Surveillance Monitoring for ART Toxicities Study in HIV Uninfected Children Born to HIV Infected Women

NCT01310023 | Completed

• 3 other identifiers: 1P01HD103133 - PH100PH1001P01HD103133
• Study Type: observational
• Target: 5,169
• Locations: 2 countries
• Sites: 22

Brief Summary

SMARTT will estimate the incidence of conditions and diagnoses potentially related to in utero exposure to antiretroviral therapy and/or exposure in the first two months of life among children born of HIV-infected mothers.

Conditions

Antiretroviral Toxicity

Keywords

Conditions and diagnoses potentially related to perinatal exposure to antiretroviral medications

Outcome Measures

Primary Outcomes (9)

• Neurologic abnormalities

  Assessed via head circumference measurement and medical record review for documented clinical diagnoses of seizures, microcephaly, or other neurologic diagnosis.

  Annually birth through age 5; semiannual thereafter, assessments vary based on age of child.

• Neurodevelopmental abnormalities

  Assessed via the following neurodevelopmental tests: Bayley Screener, Bayley III, WPPSI-III, BASC-2, WASI, WISC-IV, BRIEF, WIAT II.

  1, 3, 5, 9, and 13 years of age, assessments vary based on age of child.

• Abnormal growth and metabolic function

  Assessed through the measurement of height, weight, tricep skinfold thickness, mid-upperarm circumference measurements, insulin and glucose, and fasting lipids.

  Annually birth through age 5; semiannual thereafter, assessments vary based on age of child.

• Cardiac abnormalities

  Assessed through the administration of echocardiograms and serum biomarkers (ProBNP).

  Ages 3-5.

• Hearing dysfunction

  Assessed via audiologic evaluation conducted by an audiologist.

  At age 5 and for children of all ages meeting a hearing/language trigger.

• Language dysfunction

  Assessed via the following language tests: MCDI, Ages and Stages Communication Scale, PPVT IV, Goldman Fristoe 2, Rice Wexler, TELD-3, TOLD-3, Woodcock, CELF IV.

  1, 2, 3, 5, and 9 years of age, assessments vary based on age.

• Drug Use and Sexual Activity

  The assessment of sexual behavior and substance use will be conducted using an Audio Computer Assisted Survey Instrument (ACASI). ACASI uses computer and voice recordings so that the participant hears (through headphones) and sees (on the screen) each question and response list. The use of ACASI is proven to minimize response bias due to the presence of an interviewer.

  11, 13, 15, and 17 years of age.

• Abnormal organ function

  Assessed through the measurement of lipase, CPK, ALT, creatinine, glucose, LDH, BUN, WBC, PMN, lymphocytes, platelets, or hemoglobin ( ≥ Grade 3 adverse event).

  Birth and age one, semiannual thereafter.

• Death due to unknown medical condition

  Assessed through autopsy review.

  Annual.

Secondary Outcomes (1)

• Maternal substance use during pregnancy

  Entry visit.

Study Arms (4)

Static Cohort- closed to enrollment and follow-up

HIV-uninfected children \< 12 years of age at the time of enrollment, born of HIV-infected mothers

Dynamic Cohort

HIV-uninfected children born of HIV-infected mothers enrolled from prior to birth through ≤ 72 hours of age

Reference Cohort- closed to enrollment and follow-up

HIV-uninfected children born to a mother HIV uninfected at the time of the child's birth enrolled at 1, 3, 5, or 9 years of age(± 3 months) at the time of the study visit

Young Adult Cohort- closed to enrollment and follow-up

Former Dynamic and Static Cohort participants ≥ 18 years of age.

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Children aged 0 - \< 12 years born of HIV-infected mothers recruited from a clinical setting.

You may qualify if:

• Dynamic Cohort:
• HIV-exposed living fetus greater than or equal to 23 weeks gestation or a live infant born after 22 weeks gestation. Infants exposed and unexposed to ART will be enrolled.
• Any infant born of an HIV-infected mother may be enrolled pending determination of the infant's HIV infection status. However, infants found to be HIV-positive will be discontinued from the study and will be referred for care outside this study. HIV infection status will be determined using the Diagnosis of Lack of Infection in HIV-Exposed Children.
• ART exposure data by trimester of pregnancy must be available if ART exposed.
• Entry prior to birth through \< 72 hours of age.
• Willingness of parent/legal guardian to provide written permission for child to participate in study.
• Willingness of biological mother to enroll at initial enrollment of her child.

You may not qualify if:

• Dynamic Cohort:
• None

Sponsors & Collaborators

• Harvard School of Public Health (HSPH): lead
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): collaborator
• National Institute on Drug Abuse (NIDA): collaborator
• National Institute of Allergy and Infectious Diseases (NIAID): collaborator
• National Institute of Mental Health (NIMH): collaborator
• National Heart, Lung, and Blood Institute (NHLBI): collaborator
• National Institute on Deafness and Other Communication Disorders (NIDCD): collaborator
• National Institute on Alcohol Abuse and Alcoholism (NIAAA): collaborator
• National Institute of Neurological Disorders and Stroke (NINDS): collaborator
• Tulane University School of Medicine: collaborator
• National Institute of Dental and Craniofacial Research (NIDCR): collaborator
• NIH Office of AIDS Research (OAR): collaborator

Study Sites (22)

