Effects of HIV and ARV Exposure on Child Health and Neurodevelopment in Botswana


Principal Investigator:
Shahin Lockman, Assistant Professor of Medicine


Immunology+Infectious Diseases Prime


Dates of Research:
August 3, 2009 — January 31, 2013


In Botswana, one in three pregnant women is infected with HIV-1, reflecting a generalized epidemic that affects all social strata. The Botswana Harvard School of Public Health AIDS Initiative Partnership (BHP) has conducted clinical research related to MTCT prevention and maternal/pediatric health in Botswana since 1999. This study plans to simultaneously study the impact of perinatal ARV- and HIV exposure on child health and neurodevelopment. The primary objectives are: 1. To compare neurodevelopmental outcomes following in utero exposure to 3-drug HAART that contains 2 or more nucleoside reverse transcriptase inhibitors (NRTIs), vs. monotherapy with a single NRTI (zidovudine), among HIV-uninfected children born to HIV-infected mothers with similar antenatal CD4+ cell counts. 2. To prospectively compare neurodevelopmental outcomes among HIV-exposed but uninfected children, vs. children born to HIV-uninfected women. 3. To prospectively compare the rates of mortality in HIV-uninfected children born to HIV-infected mothers vs. children born to HIV-uninfected women in a setting of HAART availability. 4. To prospectively determine the biologic and social factors that are most strongly associated with excess mortality and neurodevelopmental delay among HIV-exposed but uninfected children compared with HIV-unexposed children.

Website: http://www.hsph.harvard.edu/bhp/index.html