Meet the CIPHER grantees

Paul Bangirana

Year awarded: 2013
Institution: Makerere University, Uganda
Research site: Makerere University
Primary mentor: Michael Boivin, Michigan State University

Paul Bangirana is a Senior Lecturer in the Department of Psychiatry, Makerere University. Since 2003, he has been involved in research looking at the neurocognitive effects of HIV/AIDS infection and cerebral malaria in Ugandan children.

More information on Paul | Email

“This IAS funding has greatly enhanced my current and future prospects as an independent investigator. It has provided me with more insight about managing a grant as a PI, and it has provided me with valuable networks in the paediatrics HIV field. It has also opened options for future research questions.”

Research project: Does HIV subtype moderate ART effect on neurocognitive functioning in children?

The issue

Infection with HIV in children is associated with neurocognitive deficits. Treatment with ART improves neurocognitive outcome in children and adults, but some children on ART still have poor neurocognitive functioning. In an earlier study, Dr Bangirana’s team observed that ART-naive children with HIV subtype A had poorer neurocognitive outcomes than children with HIV subtype D. This was attributed to HIV subtype A being able to infect macrophages and enter the CNS better that HIV subtype D.

The CIPHER project

This study was aimed at providing empirical data that has implications for ART in children. In earlier findings, more cognitive deficits were observed in ART-naive children with subtype A than D. This implies that A is more pathogenic in the CNS and may require drugs which penetrate the brain easily. Dr Bangirana wanted to determine whether these results still hold for children on ART thus providing evidence that ART treatment choice should also be determined by HIV subtype.

He used a cross-sectional study in which children on HAART were assessed for neurocognitive functioning. Test outcomes were compared by subtype to determine the children’s neurocognitive functioning, the aim of which was to determine whether neurocognitive deficits in children living with HIV on ART differ by subtype.

No differences in neurocognitive outcome were found by HIV subtype implying that ART diminishes the neurocognitive disadvantage seen in HIV subtype A.

The impact

This study has the potential to influence ART treatment policy where the decision on what drugs to prescribe does not consider subtype which would delay treatment.