
2007
Total Cost
$74,282
Indirect Cost
Name
University of Miami School of Medicine
Department
Microbiology/Immun/Virology
Type
Schools of Medicine
DUNS #
052780918
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Pilakka-Kanthikeel, Sudheesh; Kris, Arheart; Selvaraj, Anbalagan et al. (2014) Immune activation is associated with increased gut microbial translocation in treatment-naive, HIV-infected children in a resource-limited setting. J Acquir Immune Defic Syndr 66:16-24
Selvaraj, Anbalagan; Pilakka-Kanthikeel, Sudheesh; Bhavani, Perumal Kannabiran et al. (2013) Defective dendritic cell response to Toll-like receptor 7/8 agonists in perinatally HIV-infected children. Pathog Dis 69:184-93