# Epstein-Barr virus replication, malaria and clinical outcomes in hospitalized HIV infected children

> **NIH NIH R21** · UNIVERSITY OF WASHINGTON · 2020 · $233,250

## Abstract

African children diagnosed with HIV infection late in disease have a mortality rate often exceeding 20%, and
there is an urgent need for novel strategies to improve their prognosis. Epstein-Barr virus (EBV) viremia is
commonly detected in critically ill HIV-infected children, with unknown relevance. Sub-clinical malaria
parasitemia is also common in many regions of the HIV epidemic, and is immunomodulatory, interacting with
both HIV and EBV. The project will study EBV viremia and malaria parasitemia in a cohort of children
with late HIV diagnosis in hospital. The study will determine the prevalence correlates, and clinical
relevance of EBV viremia (Aim 1) and malaria parasitemia (Aim 2), and their combined effect on immune
recovery during initiation of antiretroviral therapy (Aim 3). It is hypothesized that EBV viremia and malaria will
each affect ~50% of children, and will be associated with mortality, impaired immune restoration, and higher B
cell and T cell activation after 6 months of antiretroviral therapy. Results may inform the development of novel
interventions for this population.
The study will be conducted using archived specimens and data from a cohort of 181 hospitalized Kenyan
children enrolled in the Pediatric Urgent Start of HAART (PUSH) Study. Children were diagnosed with HIV at
admission, started on antiretroviral therapy (ART), and followed longitudinally with serial plasma and PBMC
specimens stored over 24 weeks. We will use quantitative PCR to assess EBV DNA levels and determine the
prevalence and duration of EBV viremia. Ultrasensitive q-RT-PCR will be used to measure malaria parasite
levels in blood. Flow cytometry will be used to describe activated and memory T and B cell populations.
Regression models will be used to define correlates and clinical consequences of EBV viremia, and malaria
parasitemia and immunologic recovery. By defining the relationships between EBV viremia, malaria
parasitemia, and clinical and immunologic outcomes among severely ill HIV-infected children, the
study will inform interventions to reduce the high mortality rate in this population.

## Key facts

- **NIH application ID:** 10048321
- **Project number:** 1R21HD102825-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Jennifer Ann Slyker
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $233,250
- **Award type:** 1
- **Project period:** 2020-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10048321

## Citation

> US National Institutes of Health, RePORTER application 10048321, Epstein-Barr virus replication, malaria and clinical outcomes in hospitalized HIV infected children (1R21HD102825-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10048321. Licensed CC0.

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