Stellenbosch University’s Clive Gray receives the Harry Oppenheimer Fellowship Award, advancing his pioneering research on the effects of long-term antiretroviral treatment in HIV-positive mothers, shedding light on its link to premature births.
In a groundbreaking study, Professor Clive Gray of Stellenbosch University, South Africa, has established a significant link between long-term antiretroviral treatment in HIV-positive mothers and premature births. This research, supported by the Oppenheimer Memorial Trust’s Harry Oppenheimer Fellowship Award, could reshape our understanding of the effects of antiretroviral therapy (ART) on maternal and child health.
“What we found is that women who received pre-pregnancy antiretroviral treatment had a higher risk of maternal vascular malperfusion,” explains Professor Gray to FORBES AFRICA. This condition, characterized by the improper penetration of maternal blood vessels into the placenta, leads to insufficient oxygen and nutrient delivery to the fetus, increasing the risk of premature birth and low birth weight.
The research identified a key molecule, referred to as Factor X, found in lower levels in the placentas of women who give birth prematurely. Factor X, an enzyme present in macrophages (a type of white blood cell), is crucial for proper placental blood vessel formation. This discovery paves the way for developing predictive markers for adverse birth outcomes.
“Our aim is not to change policy or the use of antiretrovirals, but to understand their implications,” emphasizes Professor Gray. “If we can identify who is at risk, we can recommend adjunctive treatments to mitigate these risks.”
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The implications of this research are profound. Maternal vascular malperfusion not only affects the immediate health of the newborn but also has long-term impacts, including developmental delays and neurocognitive disorders. Children exposed to HIV in-utero but not infected often exhibit learning difficulties, increased susceptibility to infections, and other health challenges.
“These HIV exposed uninfected children are not healthy,” Gray notes. “They suffer from more bacterial and viral infections, especially in the first few years of life, than their counterparts who are born to HIV uninfected mothers.”
The study highlights the need for a deeper understanding of how antiretroviral drugs interact with placental and fetal development. Gray’s team is investigating the exact mechanisms through which these drugs influence maternal vascular malperfusion and seeking to develop a biomarker for predicting which women are at risk.
Gray’s research has been significantly bolstered by the Oppenheimer Memorial Trust’s Harry Oppenheimer Fellowship Award. This award, recognizing world-class research with far-reaching impacts, will fund the continuation and expansion of Gray’s studies.
With the award’s support, Gray’s team aims to refine their predictive marker and explore potential interventions to counteract the negative effects of antiretrovirals on placental development. The ultimate goal is to ensure that HIV-positive mothers can receive effective treatment without compromising their babies’ health.
A New Frontier in HIV Research
Gray’s work is pioneering in the field of reproductive immunology and HIV research. The findings challenge the existing understanding of antiretroviral therapy’s safety during pregnancy and highlight the need for ongoing investigation into its long-term effects.
“There is a substantial body of research on the HIV-exposed infant, but what’s missing is the immunological perspective, particularly concerning the placenta,” Gray explains. “Our research fills this gap and opens up new possibilities for improving maternal and child health outcomes.”
As Gray’s team continues to investigate the complex interactions between antiretroviral drugs and placental development, their work promises to have significant implications for public health policies and clinical practices worldwide.
“Our findings underscore the importance of monitoring and supporting the health of HIV-positive mothers and their babies,” Gray concludes. “By understanding the risks and developing targeted interventions, we can improve outcomes for both mothers and children.”
Looking Ahead
The future of this research holds promise. Gray and his team are writing grants to the National Institutes of Health to further investigate the link between HIV infection, placental dysfunction, and child development outcomes. They aim to establish a comprehensive understanding of the impact of antiretroviral therapy on both maternal and child health.
“Our goal is to create a predictive model for adverse birth outcomes and to develop interventions that can mitigate these risks,” Gray states. “We are committed to ensuring that HIV-positive mothers can receive the best possible care without compromising their children’s health.
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