HIV-exposed Uninfected
Conditions
Keywords
HIV-exposed Uninfected, In Utero Exposure, Metabolic, Immune
Brief summary
Globally, over 1 million babies are born to mothers with HIV each year. With the advent of prenatal antiretroviral therapy, up to 98% of these individuals may be HIV-exposed uninfected (HEU). A growing literature suggests that in utero HIV exposure - even in the absence of subsequent infection - may be associated with adverse health outcomes in infancy and childhood. However, there is little information about the long-term health implications of in utero HIV exposure later in life, such as into adulthood. In this study, for the first time, we seek to prospectively evaluate metabolic and immune indices among HEU young adults as compared to well-matched HIV-unexposed uninfected controls. This study serves as a necessary first step toward optimizing clinical care for this expanding and aging HEU population, including the implementation of novel screening and prevention strategies.
Interventions
OTHERIn Utero HIV Exposure
Born to mother who had HIV infection during pregnancy.
OTHERNo In Utero HIV Exposure
Born to mother who did not have HIV infection during pregnancy.
Sponsors
Massachusetts General Hospital
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
HIV-Exposed Uninfected (HEU) Mother-Young Adult Dyads 1. Male or female young adult, 18-35 years old 2. Documentation of HIV infection in mother with date of diagnosis preceding young adult birth date 3. Negative HIV test in young adult Control Mother-Young Adult Dyads 1. Matching to HEU dyad 2. Negative HIV test in mother and young adult
Exclusion criteria
All Young Adults 1. Pregnancy within 6 months or active nursing 2. Change in blood glucose or blood pressure medication within 3 months 3. Change in estrogen or testosterone therapy within 3 months 4. Chronic glucocorticoids (except steroid inhalers or creams) within 3 months 5. Antiretroviral therapy use within 6 months (i.e., prophylaxis) 6. Significant chronic illness judged by the investigator to represent a contraindication to participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Body mass index (BMI) | Baseline | — |
| Activated CD8+ T cells | Baseline | Flow cytometry |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lipids | Baseline | Standard lipid panel (including HDL, triglycerides) |
| Blood pressure | Baseline | Systolic and diastolic |
| Hepatic fat content | Baseline | Transient elastography |
| Hepatic fibrosis | Baseline | Transient elastography |
| Abdominal fat mass | Baseline | Dual-energy x-ray absorptiometry |
| Inflammatory markers | Baseline | ELISA |
| Frequency of Asthma | Baseline, Ever | — |
| DNA methylation patterns | Baseline | Epigenome-wide analysis |
| Immune cell subsets | Baseline | Flow cytometry |
| Glucose tolerance | Baseline | Oral glucose tolerance test |
Countries
United States
Outcome results
None listed