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The University of Southampton
University of Southampton Global Health Research InstituteResearch

HIV Epidemiology

Professor Marie-Louise Newell, Professor of Global Health, was until November 2013, Director of the Wellcome Trust-funded Africa Centre for Health and Population Studies, University of KwaZulu-Natal, where she established a programme of population-based research focused on the impact of HIV at a population-level, including research on HIV in pregnancy and childhood. A major contribution from her research at the Africa Centre relates to the quantification of the impact of comprehensive antiretroviral therapy (ART) coverage to reverse the substantial increase in HIV-related deaths of adults and children in populations with high HIV prevalence. The substantial increase in ART coverage across this population has now also been associated with a decline in HIV incidence in an observational study; Prof Newell established, with French collaborators, a large cluster-randomised Treatment-as-Prevention trial in the rural area north of the Africa Centre, funded by the French ANRS and the BMGF, with end results expected mid-2016.

Professor Marie-Louise Newell
Professor Marie-Louise Newell leads interdisciplinary European research in both HIV and HCV

Preventing mother-to-child transmission of HIV

With the successful roll-out of antiretroviral therapy (ART) to pregnant and breastfeeding women for the prevention of mother-to-child transmission of HIV (PMTCT), rates of vertically-acquired HIV are now substantially reduced, to such an extent that there is talk of its ‘virtual’ elimination (meaning rates of less than 1%). However, PMTCT programmes face serious challenges, with women not accessing timely antenatal care and adherence to ART, especially postnatally, a considerable challenge to programme success. Planned health systems research in Uganda and Kenya would address the support needed for these programmes.

The effects of ART/HIV on long-term development

There is growing recognition that exposure to ART and HIV during fetal and early life may affect the growing child; ART may interfere with the pregnancy-immune system and increase the risk of premature labour and delivery, and ART may also affect immune development of the fetus. Both prematurity and changing immune system may impact on the long-term development of the child. Prof Newell has a NIH-funded project in Cape Town to explore and quantify these possible adverse effect of ART for PMTCT. In research in rural KwaZulu-Natal, South Africa, Prof Newell assessed in great detail development at age 7-11 year in children born to HIV infected and uninfected mothers, who were or were not supported to exclusive breastfeed their infants in the first six months of life.

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