Invitation for single/Multi centric project proposals on Pediatric HIV

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Invitation for single/Multi centric project proposals on Pediatric HIV

Last Date of Submission : December 15, 2007

Background

By the end of November 2005, the total number of reported AIDS cases

in India was 116,905 people of which 34,177 were women (NACO,2005) .

This data also indicates that about one third of reported AIDS cases are among

young people under the age of 30 years. However many more AID cases go

unreported. The total AIDS deaths reported as on December,2005 is only 8097

(NACO,2005).

Perinatal transmission to the infant is to the tune of 3.6% .It is

significant to note from the walk-in-clinic data from VCTC, young people

seropositive cases below 14 years of age makes up to 4.3%. The new AIDS

infections among children were 0.05 and 0.06 million cases in the years 2003 and

2004 respectively.

However, half of these children die undiagnosed before their 2nd birthday. WHO

program of " 3 " by " 5 " whereby 3 million people would be given antiretroviral

therapy (ART)by the year 2005 also included that of these 10 to 15% of would be

children.

However, very few children in India had access to ART till year 2005

and thus even though children represent about 4% of the total population of

HIV/AIDS they accounted for almost 18% of the deaths in 2005.

Multi centric project Proposals are invited to conduct in-depth

research on various aspects of Pediatric HIV.

The key research areas identified in Pediatric HIV infections are

given below:

Epidemiology

• Identification of HIV infected children

– Geographic area (Urban/rural/slums)

– Street children

– Parental migration

• Social impact of HIV infection of children

• Issues in PMTCT:

– Intervention

– Role of vaccines to mothers (Hib, pneumococcal)

• Issues related to maternal nutrition and nutrition of the HIV

infected

Children

Clinical manifestations

• Cohort study: enrolment, follow up for

– Clinical manifestations

– OIs

– Natural history

– Tropical diseases

• Impact of nutritional deficiencies on the above

• Incidence of TB in HIV infected children

• Cost efficacy of special immunizations(Hib, pneumococcal, chicken

pox)

Tuberculosis

• Epidemiology

• Better diagnostic tools

– Clinical tools/ algorithms

– Newer diagnostic tests

• Role of chemoprophylaxis

• Pharmacokinetic studies: drug interactions

Diagnosis

• Validation of diagnostic algorithm based on clinical features in

children

less than 18 months and above 18 month of age.

• Documentation of normal CD4, CD8 counts, CD4/CD8 ratio

• Role of CD4/CD8 ratio of <1 in the diagnosis in HIV infection in

babies

born to HIV +ve mothers

• Validation of role on induce sputum for isolation of respiratory

pathogens.

• Development of test for diagnosis of invasive fungal infection.

• Validation of PCR techniques for diagnosis of HIV infection in

babies

born to HIV +ve mothers

Nutrition

• Nutrition and micronutrient deficiency impact on clinical

manifestation and

course of illness in HIV infected children.

• Role of nutritional supplementation/ micronutrient as an adjunct to

ART in

HIV infected children.

• Metabolic disorders in children on ART: incidence and effect on

outcome.

• Resting energy expenditure in HIV infected children

• Growth pattern of HIV infected children

Treatment

• Pharmacokinetic studies – NVP, EFV

• Efficacy of ART

– FDC

– Comparison with PI base regimen

– Determinants of response

• Methods to judge adherence

• Strategies to improve adherence

Drug resistance

• Surveillance for drug resistance in children on ART in relation to

time

• Drug resistance in mother and child pairs who were treated with

single dose

nevirapine during perinatal period.

• Alternative regimen for failing regimens (3 TC, structured treatment

interruption)

• Surrogate markers for early detection of drug resistance

Operational research

• HIV services delivery models (Decentralization)

Main streaming of services in RCH program

For Queries Contact :

Dr. Vasantha Thavaraj

Deputy Director General(SG)

Division of Reproductive Health & Nutrition

Indian Council of Medical Research, New Delhi

Email : sowmyam.vasantha@...

http://www.icmr.nic.in/icmrnews/HIV_pediatric.pdf