As HIV research has become increasingly global in nature, research gaps in children and pregnant women related to many HIV-associated co-infections, such as tuberculosis (TB), hepatitis, and malaria, have become evident. The MPIDB has responded accordingly by promoting and funding new research related to these HIV-associated infectious pathogens.
Additionally, the NIAID–NICHD-funded International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Network has broadened its focus to include TB, malaria, hepatitis, and investigation of vaccines to prevent HIV-related or other high-priority infectious diseases in children, adolescents, and pregnant women. The MPIDB is increasing its research portfolio in infectious diseases, initially focusing on TB, malaria, and hepatitis.
- A Branch HIV/TB request for applications is funding three international grants to evaluate the interaction of antiretroviral drugs and first- and second-line tuberculosis treatment in HIV-infected children. Drug interactions could lead to sub-therapeutic drug levels for the anti-HIV drugs, the anti-TB drugs, or both.
- A large program project in Uganda is evaluating the interaction of HIV, HIV treatment, and malaria in HIV-infected children and pregnant women. The study is also evaluating several different malarial prophylaxis regimens for children to determine the optimal anti-malaria preventive regimen.
- A large study in South Africa will evaluate the impact of TB and its treatment on outcomes in HIV-infected pregnant women and their infants, including HIV transmission, HIV progression, and pregnancy outcome, and will also determine the impact of rifampin-based TB treatment on antiretroviral drug concentrations in HIV-infected pregnant women.
- In Thailand, a clinical trial will evaluate ways to improve prevention of mother-to-child hepatitis B (HBV) transmission in pregnant women with hepatitis B infection who are hepatitis B e antigen positive (HBeAg) with normal liver function tests and who are not HIV infected. The study will assess the efficacy and safety of giving the anti-HBV drug tenofovir versus placebo, in addition to standard infant HBV vaccine and immune globulin, to prevent transmission to their infants. The drugs will be given from 28 weeks of gestation until 2 months postpartum, and both infant infection status and maternal health will be evaluated. The investigators will enroll 588 women and infants within 8 sites in Thailand. The results of this study will define appropriate policy for management of HBV-infected HBeAg-positive pregnant women globally.