Meet the CIPHER grantees
||Thanyawee Puthanakit, Chulalongkorn University
Watsamon Jantarabenjakul is a paediatric infectious diseases fellow and is studying in a Clinical Science programme for her PhD. Her main interests are paediatric HIV/TB research and clinical care.
More information on Watsamon | Email
“Our effort to start ARV as soon as possible in children living with perinatally acquired HIV led to better neurodevelopmental outcomes, as confirmed by our CIPHER-funded study.”
Research project: Neurodevelopmental and neuroanatomical outcomes in early antiretroviral treated young children with perinatally acquired HIV infection (PHIV) compared to age matched perinatally HIV exposed uninfected children (PHEU)
HIV infection has neurodevelopmental (ND), as well as physical, affects. It sometimes enters the central nervous system of infants during pregnancy and may be associated with neuronal damage. Most ND data are from developed countries, which may not be fully relevant to resource-limited settings (RLS), where children and families face poor socio-economic, educational and healthcare systems.
About 10-30% of PHIV children are reported to have poor ND scores. And PHIV children often have abnormalities in the development of motor and language skills. The Children with HIV Early Antiretroviral Therapy (CHER) study showed ND scores were significantly better if ART was initiated before three months of age. Other interventions that could be used to improve ND in children include physical therapy, occupational therapy, speech language therapy and computerized cognitive rehabilitation therapy. Having an easy-to-perform tool to assess ND is critical for RLS.
The CIPHER project
Dr Jantarabenjakul’s research aims to evaluate and compare the ND and neurobehavioural outcomes between young early-ART-treated children with PHIV and age-matched PHEU children. The hypothesis is that PHIV children who initiate ART before the age of one year and who have had at least one year of ART have similar ND outcomes to PHEU children. This project will also evaluate the neuroimaging signature for ND outcomes by brain MRI in PHIV children. The goal is to fill the knowledge gap about ND and neuroanatomical outcomes in early-treated young children.
Guidelines now recommend ART regardless of CD4 count, which means that there will be more early-treated children worldwide. This data may inform the extent of vulnerability to HIV insult and help create preventative strategies and mitigate ND impairments.
Early data from Dr Jantarabenjakul’s study confirms that early ART in infants living with HIV improves neurodevelopmental outcome. This research forms part of her dissertation for a Doctor of Philosophy in Clinical Sciences at Chulalongkorn University.
Her team received additional funding from TREAT Asia to evaluate the mental health of caregivers by reporting on the PHQ-9 questionnaire.