University of Alabama

Birmingham, Alabama, 35294, United States

Location

University of California San Diego

La Jolla, California, 92093, United States

Location

University of Southern California

Los Angeles, California, 90033, United States

Location

University of Colorado Denver Health Sciences Center

Aurora, Colorado, 80045, United States

Location

Children's Diagnostic & Treatment Center

Fort Lauderdale, Florida, 33316, United States

Location

University of Florida Health Science Center

Jacksonville, Florida, 32209, United States

Location

University of Miami

Miami, Florida, 33136, United States

Location

University of Illinois, Chicago

Chicago, Illinois, 60612, United States

Location

Ann and Robert H. Lurie Children's Hospital

Chicago, Illinois, 60614, United States

Location

Tulane University Health Sciences Center

New Orleans, Louisiana, 70112, United States

Location

University of Maryland

Baltimore, Maryland, 21201, United States

Location

Rutgers - New Jersey Medical School

Newark, New Jersey, 07101-1709, United States

Location

SUNY Downstate Medical Center

Brooklyn, New York, 11203-2098, United States

Location

New York University School of Medicine

New York, New York, 10016, United States

Location

SUNY Stony Brook

Stony Brook, New York, 11794, United States

Location

Bronx Lebanon Hospital Center

The Bronx, New York, 10457, United States

Location

Jacobi Medical Center

The Bronx, New York, 10461, United States

Location

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104-4318, United States

Location

St. Jude Children's Research Hospital

Memphis, Tennessee, 38105-2764, United States

Location

Baylor College of Medicine

Houston, Texas, 77030-3498, United States

Location

University of Puerto Rico Medical Center

San Juan, PR, 00935, Puerto Rico

Location

San Juan Research Hospital

San Juan, 00936-8344, Puerto Rico

Location

Related Publications (72)

• Fulcher IR, Tchetgen Tchetgen EJ, Williams PL. Mediation Analysis for Censored Survival Data Under an Accelerated Failure Time Model. Epidemiology. 2017 Sep;28(5):660-666. doi: 10.1097/EDE.0000000000000687.

  PMID: 28574921 BACKGROUND

• Correia K, Williams PL. Estimating the Relative Excess Risk Due to Interaction in Clustered-Data Settings. Am J Epidemiol. 2018 Nov 1;187(11):2470-2480. doi: 10.1093/aje/kwy154.

  PMID: 30060004 BACKGROUND

• Correia K, Williams PL. A hierarchical modeling approach for assessing the safety of exposure to complex antiretroviral drug regimens during pregnancy. Stat Methods Med Res. 2019 Feb;28(2):599-612. doi: 10.1177/0962280217732597. Epub 2017 Oct 3.

  PMID: 28969502 BACKGROUND

• Zash RM, Williams PL, Sibiude J, Lyall H, Kakkar F. Surveillance monitoring for safety of in utero antiretroviral therapy exposures: current strategies and challenges. Expert Opin Drug Saf. 2016 Nov;15(11):1501-1513. doi: 10.1080/14740338.2016.1226281. Epub 2016 Sep 6.

  PMID: 27552003 BACKGROUND

• Bather JR, Horton NJ, Coull BA, Williams PL. The impact of correlated exposures and missing data on multiple informant models used to identify critical exposure windows. Stat Med. 2023 Apr 15;42(8):1171-1187. doi: 10.1002/sim.9664. Epub 2023 Jan 16.

  PMID: 36647625 BACKGROUND

• Tassiopoulos K, Read JS, Brogly S, Rich K, Lester B, Spector SA, Yogev R, Seage GR 3rd. Substance use in HIV-Infected women during pregnancy: self-report versus meconium analysis. AIDS Behav. 2010 Dec;14(6):1269-78. doi: 10.1007/s10461-010-9705-0.

  PMID: 20532607 RESULT

• Griner R, Williams PL, Read JS, Seage GR 3rd, Crain M, Yogev R, Hazra R, Rich K; Pediatric HIV/AIDS Cohort Study. In utero and postnatal exposure to antiretrovirals among HIV-exposed but uninfected children in the United States. AIDS Patient Care STDS. 2011 Jul;25(7):385-94. doi: 10.1089/apc.2011.0068. Epub 2011 Jun 10.

  PMID: 21992592 RESULT

• Crain MJ, Williams PL, Griner R, Tassiopoulos K, Read JS, Mofenson LM, Rich KC; Pediatric HIVAIDS Cohort Study. Point-of-care capillary blood lactate measurements in human immunodeficiency virus-uninfected children with in utero exposure to human immunodeficiency virus and antiretroviral medications. Pediatr Infect Dis J. 2011 Dec;30(12):1069-74. doi: 10.1097/INF.0b013e318234c886.

  PMID: 22051859 RESULT

• Williams PL, Seage GR 3rd, Van Dyke RB, Siberry GK, Griner R, Tassiopoulos K, Yildirim C, Read JS, Huo Y, Hazra R, Jacobson DL, Mofenson LM, Rich K; Pediatric HIV/AIDS Cohort Study. A trigger-based design for evaluating the safety of in utero antiretroviral exposure in uninfected children of human immunodeficiency virus-infected mothers. Am J Epidemiol. 2012 May 1;175(9):950-61. doi: 10.1093/aje/kwr401. Epub 2012 Apr 6.

