• Alimenti, Ariane

    Titles
    Investigator, BC Children's Hospital
    Clinical Assistant Professor, Division of Infectious and Immunological Diseases, Department of Pediatrics, Faculty of Medicine, University of British Columbia
    Degrees / Designations
    MD
    Primary Area of Research
    Childhood Diseases
    Secondary Area(s) of Research
    Phone
    604-875 2000 ext. 5489
    Fax
    604-875-3063
    Lab Phone
    604-875-2463
    Assistant
    Elaine Fernandes
    Assistant Phone
    604- 875 2000 ext. 6861
    Mailing Address
    BC Women’s Hospital & Health Centre
    Room E600B 

    4500 Oak Street
    Vancouver, BC  V6H 3N1

    Affiliate Websites
    Research Areas
    • Pediatric HIV
    Summary

    My clinical research takes place at the Oak Tree Clinic, where a multidisciplinary team provides care to HIV+ women, their partners, and their children, both uninfected and HIV infected. We coordinate a Canadian surveillance program of mother-to-child HIV transmission. In uninfected children born to seropositive mothers, we investigate the potential effects of exposure to anti-HIV drugs during prenatal life on their long term health. In collaboration with a UBC laboratory, we study maternal, placental and infant blood cells for markers of premature aging or mutations.

    In children and adolescents living with HIV in BC, we investigate long term effects of HIV infection and the potential effects of medications on bone health and bone acquisition. We participate in multicentre studies, evaluating the response to the HPV vaccine in HIV+ girls and women, or the effectiveness of fish-oil (omega-3) supplements in the treatment of medication-associated high lipids in HIV+ children.

    Current Projects
    1. IS THE BONE HEALTH OF HIV INFECTED CHILDREN AND ADOLESCENTS COMPROMISED?

    A substudy of CARMA, the CIHR emerging team grant "Mechanism of aging following exposure to HIV antiretroviral drugs."

    Both HIV and the antiretrovirals are suspected to affect the acquisition of bone mass, raising concerns about bone strength and fracture risk.
    We have completed year 1 of this 3-year longitudinal study involving HIV infected children in BC (approximately 30). The objectives are to:
    a. Determine whether HIV infected children have low bone mass compared to a healthy local population, using DXA (Dual-Energy X-ray Absorptiometry)
    b. Assess bone strength using pQCT (peripheral quantitative computed tomography, a novel scanning technology
    c. Determine the role of calcium and vitamin D intake, physical activity, muscle power, severity of disease and HIV medications on bone mass and bone strength.
    Results are compared to an existing group of healthy BC children.
    This study will set the basis for a multicentre study and for clinical guidelines for assessment and intervention.

    2. CANADIAN PERINATAL HIV SURVEILLANCE PROGRAM (CPHSP)

    in collaboration with the Canadian HIV Trials Network (CTN) and Public Health Agency of Canada (PHAC).

    This web-based database collects data from 21 pediatric sites covering all Canadian provinces and territories. The program generates descriptive data annually on:
    A. HIV exposed children:
    • the number of infants born to HIV positive women in Canada
    • demographic, geographic and risk factor parameters of mother-infant pairs
    • the use of antiretroviral therapy (ART) in pregnancy (proportion of HIV+ pregnant women receiving ART, type and duration of ART in mother and infant)
    • the rate of mother-to-child HIV transmission
    • infant outcomes (mortality)
    B. HIV infected children:
    •the number of known perinatally infected infants and children followed at the centres
    •annual update on their clinical status, immune status and mortality

    3. LONG TERM HEALTH OUTCOMES OF HIV UNINFECTED CHILDREN BORN TO HIV INFECTED MOTHERS

    This study explores the accessibility of the BC cohort and examines the longer term health outcomes of HIV negative children exposed to antiretroviral therapy perinatally using a health questionnaire and by contact with their past or current health care professionals.
    At the end of this pilot project, based on study outcomes, we will develop and implement a comprehensive and outcome oriented study exploring:
    • the incidence of poor health outcomes such as growth abnormalities, susceptibility to infection, admissions to hospital, significant developmental disorders, poor scholastic performance, interaction with law enforcement, etc. in ARV exposed children compared to a age, sex and socio-economic status (parental education, household income and first 3 digits of postal code) matched control population;
    • the association between length and type of ARV exposure and specific poor health outcomes;
    • a comparison with the health outcomes of uninfected ARV exposed children from BC and three other pediatric HIV referral centres in Canada.

    We hypothesize that, compared to all British Columbian children, HIV-uninfected, ARV exposed children will have a higher frequency of poor health outcomes such as described above. Enrolment is 95% complete. This pilot of British Columbia HIV/ARV exposed children is largely hypothesis generating and will guide the development of a larger multi-centred project.

    Selected Publications

    A Alimenti, DR Burdge, G Ogilvie, D Money, J Forbes. Lactic acidemia in HIV uninfected infants exposed to perinatal antiretroviral therapy. Pediatr Infect Dis J, 2003; 22:782-8.

    A Alimenti, J.C. Forbes, Tim F. Oberlander, Deborah M Money, Ruth E Grunau, Michael P. Papsdorf, Evelyn Maan, Lesley J. Cole and David Burdge. A prospective controlled study of neurodevelopment in HIV-uninfected children exposed to combination antiretroviral drugs in pregnancy. Pediatrics 2006; 118; 1139-45.

    Public Health Agency of Canada. HIV and AIDS in Canada. Surveillance report to December 2007.

    Côté HC, Raboud J, Bitnun A, Alimenti A, Money DM, Maan E, Costei A, Gadawski I, Diong C, Read S, Shen S, Harrigan PR, Burdge DR, King SM, Forbes JC. Perinatal exposure to antiretroviral therapy is associated with increased blood mitochondrial DNA levels and decreased mitochondrial gene expression in infants.J Infect Dis. 2008 Sep 15;198(6):851-9.

    Grants
    Honours & Awards
    Research Group Members
    • Helene Cote, PhD, UBC Pathology Laboratory
    • Jack Forbes, MD
    • Deborah Money, MD
    • Neora Pick, MD 
    • Eliana Castillo, MD
    • David Burdge, MD 
    • Julie Van Shalkwijk, MD
    • Evelyn Maan, Research Coordinator 
    • Elaine Fernandes, Research Analyst 
    • Karen Friesen, Research Analyst 
    • Tessa Chaworth-Musters, Graduate Student