Michael Ebangha Besong, MD
Nominated From: University of Hawaii
Research Site: Cameroon
Research Area: HIV/AIDS, Maternal & child health
Primary Mentor: Gabriel Loni Ekali
The Prevalence and Impact of early CMV infection on Morbidity in HIV-exposed Uninfected Cameroonian Infants.
With wide spread use of anti-retroviral therapy (ART) in Sub-Saharan Africa (SSA) for the prevention of mother-to-child transmission of HIV, there is a growing population of infants exposed in utero both to HIV and ART, but who remain HIV-uninfected (HIV-EU). These HIV-EU still experience numerous health and development problems such as increased mortality, lower birth weight, impaired early growth, impaired psychomotor and cognitive development, and immune abnormalities. These presumably results from stressors during in utero and early postnatal life. The underlying causes of these impairments in HIV-EU infants are probably multifactorial and include exposure to HIV itself, exposure ART, maternal health etc. In addition, these poorer health outcomes could be attributed to infections other than HIV, which are still transmitted from mother to child despite interventions to prevent mother-to-child HIV transmission like cytomegalovirus (CMV) infection. Cytomegalovirus infection is widespread in SSA and most African children acquire CMV infection during infancy. Infant CMV acquisition can occur in utero during intrapartum period or via contact with infected breast milk, saliva or Urine. Although the extensive use of ART has been effective in decreasing MTCT of HIV, it has not been found to appreciably alter the rate of infant CMV acquisition in SSA . Early CMV infection, namely in utero or during infancy adversely affects growth, development and morbidity in African infants and thus, may be a contributing factor to the reduced growth, impaired or altered immune functions and cognitive deficits observed in HIV-EU. Little is known about the real burden of CMV infection in HIV-EU, & its impact on morbidity ( growth and neurodevelopment). This is what we therefore seek to investigate in this study.
This study will provide epidemiological data on the burden of early CMV infection in HIV-EU infants and its association to poorer health outcomes in these infants as defined by growth and neurodevelopment. Findings will be important in providing evidence for subsequent interventions to improve HIV-EU health outcomes if such an association is found.
Advice for Potential Candidates
Identify potential mentors who are already working in the research area you intend to focus on and follow their guidance in choosing the research topic for your application.
- Dr Gabriel Loni Ekali, CDC/PEPFAR at National AIDS Control Committee, Cameroon
- Dr Bruce Shiramizu, John A Burns School of Medicine, Department of Tropical Medicine, Medical Microbiology & Pharmacology, University of Hawai’i, USA
- Dr Dora Mbanya, of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon/a>