# Neonatal imaging as an early marker of neurodevelopment and predictor of cognitive performance in infants exposed to HIV and ART in utero and perinatally

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $450,991

## Abstract

Project Summary
 In 2010, 330,000 infants were born with HIV, predominantly due to mother-to-child transmission (MTCT),
and 90% of these infants were born in Sub-Saharan Africa. The number has dropped considerably due to
increasingly successful prevention of MTCT using combination (triple) antiretrovirals (ARVs). The HIV epidemic
remains substantial in South Africa, with 30% infection in pregnant women presenting at South African
antenatal clinics. The Western Cape Government has adopted the WHO recommended “Option B+” treatment
plan, which has the potential to reduce HIV MTCT to under 1%, and the MTCT rate has fallen considerably.
However, it has been reported that HIV-exposed, uninfected infants experience neurodevelopmental delays
relative to their unexposed peers. In this study, we propose to measure the effects of in utero and perinatal
exposure to ART and HIV on the developing infant brain, using neuroimaging at 38 to 41 weeks gestational
age (GA) and neurodevelopmental assessments at 9 and 19 months of age. We aim to determine whether
early clinical indicators, including both infant and maternal health, and neuroimaging of the neonatal brain are
predictive of later neurodevelopmental outcomes, whether HIV and ART exposure affect infant
neurodevelopment, and whether the duration of in utero ART exposure affects outcomes.
 We will recruit 210 pregnant women, 140 HIV-infected and 70 uninfected, attending the antenatal clinic at
the Michael Mapongwana Community Health Centre in Khayelitsha. Infected mothers and infants are treated
according to the “Option B+” guidelines, so that their infants will have been exposed to ARVs in utero either
since conception (70 infants) or after 12 weeks (70 infants), postnatally and longer if breast feeding. Infants will
be tested with HIV-1 DNA PCR at birth, and every 3 months if breast feeding. At 38 to 41 weeks GA, the
infants will undergo neuroimaging at the Cape Universities Body Imaging Centre, including structural imaging
for brain morphometry, diffusion for brain connectivity, and spectroscopy for brain metabolism. Participants will
be followed every three months, with general examinations and growth assessments of the infants, and
maternal health assessments, including depression, feeding practices and ARV compliance. Comprehensive
neurodevelopmental testing with the Griffiths Mental Development Scale will be done at 9 and 19 months at
the KID-CRU at Stellenbosch University (SUN). Acquisition and analysis techniques will be developed jointly
by the University of Cape Town (UCT) and Massachusetts General Hospital (MGH).
 This project extends a successful collaboration between Dr. Barbara Laughton (SUN), Dr. Ernesta Meintjes
(UCT) and Dr. André van der Kouwe (MGH). The project will build leading-edge neonatal brain imaging
capacity in Cape Town, with unique imaging sequences and hardware, and infant handling techniques
developed locally for ethically imaging neonates without sedation. UCT and SUN student...

## Key facts

- **NIH application ID:** 9940755
- **Project number:** 5R01HD085813-05
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Barbara Laughton
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $450,991
- **Award type:** 5
- **Project period:** 2016-09-19 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9940755

## Citation

> US National Institutes of Health, RePORTER application 9940755, Neonatal imaging as an early marker of neurodevelopment and predictor of cognitive performance in infants exposed to HIV and ART in utero and perinatally (5R01HD085813-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9940755. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*