  PMID: 22491086 RESULT

• Siberry GK, Williams PL, Mendez H, Seage GR 3rd, Jacobson DL, Hazra R, Rich KC, Griner R, Tassiopoulos K, Kacanek D, Mofenson LM, Miller T, DiMeglio LA, Watts DH; Pediatric HIV/AIDS Cohort Study (PHACS). Safety of tenofovir use during pregnancy: early growth outcomes in HIV-exposed uninfected infants. AIDS. 2012 Jun 1;26(9):1151-9. doi: 10.1097/QAD.0b013e328352d135.

  PMID: 22382151 RESULT

• Watts DH, Williams PL, Kacanek D, Griner R, Rich K, Hazra R, Mofenson LM, Mendez HA; Pediatric HIV/AIDS Cohort Study. Combination antiretroviral use and preterm birth. J Infect Dis. 2013 Feb 15;207(4):612-21. doi: 10.1093/infdis/jis728. Epub 2012 Nov 29.

  PMID: 23204173 RESULT

• Wilkinson JD, Williams PL, Leister E, Zeldow B, Shearer WT, Colan SD, Siberry GK, Dooley LB, Scott GB, Rich KC, Lipshultz SE; Pediatric HIVAIDS Cohort Study (PHACS). Cardiac biomarkers in HIV-exposed uninfected children. AIDS. 2013 Apr 24;27(7):1099-108. doi: 10.1097/QAD.0b013e32835cf21c.

  PMID: 23211773 RESULT

• Sirois PA, Huo Y, Williams PL, Malee K, Garvie PA, Kammerer B, Rich K, Van Dyke RB, Nozyce ML; Pediatric HIVAIDS Cohort Study. Safety of perinatal exposure to antiretroviral medications: developmental outcomes in infants. Pediatr Infect Dis J. 2013 Jun;32(6):648-55. doi: 10.1097/INF.0b013e318284129a.

  PMID: 23340561 RESULT

• Himes SK, Scheidweiler KB, Tassiopoulos K, Kacanek D, Hazra R, Rich K, Huestis MA; Pediatric HIV/AIDS Cohort Study. Development and validation of the first liquid chromatography-tandem mass spectrometry assay for simultaneous quantification of multiple antiretrovirals in meconium. Anal Chem. 2013 Feb 5;85(3):1896-904. doi: 10.1021/ac303188j. Epub 2013 Jan 14.

  PMID: 23256731 RESULT

• Rice ML, Zeldow B, Siberry GK, Purswani M, Malee K, Hoffman HJ, Frederick T, Buchanan A, Sirois PA, Allison SM, Williams PL; Pediatric HIVAIDS Cohort Study (PHACS). Evaluation of risk for late language emergence after in utero antiretroviral drug exposure in HIV-exposed uninfected infants. Pediatr Infect Dis J. 2013 Oct;32(10):e406-13. doi: 10.1097/INF.0b013e31829b80ee.

  PMID: 24067563 RESULT

• Malee KM, Mellins CA, Huo Y, Tassiopoulos K, Smith R, Sirois PA, Allison SM, Kacanek D, Kapetanovic S, Williams PL, Grant ML, Marullo D, Aidala AA; Pediatric HIVAIDS Cohort Study (PHACS). Prevalence, incidence, and persistence of psychiatric and substance use disorders among mothers living with HIV. J Acquir Immune Defic Syndr. 2014 Apr 15;65(5):526-34. doi: 10.1097/QAI.0000000000000070.

  PMID: 24759063 RESULT

• Nozyce ML, Huo Y, Williams PL, Kapetanovic S, Hazra R, Nichols S, Hunter S, Smith R, Seage GR 3rd, Sirois PA; Pediatric HIVAIDS Cohort Study. Safety of in utero and neonatal antiretroviral exposure: cognitive and academic outcomes in HIV-exposed, uninfected children 5-13 years of age. Pediatr Infect Dis J. 2014 Nov;33(11):1128-33. doi: 10.1097/INF.0000000000000410.

  PMID: 25361407 RESULT

• Williams PL, Crain MJ, Yildirim C, Hazra R, Van Dyke RB, Rich K, Read JS, Stuard E, Rathore M, Mendez HA, Watts DH; Pediatric HIV/AIDS Cohort Study. Congenital anomalies and in utero antiretroviral exposure in human immunodeficiency virus-exposed uninfected infants. JAMA Pediatr. 2015 Jan;169(1):48-55. doi: 10.1001/jamapediatrics.2014.1889.

  PMID: 25383770 RESULT

• Lipshultz SE, Williams PL, Zeldow B, Wilkinson JD, Rich KC, van Dyke RB, Seage GR 3rd, Dooley LB, Kaltman JR, Siberry GK, Mofenson LM, Shearer WT, Colan SD; Pediatric HIVAIDS Cohort Study (PHACS). Cardiac effects of in-utero exposure to antiretroviral therapy in HIV-uninfected children born to HIV-infected mothers. AIDS. 2015 Jan 2;29(1):91-100. doi: 10.1097/QAD.0000000000000499.

  PMID: 25562493 RESULT

• Rough K, Tassiopoulos K, Kacanek D, Griner R, Yogev R, Rich KC, Seage GR 3rd; Pediatric HIVAIDS Cohort Study. Dramatic decline in substance use by HIV-infected pregnant women in the United States from 1990 to 2012. AIDS. 2015 Jan 2;29(1):117-23. doi: 10.1097/QAD.0000000000000503.

