Research Project: South African exposed uninfected infants: does in-utero HIV exposure contribute to increased infectious morbidity?

Postdoc Year(s): 2013-2014

Dr. Amy Slogrove is a South African pediatrician working to better understand how HIV affects children, joining the postdoctoral program as an International Fellow in 2013. Her research was based in Cape Town, working at Stellenbosch University under the supervision of her local supervisor Dr. Mark Cotton, while her Canadian supervisor is CTN’s Dr. Joel Singer at the University of British Columbia in Vancouver.

South Africa is relatively well off compared to the rest of Africa, says Dr. Slogrove, but next to similar economies such as Brazil or Indonesia, a greater number of South African children die before their fifth birthdays. In addition, 30 per cent of pregnant women in South Africa are also living with HIV.

“This has always really bothered me,” she says. “At first it was tremendous that we were able to prevent HIV infection in babies born to HIV-positive moms, but we are finding significant consequences for these babies. Even though they are HIV uninfected, they are still at greater risk of general childhood infections such as pneumonia or diarrheal diseases, compared to babies that are born to HIV uninfected moms living in similar circumstances.”

With her CTN international fellowship, Dr. Slogrove will investigate what factors lead to these worse outcomes, and to tease out the difference between the effects of poverty and social circumstances, and the biological impacts of HIV exposure. Her study is enrolling HIV-positive and HIV-negative mothers and their newborns from a single community obstetrical unit in Cape Town.

She is following the mother-infant pairs until the babies’ first birthdays to see how often they are hospitalized for infectious events. The participants from both groups come from similar disadvantaged neighbourhoods. She names breastfeeding avoidance (in order to prevent HIV transmission) as a potential health issue, while another concern is that the infants may develop differently immunologically since their immune systems were exposed to HIV and antiretroviral drugs in utero.

“My motivation is to start looking at HIV-exposed children,” she says, “but then to look more broadly at all children in South Africa, to help improve their health outcomes.”

Dr. Slogrove is currently finishing her PhD in Epidemoilogy & Biostatistics at the University of British Columbia.