Working Groups and Task Forces
The PHACS Working Groups and Task Forces are responsible for close examination of the data in their domain. They are also responsible for the development of abstracts for presentation and manuscript publication. Click below for a description of each Working Group and Task Force, contact information for the Chair(s), and a link to its published research.
Adolescent and Young Adult Health and Behaviors Working Group
Chair: Barbara Moscicki, MD, Professor of Pediatrics, University of California Los Angeles
Chair: Katherine Tassiopoulos, DSc, Senior Research Scientist, Harvard T. H. Chan School of Public Health
The primary aims of the Adolescent and Young Adult Health and Behaviors Working Group are to: define the impact of perinatal HIV infection and ARV exposure on behavioral health outcomes including sexual behaviors, substance use, mental health, independent living skills, vocational/educational achievement, and social relationships, as PHIV and PHEU youth transition through adolescence and young adulthood; determine the prevalence and incidence of reproductive health outcomes including pregnancies, sexually transmitted infections, menstrual irregularity and precancerous HSIL; and, among PHIV adolescents and young adults, to describe the individual, social, and health care system barriers and facilitators of (a) transitioning from pediatric to adult health care, (b) adherence to medications and retention in health care, and (c) physical and mental health. Examples of analyses the working group has undertaken include examining the co-occurrence of sexual, substance use, and mental health behavior risks in PHIV and PHEU youth; understanding the association between exposure to violence and virologic and immunological outcomes in PHIV youth; identifying factors associated with initiation of sexual activity and unprotected sex among PHIV youth; estimating the agreement between self-reported measures of antiretroviral treatment adherence and HIV RNA viral load; examining the prevalence of and risk factors for substance use among PHIV and PHEU youth; and a comparison of HPV antibodies and effectiveness between HPV-vaccinated PHIV and PHEU youth.
1. Moscicki AB, Karalius K, Tassiopoulos K, Yao TJ, Jacobson DL, Patel K, Purswani M,Seage GR III, for the Pediatric HIV/AIDS Cohort Study. Human papillomavirus (HPV) antibody levels and quadrivalent vaccine clinical effectiveness in perinatally-HIV infected and exposed, uninfected youth. CID 2018.
4. Tassiopoulos K, Moscicki B, Mellins C, Kacanek D, Malee K, Allison S, Hazra R, Siberry G, Smith R, Paul M, Van Dyke R, and Seage GR III for the Pediatric HIV/AIDS Cohort Study. Sexual risk behavior among youth with perinatal HIV infection in the US: Predictors and implications for intervention development. Clin Infect Dis 2013; 56(2):283-90. PMCID: PMC3526253. http://www.ncbi.nlm.nih.gov/pubmed/23139252
Cardiopulmonary Working Group
Chair: Engi Attia, MD, PhD, Acting Assistant Professor, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington
Chair: Steven Lipshultz, MD, A. Conger Goodyear Professor and Chair, Department of Pediatrics, University at Buffalo
Chair: Paige Williams, PhD, Senior Lecturer on Biostatistics, Harvard T. H. Chan School of Public Health
The primary aims of the Cardiopulmonary Working Group (CPWG) are to (1) evaluate the effects of HIV and antiretroviral (ARV) treatment on cardiac and pulmonary function in children and adolescents with perinatally-acquired HIV infection (PHIV) or perinatally-exposed to HIV but uninfected (PHEU), (2) evaluate the safety of ARV treatment given to HIV-infected pregnant women on cardiac and pulmonary health of their children, and (3) explore the pathophysiologic mechanisms of cardiopulmonary abnormalities in PHIV and PHEU children and adolescents. The CPWG is comprised of 10-20 experts in cardiology, pulmonology, immunology, pediatrics, biostatistics, and epidemiology.
Some of the past projects include evaluation of serum biomarkers of cardiac function in both PHEU and PHIV children, echocardiographic measures of cardiovascular function and structure, and pulmonary function tests of PHIV and PHEU children. In terms of cardiovascular objectives, we have evaluated predictors of elevated cardiac and inflammatory biomarkers (such as C-reactive protein), and demonstrated associations of these biomarkers with echocardiographic measures among PHEU and PHIV children in both the PHACS SMARTT and AMP studies. We have also shown that PHIV children in the contemporary ARV era have marked improvement in cardiac function based on echocardiographic measures as compared to cohorts with perinatal HIV infection studied earlier in the HIV epidemic, but still show some differences from PHEU children of similar ages in the PHACS AMP study. In terms of pulmonary function, we demonstrated an increased risk of asthma and pulmonary complications in the PHIV children in AMP as compared to the PHEU controls, with some findings based on a PHACS substudy, the Ancillary Pulmonary Complications of HIV Infection study, in which pulmonary function tests were conducted in order to better understand the role of HIV in asthma and other pulmonary diseases.
