HIV and Other Infections in Pregnancy and the Prevention of Mother-to-Child Transmission (MTCT)

A major focus of the Branch is the prevention of MTCT both domestically and internationally. MTCT studies in pregnant women must consider potential effects of in utero drug exposures on the fetus and possible delayed effects in later childhood. Therefore, studies must conduct long-term follow-up of uninfected children who are perinatally exposed to increasingly complex antiretroviral regimens to evaluate for delayed adverse consequences of such exposure.

The MPIDB supports a large portfolio of domestic and international investigator-initiated grants in addition to studies within clinical trials networks the Branch supports, including the NICHD Domestic and International Pediatric and Maternal HIV Clinical Studies Network in collaboration with the International Maternal, Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) Network, observational studies in the Pediatric HIV/AIDS Cohort Study, and through collaborations with the President's Emergency Plan for AIDS Relief (PEPFAR). These projects are pursuing research focused on, but not limited to, the following areas:

  • HIV in pregnancy
    • The effect of HIV infection on pregnancy and the fetus
    • The effect of pregnancy on therapy for HIV infection, with a focus on differing susceptibility to certain drug toxicities in pregnant women and the effect of drugs on the fetus and infant
    • Pharmacokinetics and safety of antiretroviral and other antimicrobial agents in pregnant women and their infants
    • Special considerations associated with adherence in pregnant and postpartum women
    • Conception, pregnancy, and risk of HIV acquisition
    • Primary prevention of HIV in pregnant and lactating women in high-prevalence areas
  • Effects of in utero antiretroviral exposure
    • Pregnancy outcome and birth defects with antiretroviral drug exposure
    • Surveillance for long-term complications of fetal/infant exposure to drugs used to prevent perinatal infections and treat pregnant and lactating women
  • Co-infections in pregnancy
    • The interaction of HIV and its treatment with malaria and its treatment in pregnant women, including drug pharmacokinetics and safety, and optimizing malaria prevention
    • The interaction of HIV and tuberculosis in pregnant and lactating women
    • The impact of infectious hepatitis in pregnancy and prevention of mother-to-child transmission of infectious hepatitis
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