A major focus of the Branch is the prevention of MTCT both domestically and internationally. A critical component of MTCT studies in pregnant women must be the consideration of potential effects of in utero drug exposures on the fetus and possible delayed effects in later childhood. Therefore, 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 is an important area of research focus.
The MPIDB supports a large portfolio of domestic and international investigator-initiated grants in addition to studies within clinical trials networks supported by the Branch, including the NICHD International and Domestic Pediatric and Maternal HIV Clinical Trials Network in collaboration with the International Pediatric Maternal Adolescent AIDS Clinical Trials Network (IMPAACT), observational studies in the Pediatric HIV/AIDS Cohort Study, and through collaborations with the President's Emergency Plan for AIDS Relief (PEPFAR), that 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 interaction of pregnancy on therapy of HIV infection, with focus on differing susceptibility to certain drug toxicities in pregnant women and the effect of drugs on the fetus and infant;
- 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
- Prevention of mother-to-child HIV transmission
- 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 between 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
- Impact of infectious hepatitis in pregnancy and prevention of mother to child transmission of infectious hepatitis