  PMID: 25562496 RESULT

• Himes SK, Wu JW, Jacobson DL, Tassiopoulos K, Hazra R, Kacanek D, Van Dyke RB, Rich KC, Siberry GK, Huestis MA; Pediatric HIVAIDS Cohort Study (PHACS). Meconium Tenofovir Concentrations and Growth and Bone Outcomes in Prenatally Tenofovir Exposed HIV-Uninfected Children. Pediatr Infect Dis J. 2015 Aug;34(8):851-7. doi: 10.1097/INF.0000000000000747.

  PMID: 25961889 RESULT

• Himes SK, Huo Y, Siberry GK, Williams PL, Rice ML, Sirois PA, Frederick T, Hazra R, Huestis MA; Pediatric HIVAIDS Cohort Study. Meconium Atazanavir Concentrations and Early Language Outcomes in HIV-Exposed Uninfected Infants With Prenatal Atazanavir Exposure. J Acquir Immune Defic Syndr. 2015 Jun 1;69(2):178-86. doi: 10.1097/QAI.0000000000000558.

  PMID: 26009830 RESULT

• Himes SK, Tassiopoulos K, Yogev R, Huestis MA; Pediatric HIV/AIDS Cohort Study (PHACS). Antiretroviral Drugs in Meconium: Detection for Different Gestational Periods of Exposure. J Pediatr. 2015 Aug;167(2):305-11.e3. doi: 10.1016/j.jpeds.2015.04.062. Epub 2015 May 19.

  PMID: 26001315 RESULT

• Marsit CJ, Brummel SS, Kacanek D, Seage GR 3rd, Spector SA, Armstrong DA, Lester BM, Rich K; Pediatric HIV/AIDS Cohort Studies Network. Infant peripheral blood repetitive element hypomethylation associated with antiretroviral therapy in utero. Epigenetics. 2015;10(8):708-16. doi: 10.1080/15592294.2015.1060389.

  PMID: 26067216 RESULT

• Siberry GK, Jacobson DL, Kalkwarf HJ, Wu JW, DiMeglio LA, Yogev R, Knapp KM, Wheeler JJ, Butler L, Hazra R, Miller TL, Seage GR 3rd, Van Dyke RB, Barr E, Davtyan M, Mofenson LM, Rich KC; Pediatric HIV/AIDS Cohort Study. Lower Newborn Bone Mineral Content Associated With Maternal Use of Tenofovir Disoproxil Fumarate During Pregnancy. Clin Infect Dis. 2015 Sep 15;61(6):996-1003. doi: 10.1093/cid/civ437. Epub 2015 Jun 9.

  PMID: 26060285 RESULT

• Kirmse B, Yao TJ, Hofherr S, Kacanek D, Williams PL, Hobbs CV, Hazra R, Borkowsky W, Van Dyke RB, Summar M. Acylcarnitine Profiles in HIV-Exposed, Uninfected Neonates in the United States. AIDS Res Hum Retroviruses. 2016 Apr;32(4):339-48. doi: 10.1089/AID.2015.0112. Epub 2016 Jan 19.

  PMID: 26548585 RESULT

• Williams PL, Hazra R, Van Dyke RB, Yildirim C, Crain MJ, Seage GR 3rd, Civitello L, Ellis A, Butler L, Rich K; Pediatric HIV/AIDS Cohort Study. Antiretroviral exposure during pregnancy and adverse outcomes in HIV-exposed uninfected infants and children using a trigger-based design. AIDS. 2016 Jan 2;30(1):133-44. doi: 10.1097/QAD.0000000000000916.

  PMID: 26731758 RESULT

• Guerra V, Leister EC, Williams PL, Starc TJ, Lipshultz SE, Wilkinson JD, Van Dyke RB, Hazra R, Colan SD. Long-Term Effects of In Utero Antiretroviral Exposure: Systolic and Diastolic Function in HIV-Exposed Uninfected Youth. AIDS Res Hum Retroviruses. 2016 Jul;32(7):621-7. doi: 10.1089/AID.2015.0281. Epub 2016 May 9.

  PMID: 26794032 RESULT

• Caniglia EC, Patel K, Huo Y, Williams PL, Kapetanovic S, Rich KC, Sirois PA, Jacobson DL, Hernandez-Diaz S, Hernan MA, Seage GR 3rd; Pediatric HIVAIDS Cohort Study. Atazanavir exposure in utero and neurodevelopment in infants: a comparative safety study. AIDS. 2016 May 15;30(8):1267-78. doi: 10.1097/QAD.0000000000001052.

  PMID: 26867136 RESULT

• Van Dyke RB, Chadwick EG, Hazra R, Williams PL, Seage GR 3rd. The PHACS SMARTT Study: Assessment of the Safety of In Utero Exposure to Antiretroviral Drugs. Front Immunol. 2016 May 23;7:199. doi: 10.3389/fimmu.2016.00199. eCollection 2016.

  PMID: 27242802 RESULT

• Jacobson DL, Patel K, Williams PL, Geffner ME, Siberry GK, DiMeglio LA, Crain MJ, Mirza A, Chen JS, McFarland E, Kacanek D, Silio M, Rich K, Borkowsky W, Van Dyke RB, Miller TL; Pediatric HIVAIDS Cohort Study. Growth at 2 Years of Age in HIV-exposed Uninfected Children in the United States by Trimester of Maternal Antiretroviral Initiation. Pediatr Infect Dis J. 2017 Feb;36(2):189-197. doi: 10.1097/INF.0000000000001387.

