Professor Amy Slogrove, a paediatrician and epidemiologist in the Department of Paediatrics and Child Health at Stellenbosch University (SU), was recently awarded a $2 225 382 (more than R33 million) grant from the National Institutes of Health (NIH) in the United States for what she has called a “highly relevant “ study for South Africa and, particularly, the Western Cape.
The grant will be used to study the impact of exposure to HIV and antiretroviral therapy (ARV) on the survival and morbidity in children who were exposed to, but uninfected by HIV. This group will be compared to those unexposed and uninfected by HIV with similar socioeconomic, nutritional and environmental constraints to health in a setting where there is a high prevalence of HIV.
The study called CHERISH stands for Children HIV Exposed Uninfected Research to Inform Survival and Health.
The NIH, an agency of the US Health Department, is one of the world's top medical research centres.
Slogrove, who is based at SU's Worcester Campus, described the awarding of the funding as “a huge step forward".
She said the awarding of the funding was based on a unique call from the NIH for projects that will establish novel ways of evaluating longer-term outcomes in children who are HIV-exposed and uninfected, (i.e. HIV-negative children born to mothers with HIV).
“It is one of five awards made for these projects to evaluate longer-term outcomes in this particular group of children in southern and eastern Africa.
“It is very exciting as this population of children for many years were not on the global radar.
“People were relieved when HIV transmission from mothers to children came down and 95% of children born to mothers with HIV avoided HIV infection themselves. That was the initial great news as it is very important to prevent the children from becoming infected. However, there has been a slow realisation and acceptance by the HIV community that these children, even though they are HIV-uninfected, are not all doing so well."
Explaining why it is relevant to South Africa and the Western Cape, she said: “In South Africa overall, at least one in four children is born to a mother with HIV and in the Western Cape, the figure is one in five. We are seeing that even though moms are now getting ARV therapy and are themselves surviving, the outcomes in HIV-exposed uninfected children are not improving. They die more often in their first two years of life and they experience more hospitalisation, especially for more severe common infections like pneumonia and diarrhoea. There are even concerns about their growth and their meeting of developmental childhood milestones.
“Some children born to women with HIV are doing well – but there is still a group of children who are not thriving. That is what CHERISH is about – to understand who are these children in this group who are not doing well and what can be done to improve the early childhood outcomes."
Slogrove said she is “incredibly proud and grateful" that the CHERISH project has come together.
“It is a project I am already very proud of and the team – led by South African investigators and supported by Harvard – is a great combination of academic and other partners.
“This is such important research for South Africa because we have such a high prevalence of pregnant women living with HIV – close to 30 percent. We also have the largest population globally of children born to mothers with HIV. About 25% of all these children globally are in South Africa. It is South African scientists who need to figure out how to better support children, mothers and families affected by HIV."
Photo credit: Damien Schumann