Research question
What is the effect of HIV infection and highly active antiretroviral treatment (HAART) on the changing immune system during pregnancy.

Fit with Africa Centre research portfolio
This project fits in Objective 1 in the Africa Centre research strategy: HIV dynamics – understanding the HIV epidemic. 

The Africa Centre is a participating site in the EDCTP-funded Kesho Bora trial evaluating the role of HAART in reducing the risk of mother-to-child transmission of HIV during breastfeeding which will be completed in 2010 and for which preliminary results are available. Results suggest that HAART during pregnancy and the breastfeeding period (continued throughout 6 months of breastfeeding) significantly and substantially decreases the risk of mother-to-child transmission. Furthermore, it takes forward Professor Newell’s European work (that HAART given from before or early pregnancy, while substantially reducing the risk of transmission to the infant, is also associated with a substantially increased risk of premature delivery.

Methods/study design
The proposal for this study is being written, in collaboration with immunologists from Durban (William Carr) and Harvard (Marcus Altfeld, Marilyn Aldo). A prospective pregnancy cohort will be established from women in the PMTCT programme and children followed up at the family clinic, which was established as part of the HIV Treatment and Care Programme.