# Gut Integrity and Metabolic Complications in Youth Living with HIV in Uganda

> **NIH NIH R21** · CASE WESTERN RESERVE UNIVERSITY · 2020 · $160,594

## Abstract

Project Summary/Abstract:
People living with HIV are at increased risk of cardiovascular and metabolic complications
compared to HIV-uninfected control populations. Compared to what is known in older adults,
little is known about these risks in adolescents and young adults and even less in the setting of
sub-Saharan Africa. Although inflammation has been linked to cardiovascular disease in adults
with HIV, the role of alteration in gut integrity and environmental factors on metabolic
complication has been scarcely investigated in youth living with HIV. Furthermore, the impact of
non-AIDS co morbidities may be greater in sub-Saharan Africa, though no studies of metabolic
complications have been conducted in youth on ART in this setting.
The overall objective of this proposed R21 research plan is to use surrogate markers of gut
integrity, microbial translocation and inflammation to understand the mechanisms underlying
adiposity and insulin resistance in youth living with HIV, so that risk-reduction therapies can be
appropriately targeted and novel preventive strategies may be developed in the future. In a
cross-sectional study of 100 adolescents and young adults living with HIV and 100 uninfected
controls, this project aims to measure biomarkers of gut integrity and bacterial translocation to
identify ongoing evidence of a “leaky gut” in youth living with HIV compared to age and gender
match HIV uninfected controls in Kampala, an urban setting, and Gulu, a rural setting Uganda.
We will investigate whether these measures of gut integrity and bacterial translocation correlate
with metabolic disease using DXA scan to measure adiposity and insulin resistance.
Additionally, we will examine the role of environmental, nutritional and socioeconomic factors
that may differ between urban and rural settings and their associations with markers of gut
integrity and microbial translocation. This study will provide a comprehensive view of how gut
integrity, bacterial translocation and inflammation relate to metabolic disease among
adolescents and young adults living with HIV and the role that important environmental and
social differences play in urban versus rural settings in Uganda.
The PI, Dr Dirajlal-Fargo, is an exceptional candidate who is seeking to become an
internationally recognized clinician-investigator in the field of cardiometabolic complications in
pediatric HIV. She also has extensive experience conducting clinical research in Uganda.
Dr Dirajlal-Fargo has strong institutional support from Case Western Reserve University and the
Department of Pediatrics at Rainbow Babies and Children’s Hospital. She will have access to a
wealth of resources that will ensure a successful transition to independently funded investigator.

## Key facts

- **NIH application ID:** 10072265
- **Project number:** 1R21DK127522-01
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Sahera Dirajlal-Fargo
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $160,594
- **Award type:** 1
- **Project period:** 2020-07-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10072265

## Citation

> US National Institutes of Health, RePORTER application 10072265, Gut Integrity and Metabolic Complications in Youth Living with HIV in Uganda (1R21DK127522-01). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10072265. Licensed CC0.

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