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Center for Studies in Demography and Ecology

Maternal HIV Status and Risk of Infant Mycobacterium Tuberculosis is Examined by John-Stewart, Mecha, LaCourse, and Colleagues

CSDE Affiliate Dr. Grace John-Stewart (Global Health, Epidemiology, Medicine, and Pediatrics) co-authored research in the Pediatric Infectious Disease Journal, titled “Maternal HIV Status and Risk of Infant Mycobacterium Tuberculosis Infection as Measured by Tuberculin Skin Test“. Dr. Jerphason Mecha (Kenya Medical Research Institute) and Dr. Sylvia LaCourse also played key roles as authors on this article. The effect of maternal HIV on infant Mycobacterium tuberculosis (Mtb) infection risk is not well-characterized. Pregnant women with/without HIV and their infants were enrolled in a longitudinal cohort in Kenya. Mothers had interferon gamma-release assays (QFT-Plus) and tuberculin skin tests (TST) at enrollment in pregnancy; children underwent TST at 12 and 24 months of age. Authors estimated the incidence and correlates of infant TST-positivity using Cox proportional hazards regression.

Among 322 infants, 170 (53%) were HIV-exposed and 152 (47%) were HIV-unexposed. Median enrollment age was 6.6 weeks [interquartile range (IQR): 6.1–10.0]; most received Bacillus Calmette-Guerin (320, 99%). Thirty-nine (12%) mothers were TST-positive; 102 (32%) were QFT-Plus-positive. Among HIV-exposed infants, 154 (95%) received antiretrovirals for HIV prevention and 141 (83%) of their mothers ever received isoniazid preventive therapy (IPT). Cumulative 24-month infant Mtb infection incidence was 3.6/100 person-years (PY) [95% confidence interval (CI): 2.4–5.5/100 PY]; 5.4/100 PY in HIV-exposed infants (10%, 17/170) versus 1.7/100 PY in HIV-unexposed infants (3.3%, 5/152) [hazard ratio (HR): 3.1 (95% CI: 1.2–8.5)]. More TST conversions occurred in the first versus second year of life [5.8 vs. 2.0/100 PY; HR: 2.9 (95% CI: 1.0–10.1)]. Infant TST-positivity was associated with maternal TST-positivity [HR: 2.9 (95% CI: 1.1–7.4)], but not QFT-Plus-positivity. Among HIV-exposed children, Mtb infection incidence was similar regardless of maternal IPT.

Mtb infection incidence (by TST) by 24 months of age was ~3-fold higher among HIV-exposed children, despite high maternal IPT uptake. Overall, more TST conversions occurred in the first 12 months compared to 12–24 months of age, similar in both HIV-exposed and HIV-unexposed children.

Postdoctoral Position in Data Science

Yale’s Institute for Foundations of Data Science (FDS) is seeking applications for postdoctoral positions in Data Science. The FDS Postdoc Program is extremely special. Fully supported, 2-3yr appointments. $95,000 yearly salary plus $10,000 annually for travel and research expenses. No teaching requirement. Flexible mentorship. Independent research. Lots of extras. This is an opportunity to work with leading theorists as well as domain scientists who are eager to collaborate. A growing list of members may be found on our web page, https://fds.yale.edu.

CSDE Lunch & Learn: Telomere Length as a Measure of Environmental Exposure

Each quarter, CSDE offers 3-5 workshops on data sources, statistical and biomarker methodology, introductions to analysis programs, and more, all given by CSDE staff and faculty affiliates. These workshops can include hands-on training in novel methods and programming, lectures on innovative data sources, and discussions of important issues in research and data collection. There is just one more workshop on Wednesday, Dec 6th. They are happy to accommodate a few more registrants (register here).