and: The Gertrude H. Sergievsky Center, College of Physicians and Surgeons
Dr. Louise Kuhn is an epidemiologist, who has developed and manages an active research program primarily focused on aspects of the HIV/AIDS epidemic. Her work is focused on mother-to-child HIV transmission, particularly in the international arena. Central to her research endeavors is focus on translation of scientific findings into effective HIV prevention and treatment programs in low resource settings.
Perinatal HIV studies
Dr. Kuhn is conducting research to elucidate biologic factors associated with mother-to-child transmission of HIV. Better understanding of vulnerability to infection and resistance to transmission may assist with development of better interventions to prevent transmission, including vaccines. Studies are also underway to identify why some infected children progress more rapidly than others and are more difficult to treat.
Selected Global Activities:
Zambia Exclusive Breastfeeding Study
Breastfeeding poses a scientific and programmatic challenge to those concerned with global health. While the benefits of breastfeeding in the absence of HIV are many, and include substantial reductions in diarrheal and respiratory disease morbidity and mortality for infants and young children, the practice may transmit HIV infection. Thus in the face of the HIV epidemic, breastfeeding is both a protector of and a hazard for infant health in low resource settings. Research is underway among HIV-positive mothers and their infants in Lusaka, Zambia, to better understand postnatal HIV transmission and how to prevent it. As part of the study, we are investigating exclusive breastfeeding and early cessation of breastfeeding as a means of reducing HIV transmission without compromising other aspects of child health.
Prevention of mother-to-child HIV transmission
Most infants born to HIV-positive mothers do not acquire infection, even in the absence of any interventions. We are conducting studies of possible immunologic and genetic factors that might explain this protection against infection observed in some of these at risk children. Better understanding of these processes may assist with the development of vaccines against HIV.
Countries: South Africa
Nevirapine Resistance (NEVEREST)
Nevirapine is a simple and effective intervention to prevent mother to child HIV transmission but may select for drug resistant virus among mothers and children. The longer term consequences of resistance are unknown. We are investigating the effects of resistance on treatment response among adults and children in South Africa to find ways to optimize prevention and treatment protocols.
Countries: South Africa
Kuhn L, Kasonde P, Sinkala M, Kankasa C, Semrau K, Scott N, Tsai WY, Vermund S, Aldrovandi G, Thea DM. "Does the severity of HIV disease among HIV-infected mothers affect mortality and morbidity of their uninfected infants?" Clinical Infectious Diseases 41 1654-61. 2005
Kuhn L, Kasonde P, Sinkala M, Kankasa C, Semrau K, Vwalika C, Tsai WY, Aldrovandi G, Thea DM. "Prolonged breast-feeding and mortality up to two years post-partum among HIV-positive women in Zambia." AIDS 19 1677-1681 2005
Denny L, Kuhn L, De Souza M, Pollack A, Dupree W, Wright TC. "Screen and treat approaches for cervical cancer prevention in low resource settings: A randomized controlled trial." JAMA 294 2173-81 2005
Kuhn L, Trabattoni D, Kankasa C, Semrau K, Kasonde P, Lissoni F, Sinkala M, Ghosh MK, Vwalika C, Aldrovandi G, Thea DM, Clerici M. "Alpha-defensins in the prevention of HIV transmission among breastfed infants." AIDS Journal of Acquired Immune Deficiency Syndrome. 39 138-42. 2005
Kuhn L, Abrams EJ, Palumbo P, Aga R, Louie L, Bulterys M, Hodge T. "Maternal versus paternal inheritance of HLA class I alleles among HIV-infected children: consequences of clinical disease progression." AIDS 18 1281-9 2004
Kuhn L, Meddows-Taylor S, Gray G, Tiemessen CT. "HIV-specific cellular immune responses in newborns exposed to HIV in utero" Clinical Infectious Diseases 34 267-76. 2002
Kuhn L, Coutsoudis A, Moodley D, Trabattoni D, Mngqundaniso N, Shearer GM, Clerici M, Coovadia HM, Stein Z. "T-helper cell responses to HIV envelope peptides in cord blood: Protection against intrapartum and breast feeding transmission." AIDS 15 1-9 2001
Kuhn L, Denny, Pollack A, Lorincz A, Richart RM, Wright TC. "HPV testing for cervical cancer screening in developing countries." ournal of the National Cancer Institute 92 818-25 2000
Kuhn L, Steketee RW, Weedon J, Abrams EJ, Lambert G, Bamji M, Schoenbaum E, Nesheim SR, Palumbo P, Vink P, Farley J, Simonds RJ, Thea DM for the Perinatal AIDS Collaborative Transmission Study (PACTS) "Distinct risk factors for intrauterine and intrapartum HIV transmission and consequences for disease progression in HIV-infected children." Journal of Infectious Diseases 179 52-58 1999
Kuhn L, Stein ZA. "Infant survival, HIV infection and feeding alternatives in less developed countries." American Journal of Public Health 87 926-931 1997