Some of the current projects of the CPWG group include an R01-funded grant to conduct repeat echocardiograms on PHIV and PHEU young adults who previously had these performed in the AMP study about 10 years ago. This NHLBI-funded project will also include pulse wave velocity testing and collection of blood samples for evaluation of a comprehensive suite of cardiac and inflammatory biomarkers and markers of mitochondrial dysfunction. Another current project involves cardiac and pulmonary imaging studies of a small subset of PHIV young adults. Last of all, additional pulmonary studies are ongoing including an analysis to compare pulmonary function between PHIV and PHEU children and adolescents in the US to those in Kenya, and to better understand the mechanisms underlying obstructive lung disease.
The CPWG has also coordinated with other working groups to participate in research with overlapping interests. For example, the CPWG collaborated with the Metabolic, Nutrition, and Growth Working Group on an analysis of cardiac risk factors in adolescents aged 15 or older, based on risk prediction models, and completed two projects related to vitamin D deficiency and its relation to HIV infection status and echocardiographic outcomes. The creation of a DNA library on PHACS subjects also was strongly endorsed by the CPWG.
New directions of future research include proposals to use the extensive genotyping information obtained from the PHACS AMP study to better understand whether certain mutations may predispose patients to cardiovascular or pulmonary complications. These proposed genetic studies will take the PHACS program well into the next era of HIV medicine, namely the role of genetics in diagnosis and management of HIV infection in children, adolescents, and young adults.
1. Wilkinson JD, Williams PL, Yu W, et al for the Pediatric HIV/AIDS Cohort Study. Cardiac and inflammatory biomarkers in perinatally HIV-infected and HIV-exposed uninfected children. AIDS 2018 Jun 19,32(10):1267-1277. PMCID: PMC6387791. https://www.ncbi.nlm.nih.gov/pubmed/29596110
2. Shearer WT, Jacobson DL, Yu W, et al for the Pediatric HIV/AIDS Cohort Study. Long-term pulmonary complications in perinatally HIV-infected youth. J Allergy Clin Immunol 2017; pii: S0091-6749(17)30336-6.PMCID: PMC 5587357. https://www.ncbi.nlm.nih.gov/pubmed/28279683
5. Lipshultz SE, Williams PL, Wilkinson JD, et al for the Pediatric HIV/AIDS Cohort Study. Cardiac status of HIV-infected children treated with long-term combination antiretroviral therapy: results from the Adolescent Master Protocol of the NIH multicentre Pediatric HIV/AIDS Cohort Study. JAMA Pediatrics 2013; 167(6):520-7; PMCID: PMC4180681. http://www.ncbi.nlm.nih.gov/pubmed/23608879
Complications Working Group
Chair: Kunjal Patel, DSc, MPH, Senior Research Scientist, Harvard T. H. Chan School of Public Health
Chair: Russell Van Dyke, MD,Principal Investigator, PHACS Coordinating Center, Tulane University
The primary aim of the Complications working group is to identify infectious and non-infectious complications of HIV disease and evaluate their associations with antiretroviral therapy. Our working group therefore focuses on the AMP and AMP Up protocols of PHACS which include youth and young adults with perinatal HIV-infection and a comparison group of perinatally HIV-exposed but uninfected participants. Examples of our working group activities include examining trends in antiretroviral drug use, CD4 counts, HIV viral loads, and diagnoses; evaluating long-term treatment management strategies in the context of antiretroviral treatment failure, drug resistance and HIV tropism; comparing the effectiveness of vaccines for measles, mumps, rubella, varicella, and human papillomavirus among infected and uninfected youth and identifying correlates of effective immune responses; examining the relationship between tenofovir use and renal disease; estimating the prevalence of liver disease; examining oral health including the prevalence of dental caries and periodontal disease; identifying biomarkers of low proviral load to inform future cure and therapeutic vaccine strategies; and establishing a DNA repository for genomic studies. Our working group has also collaborated with international pediatric cohorts to answer research questions relevant to the global perinatal HIV epidemic.
