# Innovation across the spectrum of pediatric HIV care

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $714,209

## Abstract

Project Summary
The past decade has witnessed remarkable progress in the scale-up of antiretroviral therapy (ART), yet access
to optimal diagnosis, care, and treatment remains limited for many of the 2.1 million children living with
perinatally-acquired HIV worldwide. Novel diagnostic technologies and antiretroviral drugs (ARVs) can address
this treatment gap. Critical questions remain, however, about the most effective way to utilize these innovations
for children in settings with very limited resources. For example, how should programs best introduce new
point-of-care assays for infant HIV diagnosis, and what are the most effective and cost-effective approaches to
roll out pediatric dolutegravir and other emerging ARVs? Where long-term data are limited, or traditional clinical
studies are not feasible, computer-based microsimulation modeling can use existing data to inform decisions
about how to achieve the best outcomes for children with HIV under constrained healthcare budgets. With
NICHD R01 support (2014-2019), we developed the Cost-effectiveness of Preventing AIDS Complications
(CEPAC)-Pediatric microsimulation model and have informed guidelines and decisions from the World Health
Organization (WHO), the President's Emergency Plan for AIDS Relief (PEPFAR), and country Ministries of
Health (MOHs). In the first 4 years of the initial award cycle, we have used microsimulation and cost-
effectiveness analysis methods to publish 17 papers related to pediatric HIV prevention, diagnosis, and
treatment. We now propose to broaden the scope of this work, expanding a multidisciplinary team with diverse
expertise in pediatric HIV care, research, clinical policy, and cost-effectiveness, and adding Zimbabwe to the
original focus countries of Côte d'Ivoire and South Africa. This will allow us to compare findings across three
PEPFAR settings that encompass a wide and representative range of pediatric HIV epidemiology, clinical
practice, and healthcare costs. We will also develop new model-based methods, including location-optimization
models and regression-based metamodels that can be used by local program planners to examine emerging
care and treatment approaches across the spectrum of pediatric HIV care. We propose two new specific aims:
 1. To project the optimal placement and value of innovative diagnostic technologies for pediatric
 HIV, including point-of-care assays for infant HIV diagnosis.
 2. To evaluate the most effective and cost-effective ways to implement new ARV guidelines and
 introduce new ARV formulations for children, including the planned rollout of dolutegravir.
The goal of this proposal is to help clinicians, program planners, and policymakers at MOHs, WHO, and
PEPFAR identify the optimal use of scarce resources to improve long-term health for children with HIV.
Continuation and expansion of support for the CEPAC-Pediatric modeling program will allow us to develop and
disseminate novel modeling methods and address critical, context-s...

## Key facts

- **NIH application ID:** 9996743
- **Project number:** 5R01HD079214-07
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Andrea Lynne Ciaranello
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $714,209
- **Award type:** 5
- **Project period:** 2014-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9996743

## Citation

> US National Institutes of Health, RePORTER application 9996743, Innovation across the spectrum of pediatric HIV care (5R01HD079214-07). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9996743. Licensed CC0.

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