  PMID: 27798548 RESULT

• Hermetet-Lindsay KD, Correia KF, Williams PL, Smith R, Malee KM, Mellins CA, Rutstein RM; Pediatric HIV/AIDS Cohort Study. Contributions of Disease Severity, Psychosocial Factors, and Cognition to Behavioral Functioning in US Youth Perinatally Exposed to HIV. AIDS Behav. 2017 Sep;21(9):2703-2715. doi: 10.1007/s10461-016-1508-5.

  PMID: 27475941 RESULT

• Tassiopoulos K, Huo Y, Braun J, Williams PL, Smith R, Aschengrau A, Nichols S, Hazra R, Meyer WA, Knapp K, Deygoo NS, Seage Iii GR. Blood lead levels and neurodevelopmental function in perinatally HIV-exposed, uninfected children in a US-based longitudinal cohort study. AIDS Res Hum Retroviruses. 2017 Sep;33(9):919-928. doi: 10.1089/AID.2016.0265. Epub 2017 Mar 21.

  PMID: 28322573 RESULT

• Jao J, Kacanek D, Williams PL, Geffner ME, Livingston EG, Sperling RS, Patel K, Bardeguez AD, Burchett SK, Chakhtoura N, Scott GB, Van Dyke RB, Abrams EJ; Pediatric HIV/AIDS Cohort Study and the International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 Protocol; Pediatric HIV/AIDS Cohort Study and the International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 Protocol. Birth Weight and Preterm Delivery Outcomes of Perinatally vs Nonperinatally Human Immunodeficiency Virus-Infected Pregnant Women in the United States: Results From the PHACS SMARTT Study and IMPAACT P1025 Protocol. Clin Infect Dis. 2017 Sep 15;65(6):982-989. doi: 10.1093/cid/cix488.

  PMID: 28575201 RESULT

• Rough K, Seage GR 3rd, Williams PL, Hernandez-Diaz S, Huo Y, Chadwick EG, Currier JS, Hoffman RM, Barr E, Shapiro DE, Patel K; PHACS and the IMPAACT P1025 Study Teams. Birth Outcomes for Pregnant Women with HIV Using Tenofovir-Emtricitabine. N Engl J Med. 2018 Apr 26;378(17):1593-1603. doi: 10.1056/NEJMoa1701666.

  PMID: 29694825 RESULT

• Goodenough CJ, Patel K, Van Dyke RB; Pediatric HIV/AIDS Cohort Study (PHACS). Is There a Higher Risk of Mother-to-child Transmission of HIV Among Pregnant Women With Perinatal HIV Infection? Pediatr Infect Dis J. 2018 Dec;37(12):1267-1270. doi: 10.1097/INF.0000000000002084.

  PMID: 29742647 RESULT

• Alperen J, Davidson J, Siminski S, Seage GR 3rd; Pediatric HIV/AIDS Cohort Study. Utility of the National Death Index in Identifying Deaths in a Clinic-Based, Multisite Cohort: The Experience of the Pediatric HIV/AIDS Cohort Study. J Acquir Immune Defic Syndr. 2018 Sep 1;79(1):e37-e39. doi: 10.1097/QAI.0000000000001763. No abstract available.

  PMID: 29847477 RESULT

• Jao J, Jacobson DL, Yu W, Borkowsky W, Geffner ME, McFarland EJ, Patel K, Williams PL, Miller T; Pediatric HIV/AIDS Cohort Study. A Comparison of Metabolic Outcomes Between Obese HIV-Exposed Uninfected Youth From the PHACS SMARTT Study and HIV-Unexposed Youth From the NHANES Study in the United States. J Acquir Immune Defic Syndr. 2019 Jul 1;81(3):319-327. doi: 10.1097/QAI.0000000000002018.

  PMID: 30844997 RESULT

• Margossian R, Williams PL, Yu W, Jacobson DL, Geffner ME, DiMeglio LA, Van Dyke RB, Spector SA, Schuster GU, Stephensen CB, Miller TL, Lipshultz SE; Pediatric HIV/AIDS Cohort Study (PHACS). Markers of Bone Mineral Metabolism and Cardiac Structure and Function in Perinatally HIV-Infected and HIV-Exposed but Uninfected Children and Adolescents. J Acquir Immune Defic Syndr. 2019 Jun 1;81(2):238-246. doi: 10.1097/QAI.0000000000002007.

  PMID: 30865170 RESULT

• Sudfeld CR, Jacobson DL, Rueda NM, Neri D, Mendez AJ, Butler L, Siminski S, Hendricks KM, Mellins CA, Duggan CP, Miller TL; Pediatric HIV/AIDS Cohort Study. Third Trimester Vitamin D Status Is Associated With Birth Outcomes and Linear Growth of HIV-Exposed Uninfected Infants in the United States. J Acquir Immune Defic Syndr. 2019 Jul 1;81(3):336-344. doi: 10.1097/QAI.0000000000002041.

  PMID: 31021992 RESULT

• Wang Y, Brummel SS, Beilstein-Wedel E, Dagnall CL, Hazra R, Kacanek D, Chadwick EG, Marsit CJ, Chanock SJ, Savage SA, Poirier MC, Machiela MJ, Engels EA; Pediatric HIV/AIDS Cohort Study. Association between zidovudine-containing antiretroviral therapy exposure in utero and leukocyte telomere length at birth. AIDS. 2019 Nov 1;33(13):2091-2096. doi: 10.1097/QAD.0000000000002317.