1. Moscicki AB, Karalius B, Tassiopoulos K, Yao TJ, Jacobson DL, Patel K, Purswani M, and Seage III GR for the Pediatric HIV/AIDS Cohort Study. Human papillomavirus (HPV) antibody levels and quadravalent vaccine clinical effectiveness in perinatally-HIV infected and exposed, uninfected youth. Accepted by CID
2. Neilan AM, Karalius B, Patel K, Van Dyke RB, Abzug MJ, Agwu AL, Williams PL, Purswani M, Kacanek D, Oleske JM, Burchett SK, Wiznia A, Chernoff M, Seage GR III, and Ciaranello AL,for the Pediatric HIV/AIDS Cohort Study and the International Maternal Pediatric Adolescent AIDS Clinical Trials Network. Association of risk of viremia, immunosuppression, serious clinical events, and mortality with increasing age in perinatally human immunodeficiency virus-infected youth. JAMA Peds 2017; 171(5):450-460.PMCID: PMC 5411314. https://www.ncbi.nlm.nih.gov/pubmed/28346597
3. Purswani MU, Karalius B, Yao TJ, Schmid DS, Burchett SK, Siberry GK, Patel K, Van Dyke RB, & Yogev R, for the Pediatric HIV/AIDS Cohort Study. Prevalence and persistence of varicella antibodies in previously immunized children and youth with perinatal HIV-1-infection. Clinical Infectious Disease 2016; 62(1):106-14; PMCID: PMC4678104. http://www.ncbi.nlm.nih.gov/pubmed/26385992
4. Van Dyke RB, Patel K, Kagan RM, Karalius B, Traite S, Meyer WA 3rd, Tassiopoulos KK, Seage GR III, Seybolt LM, Burchett S, and Hazra R for the Pediatric HIV/AIDS Cohort Study (PHACS). Antiretroviral drug resistance among children and youth in the U.S. with perinatal HIV. Clin Infect Dis. 2016; 63(1):133-7; PMCID: PMC4901868. http://www.ncbi.nlm.nih.gov/pubmed/27056398
5. Moscicki A-B, Yao T-J, Ryder MI, Russell JS, Dominy SS, Patel K, McKenna M, Van Dyke RB, Seage GR III, Hazra R, and Shiboski C for the Pediatric HIV/AIDS Cohort Study. The burden of oral disease among perinatally HIV-infected and HIV-exposed uninfected youth. PLoS One 2016; 11(6); PMCID: PMC4907464. http://www.ncbi.nlm.nih.gov/pubmed/27299992
6. Uprety P, Patel K, Karalius B, Ziemniak C, Chen HY, Brummel S, Siminski S, Van Dyke RB, Seage GR III and Persaud D for the Pediatric HIV/AIDS Cohort Study. HIV-1 DNA decay dynamics with early, long-term virologic control of perinatal infection. Clin Infect Dis 2016; 64(11):1471-1478. PMCID: PMC 5434384. https://www.ncbi.nlm.nih.gov/pubmed/28329153
7. Siberry GK, Patel K, Bellini W, Karalius B, Purswani M, Burchett SK, Meyer WA III, Sowers SB, Ellis A, and Van Dyke RB for the Pediatric HIV AIDS Cohort Study. Immunity to measles, mumps and rubella in us children with perinatal HIV infection or perinatal HIV exposure without infection. Clin Infect Dis 2015; 61(6):988-95; PMCID: PMC4551008. http://www.ncbi.nlm.nih.gov/pubmed/26060291
COVID-19 Task Force
Chair: Denise Jacobson, PhD, MPH, Harvard T.H. Chan School of Public Health
Chair: Sue Siminski, MS, MBA, Principal Investigator, Frontier Science
Genomics Task Force
Chair: Sean Brummel, PhD, Senior Research Scientist, Harvard T.H. Chan School of Public Health
Chair: Stephen Spector, MD, Distinguished Professor of Pediatrics, University of California San Diego
The PHACS Genomics Task Force aims to promote and support genomic, epigenetic, and other “Omics” PHACS study proposals and analyses among HIV affected populations. Genomic studies in PHACS have focused on Single Nucleotide Polymorphisms (SNPs) and their associations with neurocognitive outcomes and bone mineral density. Genomic studies have also investigated the relationship between self-reported race and ancestry markers. While self-reported race is a critical measure for understanding the health impact of individuals' lived experiences of racism, some studies have incorrectly attributed differences by self-reported race to differences in genetics. Our findings showed great diversity in ancestry markers within self-reported racial groups, illustrating that self-reported race is not a proxy for genetic background. Additional genetic studies identified 3 SNPs within CCRL2, RETREG1, and YWHAH that are associated with neurocognitive impairment of children perinatally infected with HIV. Whereas a variant of CCRL2 is associated with a decreased risk of cognitive impairment and decreased inflammation, variants of RETREG1 and YWHAH are associated with an increased risk of cognitive impairment and increased inflammation. These findings suggest that therapeutic approaches that decrease inflammation may be of benefit to HIV-infected children with impaired cognitive function. Epigenetic analyses have focused on the effect of ART during pregnancy on global methylation in neonates and on the effect of living with HIV on epigenetic aging.
