Neurodevelopment and HIV/AIDS

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DESCRIPTION (provided by applicant): The HIV/AIDS epidemic is one of the greatest humanitarian and health challenges facing the global community. The HIV/AIDS epidemic in sub-Saharan Africa has resulted in an explosion in the numbers of orphaned children and a rapidly expanding pediatric HIV/AIDS epidemic. Studies in the US and Europe have demonstrated that a major consequence of perinatal HIV infection is the significant impact on brain development and, subsequently, on the achievement and maintenance of developmental milestones. It is quite likely that in the coming decades, HIV will be the most frequent cause of neurodevelopmental delay in sub-Saharan Africa. Even though more than 80% of childhood HIV infections occur in Africa, the impact of HIV/AIDS on the health of African children remains poorly documented. The introduction of antiretroviral therapy will not only extend the survival but also profoundly affect the social and physical functioning of children and their families and change pediatric HIV/AIDS from an acute to a chronic disease requiring a comprehensive approach to care from birth through school-going age. The HIV epidemic is not only affecting HIV infected children but is making millions of children vulnerable. The illness of a parent marks the beginning of erosion of the family and trauma in the emotional and material life of a child. As educational opportunities are key components of a "safety net" program for vulnerable children, there is a need for studies to fully explore the neurodevelopmental consequences of being confronted with parents suffering from AIDS. During the two planning grant years, we will perform a cross-sectional study on the neurodevelopment of children confronted with HIV/AIDS, in order to build the capacity to perform a Iongitudinal cohort study on HIV-related neurodevelopment and central nervous system (CNS) disorders in the Democratic Republic of Congo (DRC). Although there is a pressing need for pediatric HIV/AIDS research, there is an equally great need for the training of qualified investigators, especially sub-Saharan Africans, to contribute to and lead research efforts. We propose to develop a North-South (US, Europe, DRC) and South-South (South Africa, DRC) collaborative "Neurodevelopment and HIV/AIDS" research program to investigate the neurodevelopment and CNS disorders of children confronted with HIV/AIDS and to contribute to the long-term goal of building sustainable capacity in neurodevelopmental research at the University of Kinshasa, DRC.