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Early metabolic and lipid profiles and neurodevelopmental and metabolic outcomes in childhood: the Tunza Mwana-X study

Award Number: R01HD123924
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/10/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2029

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Early metabolic and lipid profiles and neurodevelopmental and metabolic outcomes in childhood: the Tunza Mwana-X study - PROJECT SUMMARY An estimated 16 million children globally are HIV-exposed but uninfected (CHEU), with 1.4 million born annually. CHEU exhibit metabolic derangements and an increased risk of suboptimal neurodevelopment in early life compared to children HIV unexposed uninfected (CHU), despite maternal antiretroviral therapy (ART) and breastfeeding. Long-term outcomes remain poorly understood, though limited evidence suggests mild to moderate deficits in academic achievement, language, and cognition among older CHEU. In utero exposure to HIV and ART have also been associated with metabolic alterations, including reduced insulin sensitivity, dysregulated host metabolism, and altered lipid profiles. The mechanisms underlying these neurocognitive and metabolic disruptions remain unclear, but early-life perturbations in the host metabolome and lipidome are plausible contributors. Metabolic and brain development are closely related, and dysregulation during critical developmental windows may impair cognition and increase risk of metabolic disease in adulthood. There is a lack of longitudinal data examining how early-life metabolomic and lipidomic profiles relate to neurocognitive outcomes and markers of metabolic syndrome (MetS) in school-age CHEU. This is a critical gap given the availability of scalable interventions (e.g., micronutrient supplements and microbiota-directed complementary foods) if biological targets are identified. This study will leverage and extend follow-up of a well-characterized longitudinal pregnancy cohort of CHEU and CHU to: 1) compare markers of MetS, body composition, and proinflammatory precursors at ages 5-7 years by HIV exposure; 2) identify early-life host metabolomic and lipidomic profiles associated with neurocognitive and metabolic outcomes at school age; and 3) evaluate how early biological (nutrition, gut microbiome, systemic inflammation) and social factors (maternal mental health, maternal responsiveness) influence early metabolic and lipidomic profiles and how these factors affect markers of MetS and neurocognitive function at school age. These results will advance our understanding of early-life disruptions in host metabolomic and lipidomic pathways that shape school-age metabolic health and neurocognition in children born to mothers on optimized ART. Findings will provide mechanistic insights and inform precision nutrition strategies and novel therapeutics to target metabolic and lipid-related disruptions, enabling interventions that promote lifelong metabolic and brain health.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $2,242,674 )
2026	2026	UNIVERSITY OF WASHINGTON	4333 BROOKLYN AVE NE	SEATTLE	WA	98195	KING	USA	Child Health and Human Development Extramural Research	000	1	9/10/2026	NEW	$2,242,674
														Subtotal = $2,242,674

Grand Total All Awards = $2,242,674

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Early metabolic and lipid profiles and neurodevelopmental and metabolic outcomes in childhood: the Tunza Mwana-X study

Award Number: R01HD123924

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/10/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2029

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