1. Rawat P, Brummel SS, Singh KK, Kim J, Frazer KA, Nichols S, Seage III GF, Williams PL, Van Dyke RB, Harismendy O, Trout RN, & Spector SA for the Pediatric HIV/AIDS Cohort Study. (2020). Genomics Links Inflammation With Neurocognitive Impairment in Children Living With Human Immunodeficiency Virus Type-1. The Journal of Infectious Diseases.
2. Shiau S, Brummel SS, Kennedy EM, Hermetz K, Spector SA, Williams, PL, Smith R, Drury SS, Agwu A, Ellis A, Patel K, Seage III GR, Van Dyke RB, & Marsit CJ for the Pediatric HIV/AIDS Cohort Study (PHACS. (2021). Longitudinal changes in epigenetic age in youth with perinatally acquired HIV and youth who are perinatally HIV-exposed uninfected. AIDS, 35(5), 811-819.
3. Wang Y, Brummel SS, Beilstein-Wedel E, Dagnall CL, Hazra R, Kacanek D, Chadwick EG, Marsit CJ, Chanock SJ, Savage SA, Poirer MC, Machiela MJ, Engels EA for the Pediatric HIV/AIDS Cohort Study, A. C. (2019). Association between zidovudine-containing antiretroviral therapy exposure in utero and leukocyte telomere length at birth. AIDS (London, England), 33(13), 2091.
4. Spector SA, Brummel SS, Nievergelt CM, Maihofer AX, Singh KK, Purswani MU, Williams PL, Hazra R, Van Dyke RB, & Seage III GR for the Pediatric HIV/AIDS Cohort Study. (2016). Genetically determined ancestry is more informative than self-reported race in HIV-infected and-exposed children. Medicine, 95(36).
5. Marsit CJ, Brummel SS, Kacanek D, Seage III GR, Spector SA, Armstrong DA, Lester BM, & Rich K for the Pediatric HIV/AIDS Cohort Studies Network. (2015). Infant peripheral blood repetitive element hypomethylation associated with antiretroviral therapy in utero. Epigenetics, 10(8), 708-716.
Hearing and Language Task Force
Chair: Peter Torre, PhD, Associate Professor, School of Speech, Language, and Hearing Science, San Diego State University
Chair: Tzy-Jyun Yao, PhD, Senior Statistician, Harvard T. H. Chan School of Public Health
The Hearing/Language Working Group is a team of hearing scientists, speech/language pathologists, pediatricians, psychologists, epidemiologists and statisticians whose main goal is to examine the effects of HIV and/or antiretroviral therapy (ART) exposures on hearing and/or language acquisition in youth who were exposed to HIV or infected perinatally. Examples of our working group activities include investigations of hearing mechanisms, language acquisition in infants and toddlers, risk for and consistency of language impairments in school-aged children, and the persistence of language impairments into adulthood. We are also interested in the safety of ART treatment and in the effects of congenital infections and other comorbid maternal conditions on language development and hearing outcomes in HIV-exposed uninfected children.
