Maternal and Pediatric Infectious Disease Branch (MPIDB)

Overview/Mission

MPIDB (formerly the Pediatric, Adolescent, and Maternal AIDS Branch) supports and conducts domestic and international research related to the epidemiology, diagnosis, clinical manifestations, pathogenesis, transmission, treatment, and prevention of HIV infection and its complications in infants, children, adolescents, and pregnant and nonpregnant women. As the HIV epidemic has evolved and other infectious diseases have emerged in the United States and globally, the branch has ensured that its funded research reflects these changes and addresses important research opportunities and gaps as they arise, including HIV-associated co-infections (such as tuberculosis, hepatitis, and malaria) in children and pregnant women. Furthermore, MPIDB supports and conducts research on the epidemiology, natural history, pathogenesis, transmission, treatment, and prevention of other significant infectious diseases, including congenital infections, such as Zika virus and cytomegalovirus; tropical diseases, specifically those that affect children and pregnant women; and vaccine-preventable disease in infants, children, adolescents, and women.

Emerging and Re-emerging Infectious Diseases

Gap: Emerging and re-emerging infectious diseases are ongoing threats and often have a disparate impact on pregnant women, infants, children, and adolescents.

Priority: Study emerging and re-emerging infectious diseases that affect pregnant women, infants, children, and adolescents, including their impact on the pediatric nervous system.

HIV: Adolescent Prevention

Gap: While effective biomedical modalities to prevent HIV infection in adults now exist, none have been shown to be effective in adolescents.

Priority: Investigate ways to increase the use of interventions to prevent HIV (e.g., feasible, acceptable, safe, and scalable strategies to increase uptake of and adherence to HIV prevention modalities) in adolescents and young adults, and assess their effectiveness.

HIV: Adverse Pregnancy and Infant Outcomes Related to Prevention or Treatment

Gap: With widespread use of lifelong antiretroviral therapy and newer agents, more women are conceiving while on therapy. Thus, while perinatal HIV transmission rates have declined, concerns persist that use of antiretroviral medications may increase adverse pregnancy and infant outcomes (e.g., preterm birth).

Priority: Identify and investigate causes of adverse pregnancy and infant outcomes that may be associated with antiretroviral therapy in pregnancy and methods to prevent them.

HIV: Cure/Remission in Infants and Children

Gap: HIV cure strategies may be different for infants and children than adults.

Priority: Characterize HIV reservoirs and persistence, and pursue potential strategies, including vaccine- and other immune-based therapy research, for HIV cure/remission in infants and children.

Immune Cross-Talk in Infant Immune System Development

Gap: Infectious disease may influence immune cross-talk in pregnant women and their fetuses, thus impacting development of infant immunity.

Priority: Support research to understand the immune cross-talk in pregnant women, placenta, and fetus, including contribution of microbiome/virome and host-pathogen interactions on development of the infant immune system.

Two major priorities for the clinical research networks are: 1) HIV and tuberculosis therapeutics in infants, children, adolescents, and pregnant women and 2) epidemiologic research in individuals living with HIV or at risk of HIV, including infants, children, adolescents, and young adults who were exposed to HIV in utero.

