NIH to Study Zika and HIV in Pregnant Women

The National Institutes of Health (NIH) is looking to determine whether Zika virus infection poses an additional risk in women whose pregnancies are already complicated by HIV. Specifically, NIH researchers are concerned that Zika may have the potential to interfere with medications that prevent HIV from being passed from a pregnant woman to her fetus, and therefore, increase the chance of the fetus becoming infected. Similar effects have been seen in women with coinfections with syphilis and type 2 herpes simplex virus.

“Other studies have shown that the presence of a co-infection can influence mother-to-child HIV transmission,” said the study’s lead author Catherine Spong, MD, in an interview with Contagion

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’s sister journal, MD Magazine

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. “So we’re looking to this study to provide similar information on whether co-infection with HIV and the Zika virus affects the transmissibility of either one or both of these viruses.

The new study aims to uncover any previously unidentified connection between the conditions, and whether the effects of either disease are exacerbated by the other.

“We know very little about how co-infection with HIV and Zika could affect women, pregnancy and infants. Given that Zika infection rates are likely to increase in many parts of the world where HIV infection is widespread, we hope to uncover information that will help practitioners provide the best care for their patients,” Dr. Spong said.

A total of 200 pregnant women will be initially enrolled in the study. The study group will include:

• pregnant women who are infected with HIV only,
• pregnant women infected with Zika virus only,
• pregnant women infected with HIV and Zika virus,
• and women not infected with either virus.

If successful, the researchers will attempt to enroll an additional 1800 pregnant women, for a total study group of 2000. All women in the study will be monitored throughout their pregnancies and for 6 months after giving birth. Infants will be observed for 1 year after birth. The study is expected to fun from 4 to 6 years.

“Given the neurotoxic effects seen in newborns of mothers with Zika infection, we’re especially interested in determining whether co-infection influences the rate of neurological complications,” Dr. Spong told MD Magazine

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. “In addition, there has been a question on whether coinfection, such as with Dengue or other flaviviruses, potentiates the impact of Zika virus. This study will be able to add to that information by studying the impact of HIV on Zika.”

The study is currently enrolling participants in Puerto Rico. Recruitment will soon begin at sites in the continental United States and in Brazil.

This is not the only NIH-led Zika virus-related study. In June 2017, the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) announced that they are teaming up with FUNSALUD, a non-profit organization, to conduct a large natural history study that will take a closer look at neurologic, neurodevelopmental, and clinical outcomes pertaining to Zika virus in infants and young children residing in Guatemala. The researchers of the study hope that the findings yielded from this research will not only “help inform global public health practices and assist Guatemalan health officials as they seek to understand the risks associated with early childhood Zika infection,” but also help create “healthcare programs that will provide Zika-related healthcare of benefit to Guatemalan children and families.”