1. Rice ML, Russell JS, Frederick T, Purswani M, Williams PL, Siberry GK, Redmond SM, Hoffman HJ, Yao TJ for the Pediatric HIV/AIDS Cohort Study. Risk for speech and language impairments in preschool age HIV-exposed uninfected children with in utero combination antiretroviral exposure. Pediatr Infect Dis J. 2018; 37:678–685. PMCID: PMC 5995619 https://www.ncbi.nlm.nih.gov/pubmed/29278615
2. Torre P, Zeldow B, Yao TJ, Hoffman HJ, Siberry GK, Purswani M, Frederick T, Spector SA, Williams PL for the Pediatric HIV/AIDS Cohort Study. Newborn hearing screenings in human immunodeficiency virus-exposed uninfected infants. J AIDS Immune Res. 2016; 1(1): 102. PMCID:PMC 5407375. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407375/
3. Redmond SM, Yao T-J, Russell JS, Rice ML, Hoffman HJ, Siberry GK, Frederick T, Purswani M, and Williams PL for the Pediatric HIV/AIDS Cohort Study. Longitudinal evaluation of language impairment in youth with perinatally acquired HIV and youth who were perinatally exposed to HIV and uninfected. J Pediatr Infect Dis Soc. 2016; 5(suppl 1): S33-S40. PMCID: PMC5181542. https://www.ncbi.nlm.nih.gov/pubmed/27856674
4. Torre III P, Zeldow B, Hoffman HJ, Buchanan AL, Siberry GK, Rice ML, Sirois PA,Williams PL. Hearing loss in perinatally HIV-infected and HIV-exposed but uninfected children and adolescents. Pediatr Infect Dis J. 2012; 31(8): 835-841. PMCID: 3410657. http://www.ncbi.nlm.nih.gov/pubmed/22549437
5. Rice M, Buchanan A, Siberry G, Malee K, Zeldow B, Frederick T, Purswani M, Hoffman H, Sirois P, Smith R, Torre P, Allison S, and Williams P for the Pediatric HIV/AIDS Cohort Study. Language impairment in children perinatally infected with HIV compared to children who were HIV-exposed and uninfected. J Dev Behav Pediatr. 2012; 33(2):112-23. PMCID: PMC3310927. http://www.ncbi.nlm.nih.gov/pubmed/22179050
Maternal Exposures Working Group
Chair: Ellen Chadwick, MD, PHACS Principal Investigator, Ann & Robert H. Lurie Children's Hospital of Chicago
Chair: Deborah Kacanek, ScD, Social Epidemiologist, Harvard T. H. Chan School of Public Health
The Maternal Exposures Working Group examines the relationship of individual, clinical, and social factors during pregnancy and motherhood among women living with HIV to birth outcomes and health of their children. Our studies focus on evaluating associations of maternal HIV disease severity, use of specific antiretroviral drugs, maternal mental health and substance use with pregnancy outcomes (e.g., gestational age at birth, the size of the newborn, mode of delivery, subtle or major birth defects), as well as child health and development through young adulthood. As newer antiretroviral drugs are used more widely, we conduct studies to evaluate the safety of their use during pregnancy. We apply novel strategies to measure the amount of antiretroviral drugs that cross the placenta and into the fetus by examining presence in meconium (the first stools produced by the newborn) and maternal and infant hair. Our studies also seek to determine whether events that happen in pregnancy affect the genetics of the body (epigenetic studies) and the energy system of the cells (mitochondrial function).
1. Rough K, Seage GR III, Williams PL, Hernandez-Diaz S, Huo Y, Chadwick EG, Currier JS, Hoffman RM, Barr E, Shapiro DE, Patel K for the Pediatric HIV/AIDS Cohort Study (PHACS) and International Maternal Pediatric Adolescent AIDS Clinical Trial (IMPAACT) P1025 Study Teams. Birth outcomes for pregnant women with HIV using tenofovir-emtricitabine. N Engl J Med 2018; 378:1593-1603. PMCID: PMC5984044 https://www.ncbi.nlm.nih.gov/pubmed/29694825
2. Jao J, Kacanek D, Williams PL, Geffner ME, Livingston EG, Sperling RS, Patel K, Bardequez AD, Burchett SK, Chakhtoura N, Scott GB, Van Dyke RB, Abrams EJ for the Pediatric HIV/AIDS Cohort Study and International Maternal Pediatric Adolescent AIDS Clinical Trials Network. Birth weight and preterm delivery outcomes of perinatally vs. non-perinatally HIV-infected pregnant women in the U.S.: results from the PHACS SMARTT study and IMPAACT P1025 protocol. Clin Infect Dis 2017; 65(6):982-989. PMCID: PMC 5849107. https://www.ncbi.nlm.nih.gov/pubmed/28575201
3. Williams PL, Hazra R, Van Dyke RB, Yildirim C, Crain MJ, Seage GR III, Civitello L, Ellis A, Butler L, Rich K for the Pediatric HIV/AIDS Cohort Study. Antiretroviral exposure during pregnancy and adverse outcomes in HIV-exposed uninfected infants and children using a trigger-based design: The SMARTT Study. AIDS 2016; 30(1):133-44; PMCID: PMC4704129. http://www.ncbi.nlm.nih.gov/pubmed/26731758
4. Caniglia EC, Patel K, Huo Y, Williams PL, Kapetanovic S, Rich K, Sirois PA, Jacobson DA, Hernandez-Diaz S, Hernan MA, Seage GR III for the Pediatric HIV/AIDS Cohort Study. Atazanavir exposure in utero and neurodevelopment in infants: A comparative safety study. AIDS 2016; 30(8):1267-78; PMCID: PMC4851579. http://www.ncbi.nlm.nih.gov/pubmed/26867136
5. Williams PL, Crain M, Yildirim C, Hazra R, Van Dyke RB, Rich K, Read JS, Stuard E, Rathore M, Mendez HA, and Watts DH for the Pediatric HIV/AIDS Cohort Study. Congenital anomalies and in utero antiretroviral exposure in human immunodeficiency virus - exposed uninfected infants. JAMA Pediatrics 2014; 169(1):48-55. PMCID: PMC4286442. http://www.ncbi.nlm.nih.gov/pubmed/25383770
6. Watts DH, Williams PL, Kacanek D, Griner R, Rich K, Hazra, R, Mofenson, LM, Mendez, HA for the Pediatric HIV/AIDS Cohort Study. Combination Antiretroviral Use and Preterm Birth. Journal of Infectious Diseases. 2013; 207(4):612-21. PMCID:PMC3549601.
