# Uncovering the Biological Link between Oral and Mental health in Adolescents Living with HIV (uBLOoM)

> **NIH NIH R21** · UNIVERSITY OF PENNSYLVANIA · 2024 · $181,449

## Abstract

PROJECT SUMMARY
With the global scale-up of antiretroviral therapy (ART), increasing numbers of children with perinatally-acquired
HIV (PHIV) are surviving into adolescence and beyond. Adults living with HIV on ART are at an increased risk
for chronic age-related illnesses, including neurocognitive impairment, as well as oral disease compared to the
general population. Early precursors of these disorders are also highly prevalent in children and adolescents
living with HIV (ALHIV). Given that mental and oral health co-morbidities associated with HIV and lifelong ART
could be driven by overlapping or distinct biological and immunological mechanisms, a better understanding of
these mechanisms is needed to support interventions, particularly among ALHIV. Microbiota- or aging-mediated
processes have been shown to contribute directly to HIV comorbidities. Increased incidence and prevalence of
dental pathologies observed by our group and others among people living with HIV appears predicated by a
differential colonization with pathogenic and commensal microbes. Emerging evidence suggests that controlled
HIV infection alters microbial communities, contributing to a chronic low-grade inflammatory state that underlies
age-associated conditions in children and youth with PHIV. In parallel, epigenetic age acceleration is observed
in adults with HIV on ART when compared to controls and has been linked to neurocognitive deficits. The
objective of this proposal is to identify oral microbial taxonomic and functional features, and aging
markers associated with neurocognition and oral health in ALHIV. Our multidisciplinary research team is
comprised of experts in HIV epidemiology, microbiology, dentistry, medicine, pediatrics, neuropsychology,
bioinformatics and statistical modeling. We will leverage an established NIH-funded cohort of approximately 600
children and adolescents perinatally exposed (+/- PHIV) and unexposed (controls) to HIV living in Nigeria. In 50
ALHIV and 50 sex- and age-matched uninfected adolescents (aged 10-13), we will analyze shotgun
metagenomic sequences of salivary samples to identify salivary taxonomic and functional profiles and will use
the comprehensive Illumina MethylationEPIC BeadChip array to characterize DNA methylation and measure
markers of epigenetic age acceleration in blood samples. In Aim 1, we will characterize shotgun metabolic
sequences of salivary samples and measures of epigenetic age acceleration in blood samples to examine
associations between (a) oral microbial and functional profiles and (b) epigenetic age acceleration with
neurocognition outcomes in Nigerian adolescents with and without HIV. In Aim 2, we will test whether epigenetic
age acceleration is associated with oral health outcomes in Nigerian adolescents with and without HIV. The
research proposed in this R01 is significant because it will generate new insights into how microbiota- or aging-
mediated mechanisms contribute to neurocognitive impairments and ...

## Key facts

- **NIH application ID:** 11141404
- **Project number:** 7R21DE032869-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** MODUPE COKER
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $181,449
- **Award type:** 7
- **Project period:** 2024-08-03 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11141404

## Citation

> US National Institutes of Health, RePORTER application 11141404, Uncovering the Biological Link between Oral and Mental health in Adolescents Living with HIV (uBLOoM) (7R21DE032869-03). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/11141404. Licensed CC0.

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