Many processes and problems are unique to pediatric and maternal populations infected with HIV. Although the pathogenesis of HIV infection is similar for all HIV-infected persons, there are unique considerations for HIV-infected infants, children, adolescents, and women that warrant research specifically focused on these populations. The PAMA Branch supports a portfolio of investigator-initiated grants that are pursuing research focused on, but not limited to, the following areas:
- The effect of HIV infection on pregnancy and the fetus;
- The impact of pregnancy on therapy of HIV infection, with special considerations about differing susceptibility to certain drug toxicities in pregnant women and the effect of drugs on the fetus and infant;
- Acquisition of HIV infection through in utero, intrapartum, or postnatal exposure via breast milk for most HIV-infected children;
- Potential long-term effects of in utero exposure to antiretroviral drugs used for prevention of perinatal transmission;
- Differences in the diagnostic evaluation in perinatal infection because all infants have transplacental maternal antibody until age 15 to 18 months;
- Differences between immune function and markers (such as CD4+ lymphocyte count) in children and adolescents versus adults;
- Pediatric HIV diagnosis and monitoring assays and strategies relevant to developing-country settings;
- Differences in the clinical and virologic manifestations of perinatal HIV infection and HIV-associated opportunistic infection due to acquisition of infection at a time of immunologic immaturity; and
- Special considerations associated with adherence for children and adolescents.
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