  PMID: 31335808 RESULT

• Purswani MU, Russell JS, Dietrich M, Malee K, Spector SA, Williams PL, Frederick T, Burchett S, Redmond S, Hoffman HJ, Torre P 3rd, Lee S, Rice ML, Yao TJ; Pediatric HIV/AIDS Cohort Study. Birth Prevalence of Congenital Cytomegalovirus Infection in HIV-Exposed Uninfected Children in the Era of Combination Antiretroviral Therapy. J Pediatr. 2020 Jan;216:82-87.e2. doi: 10.1016/j.jpeds.2019.09.025. Epub 2019 Oct 23.

  PMID: 31668479 RESULT

• Williams PL, Yildirim C, Chadwick EG, Van Dyke RB, Smith R, Correia KF, DiPerna A, Seage GR 3rd, Hazra R, Crowell CS; Surveillance Monitoring for ART Toxicities (SMARTT) study of the Pediatric HIV/AIDS Cohort Study. Association of maternal antiretroviral use with microcephaly in children who are HIV-exposed but uninfected (SMARTT): a prospective cohort study. Lancet HIV. 2020 Jan;7(1):e49-e58. doi: 10.1016/S2352-3018(19)30340-6. Epub 2019 Nov 15.

  PMID: 31740351 RESULT

• Powis KM, Huo Y, Williams PL, Kacanek D, Jao J, Patel K, Seage GR 3rd, Van Dyke RB, Chadwick EG; Pediatric HIV/AIDS Cohort Study (PHACS). Antiretroviral Prescribing Practices Among Pregnant Women Living With HIV in the United States, 2008-2017. JAMA Netw Open. 2019 Dec 2;2(12):e1917669. doi: 10.1001/jamanetworkopen.2019.17669.

  PMID: 31851347 RESULT

• Pintye J, Huo Y, Kacanek D, Zhang K, Kuncze K, Okochi H, Gandhi M. Extent of In Utero Transfer of Tenofovir From Mother to Fetus: A Paired Analysis of Hair Specimens Collected at Birth From a Cohort in the United States. J Infect Dis. 2021 Feb 24;223(4):638-644. doi: 10.1093/infdis/jiaa398.

  PMID: 32620015 RESULT

• Pintye J, Huo Y, Kacanek D, Zhang K, Kuncze K, Okochi H, Gandhi M; Pediatric HIV/AIDS Cohort Study (PHACS). Detectable HIV RNA in late pregnancy associated with low tenofovir hair levels at time of delivery among women living with HIV in the United States. AIDS. 2021 Feb 2;35(2):267-274. doi: 10.1097/QAD.0000000000002730.

  PMID: 33055571 RESULT

• O'Brien BE, Williams PL, Huo Y, Kacanek D, Chadwick EG, Powis KM, Correia K, Haddad LB, Yee LM, Chakhtoura N, Dola C, Van Dyke RB; Pediatric HIV/AIDS Cohort Study (PHACS). Repeat Pregnancies Among US Women Living With HIV in the SMARTT Study: Temporal Changes in HIV Disease Status and Predictors of Preterm Birth. J Acquir Immune Defic Syndr. 2020 Nov 1;85(3):346-354. doi: 10.1097/QAI.0000000000002445.

  PMID: 32701825 RESULT

• Torre P Rd, Zeldow B, Yao TJ, Hoffman HJ, Siberry GK, Purswani MU, Frederick T, Spector SA, Williams PL. Newborn Hearing Screenings in Human Immunodeficiency Virus-Exposed Uninfected Infants. J AIDS Immune Res. 2016;1(1):102. Epub 2016 Sep 5.

  PMID: 28459118 RESULT

• Rice ML, Russell JS, Frederick T, Purswani M, Williams PL, Siberry GK, Redmond SM, Hoffman HJ, Yao TJ; Pediatric HIV/AIDS Cohort Study (PHACS). Risk for Speech and Language Impairments in Preschool Age HIV-exposed Uninfected Children With In Utero Combination Antiretroviral Exposure. Pediatr Infect Dis J. 2018 Jul;37(7):678-685. doi: 10.1097/INF.0000000000001875.

  PMID: 29278615 RESULT

• Miller TL, Jacobson DL, Somarriba G, Neri D, Kurtz-Vraney J, Graham P, Gillman MW, Landy DC, Siminski S, Butler L, Rich KC, Hendricks K, Ludwig DA; Pediatric HIV/AIDS Cohort Study. A multicenter study of diet quality on birth weight and gestational age in infants of HIV-infected women. Matern Child Nutr. 2017 Oct;13(4):e12378. doi: 10.1111/mcn.12378. Epub 2016 Nov 8.

  PMID: 27863014 RESULT

• Williams PL, Huo Y, Rutstein R, Hazra R, Rough K, Van Dyke RB, Chadwick EG. Trends in Neonatal Prophylaxis and Predictors of Combination Antiretroviral Prophylaxis in US Infants from 1990 to 2015. AIDS Patient Care STDS. 2018 Feb;32(2):48-57. doi: 10.1089/apc.2017.0295.

  PMID: 30346801 RESULT

• Jao J, Kacanek D, Yu W, Williams PL, Patel K, Burchett S, Scott G, Abrams EJ, Sperling RS, Van Dyke RB, Smith R, Malee K; Pediatric HIV/AIDS Cohort Study. Neurodevelopment of HIV-Exposed Uninfected Infants Born to Women With Perinatally Acquired HIV in the United States. J Acquir Immune Defic Syndr. 2020 Jun 1;84(2):213-219. doi: 10.1097/QAI.0000000000002318.

