Institution: U.S. Military HIV Research Program
Global efforts to eradicate vertical mother-to-child HIV transmission have shown remarkable success by providing antiretroviral treatment to expectant mothers. Around the world, this has led to a spike in the population of children exposed to HIV during prenatal development despite being uninfected (HEU). Unfortunately, in countries such as Thailand, social stigma often prevents expecting mothers from accepting medication, and viral transition rates remain much higher than in the US. Nevertheless, early treatment and intervention is allowing these HIV+ children to live well beyond the previous life expectancy of 2, and into adulthood. On average, HIV+ children – and to some degree HEU children – show marked cognitive deficits and behavioral problems, throughout development, yet there is currently no comprehensive understanding of the underlying neurobiology. A hallmark of adolescent brain development is the significant axonal pruning and reorganization of brain white matter pathways. Identifying cognitive and behavior associations with delays in brain development and/or deficits in white matter microstructure will allow for targeted therapies.