Adolescent HIV Infection and Disease: Focuses on understanding HIV transmission dynamics, the course of infection, and its management in youth, including those who are infected perinatally
Epidemiology and Natural History of HIV Infection and HIV-Related Co-Infections in Infants, Children, and Adolescents: Investigates optimizing linkage to care, monitoring of therapy, adherence and durability of therapy, development of drug resistance, short- and long-term outcomes, epidemiology, treatment, and prevention of important co-infections, and other issues
Epidemiology and Natural History of HIV Infection and HIV-Related Co-Infections in Pregnant and Non-Pregnant Women: Focuses on gender-specific manifestations of HIV, including natural history, impact of therapy, transmission, and interactions with hormones
HIV and Other Infections in Pregnancy and the Prevention of Mother-to-Child Transmission (MTCT): Aims to prevent MTCT and includes studies in pregnant women, effects of in utero drug exposures on the fetus, possible delayed effects, long-term follow-up, and evaluation of delayed adverse consequences of exposure
Non-HIV Infectious Disease Research: Addresses research gaps in children and pregnant women related to many HIV-associated co-infections
Therapeutic Research in HIV and Related Co-Morbidities: Evaluates new and improved therapies for treatment of HIV infection and its associated complications in pregnant women, infants, children, and adolescents
Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN): Only domestic, multicenter research network devoted to the health and well-being of HIV-infected and at-risk adolescents and young adults
Centers for AIDS Research (CFAR): Provides administrative and shared support to synergistically enhance and coordinate high-quality AIDS research projects
International Epidemiologic Database to Evaluate AIDS (IeDEA): Collects and analyzes maternal and pediatric HIV/AIDS data from six international regional data centers: four in Africa and one each in the Asia-Pacific region and the Central/South America/Caribbean region
International Maternal, Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) Network: Evaluates potential therapies for HIV infection and its related co-infections in infants, children, adolescents, and pregnant women, including clinical trials of HIV/AIDS interventions for and prevention of mother-to-child transmission
Microbicide Trials Network (MTN): Develops and evaluates microbicides-products to prevent HIV transmission
NICHD Domestic & International Pediatric & Maternal HIV Clinical Studies Network (NICHD Network): Conducts trials related to preventing and treating HIV infection and its complications in newborns, infants, children, adolescents, and pregnant women
Pediatric HIV/AIDS Cohort Study (PHACS): Examines long-term safety of fetal and infant exposure to antiretroviral therapy and effects of perinatally acquired HIV infection in adolescents and young adults
Women's Interagency HIV Study (WIHS): Investigates the impact of HIV infection on women in the United States

Branch-Funded Projects

Centers for Disease Control and Prevention (CDC) HIV/AIDS website: CDC provides information on HIV/AIDS-related health topics
U.S. Food and Drug Administration (FDA) information for consumers on HIV/AIDS: FDA responsibilities include a variety of HIV/AIDS-related issues, including review and oversight in areas related to drugs, biologics and medical devices for the prevention and treatment of HIV/AIDS and AIDS-related conditions
AIDSinfo: Contains information on HIV/AIDS-related health topics, treatment and prevention guidelines, approved and investigational HIV/AIDS drugs, vaccine research, and HIV/AIDS-specific clinical trials
Guidelines for the Prevention and Treatment of Opportunistic Infections among HIV-exposed and HIV-infected children: Provides recommendations from CDC, NIH, HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and American Academy of Pediatrics
WHO Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection : Provides practice guidelines related to antiretroviral therapy

Rohan Hazra, Branch Chief
Main Research Areas: Epidemiology and natural history of HIV infection and HIV exposure in infants, children, and adolescents; programs and networks; therapeutic research in HIV infection in infants, children, adolescents, and pregnant & non-pregnant women; other pediatric infectious diseases; data sharing
Samantha Calabrese, Public Health Analyst
Main Research Areas: Portfolio analysis methodology; epidemiology; Zika
Nahida Chakhtoura, Medical Officer
Main Research Areas: Epidemiology and natural history of HIV infection in pregnant and non-pregnant women; Zika; women's health; cohort studies and clinical trials
Bill Kapogiannis, Medical Officer
Main Research Areas: Adolescent HIV prevention and treatment; youth HIV pre-exposure prophylaxis; youth HIV care continuum; HIV vaccines; emerging infectious diseases; adult and pediatric infectious diseases
Sonia Lee, Health Scientist Administrator
Main Research Areas: Adolescent HIV infection; neurodevelopment and assessment; behavioral science
Eric Lorenzo, Health Scientist Administrator
Main Research Areas: HIV cure; HIV persistence/latency and reservoirs
Jack Moye, Medical Officer
Main Research Areas: Laboratory quality assurance; biospecimen repository management; virology and immunology research; epidemiologic cohort studies and clinical trials
Denise Russo, Deputy Branch Chief
Main Research Areas: HIV in women; infant immunity
Ayanna Brummell, Extramural Scientific Assistant

Highlights

NIH launches prospective study of Zika and HIV co-infection during pregnancy: MPIDB staff and investigators collaborate to determine the potential risks that infection with the Zika virus might pose for pregnancies.
Collaborative HIV program improves long-term care for youths in the United States: MPIDB staff and investigators of the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) collaborated with the CDC and HRSA.
NIH funds research network devoted to the health of adolescents with HIV or at risk for HIV infection: MPIDB leads the ATN to support research for youth in the United States.
Global estimates on paediatric and adolescent HIV survival and death: NICHD supports the International Epidemiology Databases to Evaluate AIDS global consortium (IeDEA) in low- and middle-income countries to provide age-disaggregated data for modeling efforts.