# Effects of Human Milk Oligosaccharides and Gut Microbiome on Growth and Morbidity in HIV-Exposed Uninfected Infants

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $708,574

## Abstract

PROJECT SUMMARY/ABSTRACT
Despite the success in global health efforts to prevent mother-to-child transmission of HIV, there is a growing
and often overlooked HIV-exposed uninfected (HEU) population with substantially higher risk of growth
faltering, infectious morbidity, and mortality than HIV-unexposed uninfected (HUU) infants. The mechanisms
responsible for poor growth and susceptibility to infection in HEU infants are unclear, but recent evidence
implicates perturbations in the infant gut microbiome as a critical mechanism. Breast milk seeds the infant gut
microbiome, contributing nearly one-third of bacterial communities. The third largest component of breast milk
are human milk oligosaccharides (HMOs). HMOs serve as prebiotics, supporting growth of commensal gut
bacteria and influencing development of the immune system. Thus, breast milk contains prebiotics (HMOs) and
probiotics (bacteria) fundamental for colonization and development the infant gut microbiome. Little is known
about the relationship between specific HMOs and specific gut bacteria that may be associated with growth
and morbidity in HEU infants. Emerging evidence suggests that maternal HIV infection alters HMO composition
and HEU infants have reduced microbial diversity than HUU infants. Given the influence of HMOs on
microbiome development and immune function, even a small difference in HMO composition could have
important implications for growth and health outcomes in HEU infants. HMOs may be a feasible intervention to
improve growth and morbidity in HEU infants. The proposed study will evaluate the association between
maternal HIV infection, HMO composition, and the infant gut microbiome, and identify HMO-mediated
pathways associated with morbidity and linear growth in HEU infants. We will prospectively enroll and follow
HIV-infected and HIV-uninfected women and their infants in Kenya, a region with high prevalence of HIV and
poor childhood growth. The study aims to: 1) evaluate the differences in HMO composition and breast milk
microbiota between HIV-infected and HIV-uninfected women over time, 2) understand how breast milk as a
synbiotic influences bacterial communities and infant microbiome diversity, and 3) determine whether HMOs
are associated with linear growth and incidence of diarrhea, pneumonia, and enteric dysfunction in HEU and
HUU infants. Results from this longitudinal study will inform our understanding of mechanisms of growth and
the role of HMOs and the infant gut microbiome, providing critical data for the design of interventions to
optimize growth and health outcomes in HEU children in Africa, a vulnerable and growing population.

## Key facts

- **NIH application ID:** 9920737
- **Project number:** 5R01HD096999-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Grace M Aldrovandi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $708,574
- **Award type:** 5
- **Project period:** 2019-04-24 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9920737

## Citation

> US National Institutes of Health, RePORTER application 9920737, Effects of Human Milk Oligosaccharides and Gut Microbiome on Growth and Morbidity in HIV-Exposed Uninfected Infants (5R01HD096999-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9920737. Licensed CC0.

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