Mental Health, Neurodevelopment and Neurologic Conditions Working Group
Chair: Kay Malee, PhD, Psychologist, Ann & Robert H. Lurie Children's Hospital of Chicago
Chair: Renee Smith, PhD, Pediatric Research Psychologist, University of Illinois at Chicago
Chair: Katherine Tassiopoulos, DSc, Senior Research Scientist, Harvard T. H. Chan School of Public Health
The Mental Health, Neurodevelopment and Neurologic Conditions Working Group is a team of psychologists, psychiatrists, neurologists, pediatricians, epidemiologists and statisticians whose main goal is to examine the neurodevelopmental and neurological effects of HIV and/or antiretroviral medications (ARTs) on youth who were exposed or infected perinatally. We examine the potential short- and long-term consequences of exposure to or infection with HIV and its treatment on cognition, academic achievement, and on the neurological, emotional, and behavioral development of youth over time. We also examine how the environment and other possible stressors and/or protectors contribute to all of these developmental outcomes.
1. Smith, R., Huo, Y., Tassiopoulos, K., Rutstein R., Kapetanovic, S., Mellins, C., Kacanek, D. Malee, K. (2019). Mental health diagnoses, symptoms, and service utilization in US youth with perinatal HIV infection or HIV exposure. AIDS Patient Care and STDs, 33(1): 1-13.
2. Lewis-de los Angeles CP, Williams PL, Huo Y, Wang SD, Uban KA, Herting MH, Malee K, Yogev R, Csernansky JG, Nichols S, Van Dyke RB, Sowell ER, Wang L for the Pediatric HIV/AIDS Cohort Study (PHACS) and the Pediatric Imaging, Neurocognition, and Genetics (PING) Study. Lower total and regional grey matter brain volumes in youth with perinatally acquired HIV infection: Associations with HIV disease severity, substance use and cognition. Brain, Behavior, and Immunity 2017; 62:100-109. https://www.ncbi.nlm.nih.gov/pubmed/28089557
3. Malee K, Chernoff MC, Sirois PA, Williams PL, Garvie PA, Kammerer BL, Harris LL, Nozyce ML, Yildirim C, Nichols SL for the Memory and Executive Functioning Study of the Pediatric HIV/AIDS Cohort Study. Impact of perinatally acquired HIV disease upon longitudinal changes in memory and executive functioning. Journal of Acquired Immune Deficiency Syndromes 2017; 75 (4):455-464. https://www.ncbi.nlm.nih.gov/pubmed/28481783
4. Garvie PA, Brummel SS, Allison SM, Malee KM, Mellins CA, Wilkins ML, Harris LL, Patton ED, Chernoff MC, Rutstein RM, Paul ME, Nichols SL for the Pediatric HIV/AIDS Cohort Study (PHACS). Roles of medication responsibility, executive and adaptive functioning in adherence for children and adolescents with perinatally acquired HIV. Pediatric Infectious Diseases Journal 2017; 36(8): 51-757. https://www.ncbi.nlm.nih.gov/pubmed/28709161
5. Harris L, Chernoff M, Nichols S, Williams P, Garvie P, Yildirim C, McCauley S, Woods S. Prospective memory in youth with perinatally-acquired HIV infection. Child Neuropsychology 2017; 7:1-21. https://www.ncbi.nlm.nih.gov/pubmed/28782457
Nutrition-Growth-Metabolism Working Group
Chair: Denise Jacobson, PhD, Senior Research Scientist, Harvard T. H. Chan School of Public Health
Chair: Jennifer Jao, MD, MPH, Associate Professor of Pediatrics, Northwestern Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago
The primary aims of Nutrition-Growth-Metabolic Working Group are to investigate the effects of HIV and antiretroviral medications on aspects of nutrition, growth, and metabolism in children, youth and young adults living with perinatally acquired HIV infection (PHIV) and those who are perinatally HIV-exposed but uninfected (PHEU). We are also investigating nutrition and metabolic issues in pregnant women living with HIV and their effects on birth and child outcomes. In particular, we have published studies on distribution of fat mass, the prevalence and incidence of insulin