The Bhagirath Singh Early Career Award in Infection and Immunity 2020 Recipient

Isabelle Boucoiran

There are very little recent data on cytomegalovirus (CMV) among the 20 million women living with HIV (WLWH) globally, who are at increased risk of CMV manifestations and transmission to their infants during pregnancy and shortly after delivery. Up-to-date data are critical as recommendations have changed such that all WLWH should now be receiving HIV treatment for life and this may change the risks associated with CMV. Improved understanding of the dynamics of CMV infection in the context of pregnancy in WLWH compared to women without HIV will inform optimal clinical care and infant outcomes through the use of available and novel interventions.  This study will use existing samples and the ongoing recruitment infrastructure of an existing CIHR-funded cohort to comprehensively study CMV dynamics in HIV-affected pregnancies compared to HIV-unaffected pregnancies. We will examine the association between CMV transmission to infants and CMV viral replication, diversity, and shedding in different bodily compartments in pregnancy and the postnatal period, compare the dynamics of CMV shedding during pregnancy between women with and without CMV reinfections during pregnancy, and compare the genotypic features of transmitted CMV strains acquired during pregnancy and after delivery to those of non-transmitted CMV viruses, as well as to determine the overall CMV viral diversity in infants infected during pregnancy.  These data will inform what genotypes should be included in candidate vaccines and may result in recommendations for targeted CMV screening in infants based on maternal viral shedding during pregnancy. Ultimately, our findings will help to reduce the enormous global health burden of CMV infection, which is the leading infant infection during pregnancy and is the leading cause of non-genetic childhood hearing loss and neurodevelopmental delay.

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