Harvard School of Public Health
Boston, MA

Principal Investigator: Dr. Max Essex
Chair of the Harvard AIDS Initiative
Lasker Professor of Health Sciences at Harvard University
Chair of the Botswana–Harvard AIDS Institute

Dear Members and Supporters of the T.J. Martell Foundation for Leukemia, Cancer, and AIDS Research:

This is to express my gratitude for your recent decision to fund our research on HIV/AIDS in children.  This support is particularly valuable to allow us to begin new projects.  We work with a population where at least a quarter of the pregnant women are HIV infected, putting their infants at great risk for death and disease.

            One of our projects focuses on mechanisms to prevent pneumonia and diarrheal diseases in children born to HIV-positive mothers.  We recently had great success in protecting infants from maternal HIV infections with antiretroviral drugs.  However, it is clear that even HIV-uninfected infants, who are born to HIV-positive mothers, have an increased risk of death from pneumonia and diarrhea.  To address this, we are using a multipronged approach that includes both clinical intervention and better characterization of the children’s risk.

            For interventions, we are testing the efficacy of cotrimoxazole, a very inexpensive antibiotic, to prevent serious infections in the children at their time of greatest risk.  The cotrimoxazole will be tested for prevention of infant deaths up to, and just after, weaning.  We are also testing iron supplementation as a means to prevent neonatal anemias, especially those that might occur in infants born to mothers that have a particular strain of HIV that is associated with anemia in the mothers.  To better understand the origin of this type of anemia, we will compare the HIV viruses of pregnant women to see which HIVs have the greatest ability to grow in bone marrow progenitor cells, and whether these viruses cause higher viral loads in the pregnant women.  High viral loads have been linked to a high risk of maternal transmission.  Although we can now block most maternal transmission of HIV to infants, it is important to determine if this is also associated with a high risk of pneumonia and diarrheas in HIV-uninfected infants.  If so, we can use antiretroviral drugs for longer periods in the pregnant women to prevent this.

            The new T.J. Martell Foundation support will allow us to test new hypotheses and interventions to protect children from the disaster of HIV/AIDS.  We are grateful for this support.

Sincerely,

M. Essex