Meet the CIPHER fellows
||University of Toulouse
||Valériane Leroy, Inserm / Ruth Goodall, University College London
Julie Jesson is a postdoctoral fellow in epidemiology and biostatistics. Her research topic focuses on nutritional care, growth patterns and food insecurity among children and adolescents living with HIV in sub-Saharan Africa. She is part of the IeDEA West Africa collaboration with the University of Toulouse, France; she contributes to a better understanding and improvement of HIV outcomes for adolescents living with HIV in West Africa. She is also interested in adolescent global health and is conducting research to document health outcomes of adolescents and young adults during the COVID-19 pandemic, in collaboration with Simon Fraser University, Canada, and the University of the Witwatersrand, South Africa.
More information on Julie Jesson | Email
“Adolescents living with HIV face multiple challenges due to their chronic infection and long-life treatment. Growth retardation is often observed, especially in those with a late HIV diagnosis. This contributes to hindering their psychosocial and cognitive development, with potentially long-term, detrimental effects on their life and well-being. This CIPHER project aims to document the growth and CD4 patterns observed in this population, factors associated with poor growth and immune response, and factors associated with better growth and CD4 evolution during adolescence.”
Research project: Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis
In 2019, an estimated 1.7 million adolescents aged 10-19 years were living with HIV, with 90% of them in sub-Saharan Africa and 8% in Asia and the Pacific. This population is experiencing specific challenges due to their life-long infection and long-term follow up in HIV care. Previous work has demonstrated that linear growth improves after antiretroviral therapy (ART) initiation, with better outcomes associated with earlier ART, but long-term growth evolution on ART has been less described, especially in adolescents. Similarly, the immune response following ART initiation has been extensively described in children and adolescents living with HIV, but long-term CD4 evolution on ART for adolescents has not been sufficiently explored.
The CIPHER project
This is a multiregional analysis of growth and CD4 patterns of adolescents, using a multiregional dataset developed by the CIPHER cohort collaboration, combining data collected from 1994 to 2015 from 11 CIPHER networks. This project is conducted by Dr Jesson, representative of the IeDEA West Africa network, in partnership with Dr Siobhan Crichton, representative of the EPPICC network, at the University College of London, UK. The main objectives are to, among adolescents with perinatal HIV:
- Describe the growth and immune evolution across adolescence
- Describe the timing and shape of the pubertal growth spurt
- Describe growth trajectories from ART initiation in children and adolescents.
About 20,000 adolescents are included in those analyses.
First results showed that growth patterns during adolescence differed substantially by sex and region; CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Those data will contribute to a better understanding of long-term outcomes of adolescents to improve HIV care. This is also a first step to better integrating and developing nutritional care programmes for this population. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical for improving the growth and CD4 outcomes of adolescents with perinatally acquired HIV by the time they reach adulthood.