Anna Babakhanyan, MBT
Nominated From: University of Hawaii
Research Site: Cameroon
Research Area: Infectious Disease & Immunology
Primary Mentor: Diane Taylor
HIV and Malaria Co-Infections in Pregnant Cameroonian Women
HIV-malaria co-infections have become an increasing concern for both clinicians and policy makers, as both infections intersect in pregnancy, causing an upsurge of patients with poor pregnancy outcomes. P. falciparum malaria infection during pregnancy creates an inflammatory response that disturbs placental function, leading to premature deliveries, low birth weight, maternal anemia and in severe cases death. HIV infection doubles the risk of malaria during pregnancy and HIV-related immunosuppression leads to decreases in the levels of protective antibodies, important in clearing malaria parasites from the placenta. Furthermore, malaria increases expression of HIV cell-attachment markers on white blood cells (monocytes) in the placenta and malaria associated damage to the placenta increases the risk of mother to child transmission of HIV; thereby promoting HIV latency. There is a gap in our understanding of changes in the maternal-fetal interface of the placenta associated with poor pregnancy outcomes in co-infected women. We hypothesize that HIV infection results in the accumulation of malfunctioned monocytes in the placenta, which leads to pathology: higher malaria parasite burden, HIV latency, and mother to child transmission of HIV. This pilot study seeks to provide data to support our model, which will help elucidate the mechanism of pathogenesis in co-infected pregnant women and explain why malaria during pregnancy is exacerbated in HIV+ women. Knowing how malaria and HIV infections alter immune responses in pregnant women will ultimately lead to development of integrated interventions for combating these life-threatening diseases.
Despite the fact that use of antimalarial chemoprophylaxis and antiretroviral therapies improved the health of pregnant women with co-infections, low adherence, poor quality drugs, malaria and HIV drug interactions, resource scarcity, lack of infrastructure and inadequate treatment in sub-Saharan Africa result in poor treatment and pregnancy outcomes. The results from this study will help explain pathophysiology of malaria and HIV co-infections in pregnant women. This will be important in developing effective management of co-infections; i.e. antiretroviral therapy and antimalarials should not inhibit protective monocyte subsets. In addition, results will help establish if malfunctioned monocytes recruited to the placenta produce proteins important in mother to child transmission of HIV. Finally, we will define level of protection from malaria in co-infected pregnant women and establish if malaria vaccines will protect HIV+ pregnant women.
Advice for Potential Applicants
Do your due diligence to make sure that the study you propose to do is feasible at the international site, in the allotted budget and time.
- Dr. Diane W. Taylor, John A. Burns School of Medicine, Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii at Manoa, USA
- Dr. Lishomwa Ndhlovu, John A. Burns School of Medicine, Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii at Manoa, USA
- Dr. Rose G. F. Leke, Biotechnology Centre, University of Yaounde I, Cameroon
- Dr. Godwin Nchinda, International Reference Centre Chantal Biya, Cameroon