Research to Explore How HIV Affects Immune System of Infants In Utero

The University of Maryland School of Medicine has received a $2 million grant to conduct a 5-year study of the impact of HIV exposure on the immune systems of infants in utero.

More than 13.8 million women of childbearing age are estimated to be living with HIV in sub-Saharan Africa, and each year, more than 1.5 million HIV-positive women give birth, according to a university press release. Furthermore, nearly 30% of all infants born in sub-Saharan Africa are exposed to HIV in utero, but are uninfected at birth.

Sub-Saharan women are routinely screened for HIV during their pre-natal visit, typically in the second or third trimester. If diagnosed, the patients receive antiretroviral treatment to get the virus under control.

Most infants prenatally exposed to HIV do not become infected due to ART, but they still have higher morbidity and mortality during the first 2 years of life because of common infections, according to the release.

Although, the precise mechanism of this increased susceptibility to infection remains unclear, scientists hope the study will provide one of the most in-depth immunological investigations to begin to understand why this occurs.

“Our long-term goal is to identify an approach for preventing mother-to-child transmission of HIV that also minimizes the impact of maternal infection on the immune development of infants exposed to HIV but not infected,” said principal investigators Cristiana Cairo, PhD, and Miriam K. Laufer, MD, MPH.

For the study, investigators will analyze the infants’ adaptive immune response with different HIV exposure in utero. They will compare infants born to HIV-infected mothers on ART prior to conception with mothers first diagnosed with HIV and treated during pregnancy to determine if there are any differences.

The first group of infants will be exposed to very low levels of HIV, whereas the second group will be exposed to high levels throughout most of the mother’s pregnancy.

“It is of critical importance to clearly understand the impact of maternal HIV infection on exposed uninfected infant immunity, in order to identify the right strategy to improve the health of HIV-exposed infants throughout the world,” Dr Cairo said.

The investigators hope the study leads to earlier HIV testing and related prenatal care.

“Early HIV testing in all women of child bearing age may have a significant impact on infant health and survival,” Dr Laufer said.