Ashley Karczewski

Nominated From: Indiana University

Research Site: University of Nairobi

Research Area: Oral Health, HIV

Primary Mentor: Ana Lucia Seminario

Research Project

The Association Between Levels of Salivary Antimicrobial Peptides and the Presence of Periodontal Disease in HIV-infected Adolescents

Approximately 120,000 children and adolescents are living with HIV/AIDS in Kenya, one of the largest HIV epidemic areas in world. Even with advancements in antiretroviral drug therapies, there is still a high burden of HIV-related oral disease in these patients, which can greatly impact a child’s systemic health and quality of life. For my fellowship year, I’m joining the ongoing Children’s HIV Oral Manifestations Project (CHOMP). This project is looking at levels of certain components of innate immunity (salivary antimicrobial peptides) and how these values correspond with the presence of oral diseases, serum vitamin D levels, and quality of life in children and adolescents living with HIV. The main goal of CHOMP is to evaluate these relationships in order to inform a larger study looking to implement a cost-effective and easy-to-administer public health intervention which can increase innate immunity (i.e. vitamin D supplementation) to decrease the burden of oral disease and improve the quality of life for youth affected by HIV in Kenya. My Fogarty project is nested within CHOMP, focusing on determining the association between levels of certain salivary antimicrobial peptides (cathelicidin LL-37, histatins 1,3, & 5, and HNP1-3) and the presence of periodontal disease in adolescents affected by HIV. We will be collecting saliva and using ELISA to determine AMP levels in 85 HIV-infected adolescents (12-18yo). Periodontal status will be determined using Gingival Bleeding Index (GBI) and modified Community Periodontal Index (CPI) scores. The data will be analyzed to determine a correlation between periodontal status and salivary AMP levels.

Research Significance

According to the World Health Organization, oral diseases are the most common noncommunicable diseases in humans in the world and are only increasing in prevalence in Low and Middle Income Countries (LMICs). Despite the prevalence and ubiquity of oral diseases, there is a disparity of global oral health research studies, interventions, and incorporation into health care- especially in regards to patients living with HIV. Oral diseases can be very painful, cause systemic infection, and have a deleterious effect on a child’s nutrition, speech and self-esteem. Therefore, an examination into establishing a concrete relationship between HIV status, salivary AMP levels, and periodontal disease is necessary to understand what interventions may be useful in reducing the burden of oral disease, especially in youth.

Advice for Potential Candidates

The Fogarty Fellowship is not just limited to medical students, physicians, or PhD candidates- it is an opportunity for people from all backgrounds and disciplines to engage in global health research (calling all dental students/dental researchers!). Take advantage of the unique opportunity the Fogarty fellowship offers to learn the language and history of your area, participate in cultural events, and really live like a local in the community you are trying to help. Engaging in meaningful relationships and forming friendships with people living where you are working can have as big an impact on your research approach as learning new techniques and research methodologies. It’s easier to understand the true needs and potential interventions in a community when you become part of it.


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