# HIV/ART, low birth weight, and mortality in HIV-exposed uninfected children: a translational mechanistic study

> **NIH NIH R01** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2021 · $772,373

## Abstract

Abstract
Despite the rapid scale-up of lifelong triple antiretroviral therapy (ART) among pregnant women living with HIV
(WLH), children born to WLH continue to have an increased risk of low birth weight (LBW), morbidity, and
mortality compared to infants born to women who are not living with HIV. Although the association between
LBW and decreased child survival has been well studied, the biological mechanisms linking HIV or ART and
LBW are not well described. To better understand how HIV/ART increases the risk of LBW, we leverage an
ongoing, well-characterized cohort of women living with HIV enrolled in a trial of data-driven continuous quality
intervention to improve long term outcomes of ART in Kinshasa, Democratic Republic of Congo; our specific
focus is on HIV-associated inflammation, immune activation, and microbial communities in the context of
universal ART. A cohort of 600 women living with HIV on ART and 600 HIV-negative control along with their
HIV-exposed un-infected (HEU) and HIV unexposed (HU) infants will be recruited and followed up through
delivery and up to 12 months postpartum to determine how HIV/ART-induced placental dysfunction (Aim 1) or
microbial dysbiosis (Aim 2) modulate the risk of LBW and subsequent infant mortality. Using biological
specimen obtained from those women, we will document histopathologic placental abnormalities (e.g.
necrosis) and measure levels of markers of inflammation, immune activation, and microbial translocation. We
will also use a cutting-edge microbiome and virome toolkit with machine learning and ecosystem modeling
approaches to evaluate associations between these entities and inflammation and LBW, as well as in silico test
myriad mechanistic hypotheses derived from functional analyses. We expect that completion of these
complementary aims will provide insight into the biological mechanism(s) associated with increased risk of
LBW among HIV-exposed infants. This insight could ultimately identify an optimal HIV- treatment or care
modality for pregnant WLH: one which promotes maternal health, prevents HIV mother-to-child transmission,
and maximizes infant survival.

## Key facts

- **NIH application ID:** 10258233
- **Project number:** 1R01HD105526-01
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** JESSE J KWIEK
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $772,373
- **Award type:** 1
- **Project period:** 2021-04-15 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10258233

## Citation

> US National Institutes of Health, RePORTER application 10258233, HIV/ART, low birth weight, and mortality in HIV-exposed uninfected children: a translational mechanistic study (1R01HD105526-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10258233. Licensed CC0.

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