resistance, pubertal onset, vascular markers of endothelial dysfunction, cardiovascular disease risk, bone mineral density, vitamin D and parathyroid levels and associations with bone density in PHIV compared to PHEU and mitochondrial abnormalities and insulin resistance, and changes in lipids after switching to newer protease inhibitor agents. In PHEU children we have published many studies evaluating growth and metabolic abnormalities associated with in utero antiretroviral medication exposure . Currently we are investigating fracture rates since birth, blood pressure and cardiac health, physical activity, lipid abnormalities, longitudinal assessments of bone growth, and mitochondrial abnormalities among individuals with PHIV, and among those with PHEU, growth patterns by preterm birth, small-for-gestational age, and maternal PHIV status.
1. Sudfeld CR, Jacobson DL, Rueda NM, Neri D, Mendez AJ, Butler L, Siminski S, Hendricks KM, Mellins CA, Duggan CP, Miller TL for Pediatric HIV/AIDS Cohort Study. Third trimester vitamin D status is associated with birth outcomes and linear growth of HIV-exposed uninfected infants in the United States. J Acquir Immune Defic Syndr. 2019 Apr 1. doi: 10.1097/QAI.0000000000002041. [Epub ahead of print] PMID: 31021992 [PubMed - as supplied by publisher]
2. Jao J, Jacobson DL, Yu W, Borkowsky W, Geffner ME, McFarland EJ, Patel K, Williams PL, Miller T; Pediatric HIV/AIDS Cohort Study. A comparison of metabolic outcomes between obese HIV- exposed uninfected youth from the Pediatric HIV/AIDS Cohort SMARTT Study and HIV-unexposed youth from the U.S. National Health and Nutrition Examination Survey (NHANES). J Acquir Immun Defic Syndr 2019; in press. https://www.ncbi.nlm.nih.gov/pubmed/30844997
3. Takemoto JK, Miller TL, Wang J, Jacobson DL, Geffner ME, Van Dyke RB, and Gerschenson M for the Pediatric HIV/AIDS Cohort Study. Insulin Resistance in HIV-Infected Youth is associated with decreased mitochondrial respiration. AIDS 2016. 31(1):15-23. PMCID: PMC 5131681. https://www.ncbi.nlm.nih.gov/pubmed/27755108
4. DiMeglio L, Wang J, Siberry G, Miller T, Geffner M, Hazra R, Borkowsky W, Chen J, Dooley L, Patel K, Van Dyke R, Fielding R, Gurmu Y, and Jacobson D for the Pediatric HIV/AIDS Cohort Study. Bone mineral density in children and adolescents with perinatal HIV infection. AIDS 2013; 27(2):211-20; PMCID: PMC4157938. http://www.ncbi.nlm.nih.gov/pubmed/23032412
5. Jacobson D, Patel K, Siberry G, Van Dyke R, DiMeglio L, Geffner M, Chen J, McFarland E, Borkowsky W, Silio M, Fielding R, Siminski S, and Miller T for the Pediatric HIV/AIDS Cohort Study. Body fat distribution in perinatally HIV-infected and HIV-exposed but uninfected children in the era of highly active antiretroviral therapy: outcomes from the Pediatric HIV/AIDS Cohort Study. Am J Clin Nutr 2011; 94(6):1485-95. PMCID: PMC3252548. http://www.ncbi.nlm.nih.gov/pubmed/22049166
Oral Health Task Force
Chair: Barbara Moscicki, MD, Professor of Pediatrics, University of California Los Angeles Chair: Mark Ryder, DMD, Professor of Orofacial Sciences, University of California San Francisco
Chair: Caroline Shiboski, DDS, PhD, Professor of Orofacial Sciences, University of California San Francisco
Chair: Tzy-Jyun Yao, PhD, Harvard T.H. Chan School of Public Health