  PMID: 32032301 RESULT

• Crowell CS, Williams PL, Yildirim C, Van Dyke RB, Smith R, Chadwick EG, Seage GR 3rd, Diperna A, Hazra R; Pediatric HIV/AIDS Cohort Study. Safety of in-utero antiretroviral exposure: neurologic outcomes in children who are HIV-exposed but uninfected. AIDS. 2020 Jul 15;34(9):1377-1387. doi: 10.1097/QAD.0000000000002550.

  PMID: 32310900 RESULT

• Labuda SM, Huo Y, Kacanek D, Patel K, Huybrechts K, Jao J, Smith C, Hernandez-Diaz S, Scott G, Burchett S, Kakkar F, Chadwick EG, Van Dyke RB; Pediatric HIV/AIDS Cohort Study. Rates of Hospitalization and Infection-Related Hospitalization Among Human Immunodeficiency Virus (HIV)-Exposed Uninfected Children Compared to HIV-Unexposed Uninfected Children in the United States, 2007-2016. Clin Infect Dis. 2020 Jul 11;71(2):332-339. doi: 10.1093/cid/ciz820.

  PMID: 31504291 RESULT

• Lin SH, Wang Y, Hartley SW, Karyadi DM, Lee OW, Zhu B, Zhou W, Brown DW, Beilstein-Wedel E, Hazra R, Kacanek D, Chadwick EG, Marsit CJ, Poirier MC, Brummel SS, Chanock SJ, Engels EA, Machiela MJ; Pediatric HIV/AIDS Cohort Study. In-utero exposure to zidovudine-containing antiretroviral therapy and clonal hematopoiesis in HIV-exposed uninfected newborns. AIDS. 2021 Aug 1;35(10):1525-1535. doi: 10.1097/QAD.0000000000002894.

  PMID: 33756513 RESULT

• Jacobson DL, Neri D, Gaskins A, Yee L, Mendez AJ, Hendricks K, Siminski S, Zash R, Hyzy L, Jao J; Pediatric HIV/AIDS Cohort Study. Maternal anemia and preterm birth among women living with HIV in the United States. Am J Clin Nutr. 2021 Jun 1;113(6):1402-1410. doi: 10.1093/ajcn/nqaa441.

  PMID: 35104854 RESULT

• Smith C, Huo Y, Patel K, Fetters K, Hegemann S, Burchett S, Van Dyke R, Weinberg A. Immunologic and Virologic Factors Associated With Hospitalization in Human Immunodeficiency Virus-Exposed, Uninfected Infants in the United States. Clin Infect Dis. 2021 Sep 15;73(6):1089-1096. doi: 10.1093/cid/ciab272.

  PMID: 34157096 RESULT

• Yee LM, Kacanek D, Brightwell C, Haddad LB, Jao J, Powis KM, Yao TJ, Barr E, Broadwell C, Siminski S, Seage GR 3rd, Chadwick EG; Pediatric HIV/AIDS Cohort Study. Marijuana, Opioid, and Alcohol Use Among Pregnant and Postpartum Individuals Living With HIV in the US. JAMA Netw Open. 2021 Dec 1;4(12):e2137162. doi: 10.1001/jamanetworkopen.2021.37162.

  PMID: 34860242 RESULT

• Yu W, Jacobson DL, Williams PL, Patel K, Geffner ME, Van Dyke RB, Kacanek D, DiMeglio LA, Jao J; Pediatric HIV/AIDS Cohort Study (PHACS). Growth patterns of uninfected children born to women living with perinatally versus nonperinatally acquired HIV. AIDS. 2022 Mar 15;36(4):593-603. doi: 10.1097/QAD.0000000000003136.

  PMID: 34860195 RESULT

• Young MR, Broadwell C, Kacanek D, Chadwick EG, Jao J, Moscicki AB, Powis K, Tassiopoulos K, Yee LM, Haddad LB; Pediatric HIV/AIDS Cohort Study. Sexually Transmitted Infections in Pregnant People With Human Immunodeficiency Virus: Temporal Trends, Demographic Correlates, and Association With Preterm Birth. Clin Infect Dis. 2022 Dec 19;75(12):2211-2218. doi: 10.1093/cid/ciac321.

  PMID: 35486952 RESULT

• Yee LM, Jacobson DL, Haddad LB, Jao J, Powis KM, Kacanek D, Zash R, DiPerna A, Chadwick EG; Pediatric HIV/AIDS Cohort Study. Evaluating the association of antiretroviral therapy and immune status with hypertensive disorders of pregnancy among people with HIV. AIDS. 2023 Sep 1;37(11):1715-1723. doi: 10.1097/QAD.0000000000003607. Epub 2023 May 23.

  PMID: 37260289 RESULT

• Jao J, Kacanek D, Broadwell C, Jacobson DL, Chadwick EG, Williams PL, Powis KM, Haddad LB, Yee L; Pediatric HIV/AIDS Cohort Study. Gestational weight gain in persons with HIV in the United States. AIDS. 2023 May 1;37(6):883-893. doi: 10.1097/QAD.0000000000003454. Epub 2022 Dec 2.

  PMID: 36729961 RESULT

• Shiau S, Jacobson DL, Huo Y, Kacanek D, Yee LM, Williams DB, Haddad LB, Serghides L, Powis K, Sperling RS, Williams PL, Jao J; Pediatric HIV/AIDS Cohort Study. Unique Profile of Inflammation and Immune Activation in Pregnant People With HIV in the United States. J Infect Dis. 2023 Mar 1;227(5):720-730. doi: 10.1093/infdis/jiac501.

  PMID: 36592383 RESULT

• Yao TJ, Malee K, Zhang J, Smith R, Redmond S, Rice ML, Frederick T, Torre P, Mellins CA, Hoffman HJ, Williams PL. In Utero Antiretroviral Exposure and Risk of Neurodevelopmental Problems in HIV-Exposed Uninfected 5-Year-Old Children. AIDS Patient Care STDS. 2023 Mar;37(3):119-130. doi: 10.1089/apc.2022.0189. Epub 2023 Feb 24.

  PMID: 36827595 RESULT

• Davtyan M, Kacanek D, Lee J, Berman C, Chadwick EG, Smith R, Salomon L, Frederick T; Pediatric HIV/AIDS Cohort Study. The role of internalised HIV stigma in disclosure of maternal HIV serostatus to children perinatally HIV-exposed but uninfected: a prospective study in the United States. J Int AIDS Soc. 2023 Oct;26 Suppl 4(Suppl 4):e26167. doi: 10.1002/jia2.26167.

  PMID: 37909234 RESULT

• Davtyan M, Kacanek D, Lee J, Berman C, Chadwick EG, Smith R, Salomon L, Frederick T; Pediatric HIV/AIDS Cohort Study. Factors associated with internalized HIV-related stigma among biological mothers living with HIV enrolled in a US cohort study. AIDS Care. 2024 Feb;36(2):220-226. doi: 10.1080/09540121.2023.2263680. Epub 2024 Jan 30.

  PMID: 37757482 RESULT

• Fisher SA, Jao JK, Yee LM, Serghides L, Chadwick EG, Jacobson DL. Association of Fatty Acid Signatures with HIV Viremia in Pregnancy. AIDS Res Hum Retroviruses. 2024 Apr;40(4):257-267. doi: 10.1089/AID.2023.0040. Epub 2023 Oct 30.

  PMID: 37772708 RESULT

• Berhie S, Kacanek D, Lee J, Jao J, Powis K, Salomon L, Siddiqui D, Yee LM; Pediatric HIV/AIDS Cohort Study. Routine Vaccination During Pregnancy Among People Living With HIV in the United States. JAMA Netw Open. 2024 May 1;7(5):e249531. doi: 10.1001/jamanetworkopen.2024.9531.

  PMID: 38696165 RESULT

• Fung K, Hernandez-Diaz S, Zash R, Chadwick EG, Van Dyke RB, Broadwell C, Jao J, Powis K, Yee LM, Williams PL; Pediatrics HIV/AIDS Cohort Study (PHACS). First-trimester exposure to newer antiretroviral agents and congenital anomalies in a US cohort. AIDS. 2024 Sep 1;38(11):1686-1695. doi: 10.1097/QAD.0000000000003955. Epub 2024 Jun 11.

  PMID: 38864586 RESULT

• Purswani MU, Jacobson DL, DiMeglio LA, Yao TJ, Kopp JB, Van Dyke RB, Yu W, Siberry GK; Pediatric HIV/AIDS Cohort Study (PHACS). Phosphaturia in HIV-Exposed Uninfected Neonates Associated with Maternal Use of Tenofovir Disoproxil Fumarate in Late Pregnancy. J Pediatric Infect Dis Soc. 2024 Aug 24;13(8):396-405. doi: 10.1093/jpids/piae054.

  PMID: 38820092 RESULT

• Gojanovich GS, Marsit CJ, Kacanek D, Russell J, Hudson G, Van Dyke RB, Naini AB, Gerschenson M; Pediatric HIV/AIDS Cohort Study. Relationships of mitochondrial DNA mutations and select clinical diagnoses in perinatally HIV- and ART-exposed uninfected children. Mitochondrion. 2024 Nov;79:101949. doi: 10.1016/j.mito.2024.101949. Epub 2024 Aug 30.

  PMID: 39218053 RESULT

• Olivero R, Williams PL, Sawyer G, Yee LM, Patel K, Hernandez-Diaz S, Powis K, Paul M, Chadwick EG; Pediatric HIV/AIDS Cohort Study and the HOPE study. Birth outcomes following bictegravir exposure during pregnancy. AIDS. 2025 Mar 15;39(4):381-386. doi: 10.1097/QAD.0000000000004041. Epub 2024 Oct 14.

  PMID: 39411892 RESULT

Related Links

• Pediatric HIV/AIDS Cohort Study

Biospecimen

Retention: SAMPLES WITH DNA

Serum, cell pellets, meconium, saliva, hair

Study Officials

• Paige L Williams

  Harvard School of Public Health (HSPH)

  PRINCIPAL INVESTIGATOR

• Ellen Chadwick, M.D.

  Ann & Robert H Lurie Children's Hospital of Chicago

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Lecturer on Biostatistics

Study Record Dates

• First Submitted: March 4, 2011
• First Posted: March 7, 2011
• Study Start: March 1, 2007
• Primary Completion: May 31, 2025
• Study Completion: May 31, 2025
• Last Updated: June 27, 2025

Record last verified: 2025-06

Locations

PR (2); US (20)