The primary aims of the Oral Health Task Force are to identify factors associated with poor oral health among persons living with perinatal HIV and among those HIV-exposed but uninfected. More specifically, mucosal oral health, periodontal health and enamel (caries) health are targeted. Factors affecting oral health that we examine include behavioral (oral hygiene, tobacco, alcohol and other substance use), as well as adverse effects of ARV and inflammation. Biomarkers of inflammation are examined by assaying crevicular fluid and saliva samples for cytokines, chemokines, and bone turnover markers. In addition, the task force examines social determinants of access to dental care. Examples of our findings include the observation that gingivitis or periodontitis was quite common (around 80%) among those living with PHIV and caries (cavities) were higher in those living with PHIV compared to those with PHEU. Among those living with PHIV, integrase strand inhibitors appeared to be associated with caries. We also found that inflammation using biomarkers was associated with periodontal inflammation among those living with PHIV but not among those PHEU suggesting youth living with PHIV may be at higher risk for developing significant periodontal diseases which are associated with tooth loss and HIV progression. In another study examining metabolites, we showed that individuals with periodontitis had high levels of cadaverine, suggesting that HIV infection, or its treatment, may influence the metabolism of oral bacteria.
The task force completed a follow-up study. The future goal is to study the change of oral health over time and the factors to predict incidence or progression with the collected information.
Moscicki AB, Yao TJ, Russell JS, Farhat S, Scott M, Magpantay L, Halec G, Shiboski CH, Ryder MI; Pediatric HIV/AIDS Cohort Study. Biomarkers of oral inflammation in perinatally HIV-infected and perinatally HIV-exposed, uninfected youth. J Clin Periodontol 2019 Nov; 46(11):1072-1082.
Starr JR, Huang Y, Lee KH, Murphy CM, Moscicki AB, Shiboski CH, Ryder MI, Yao TJ, Faller LL, Van Dyke RB, Paster BJ; Pediatric HIV/AIDS Cohort Study. Oral microbiota in youth with perinatally acquired HIV infection.Microbiome 2018 May 31; 6(1):100.
Shiboski CH, Yao TJ, Russell JS, Ryder MI, Van Dyke RB, Seage GR 3rd, Moscicki AB; Pediatric HIV/AIDS Cohort Study. The association between oral disease and type of antiretroviral therapy among perinatally HIV-infected youth. AIDS 2018 Nov 13;32(17):2497-2505.
Ryder MI, Yao TJ, Russell JS, Moscicki AB, Shiboski CH; Pediatric HIV/AIDS Cohort Study. Prevalence of periodontal diseases in a multicenter cohort of perinatally HIV-infected and HIV-exposed and uninfected youth. J Clin Periodontol 2017; 44(1):2-12.
Moscicki AB, Yao TJ, Ryder MI, Russell JS, Dominy SS, Patel K, McKenna M, Van Dyke RB, Seage GR 3rd, Hazra R; Shiboski. The Burden of Oral Disease among Perinatally HIV-Infected and HIV-Exposed Uninfected Youth.PLoS One 2016;11(6):e0156459.
Women's Health Working Group
Chair: Deborah Kacanek, ScD, Social Epidemiologist, Harvard T. H. Chan School of Public Health
Chair: Kate Powis, MD, Research Associate, Harvard T. H. Chan School of Public Health
The mission of the Women’s Health Working Group (WHWG) is to address the health and well-being of reproductive aged women living with or affected by HIV through impactful research driven by PHACS community members, including CAB members, study staff and investigators, and to support new investigators to conduct women’s health research. Working with women participating in SMARTT, AMP, AMP UP and AMP UP Lite protocols of PHACS, we foster collaborative research efforts to expand our understanding of health issues which have an impact on women living with HIV. Examples of research in progress include studies examining trends in ART prescribing patterns for pregnant women, determinants of viral suppression and CD4 in repeat pregnancies, substance use in pregnancy and in the postpartum period, associations of ART with hypertensive disorders of pregnancy, and relationship of antiretroviral treatment (ART) to weight gain during pregnancy and postpartum. The WHWG is committed to investigating biomedical, as well as social determinants of women’s physical health, mental health, and health-related behaviors to inform guidelines and policies to optimize the health of women living with or affected by HIV.