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.


Blood Mitochondrial DNA Content in HIV-Exposed Uninfected Children with Autism Spectrum Disorder
Matthew Budd, Kristina Calli, Lindy Samson, Jennifer Bowes, Anthony Hsieh, John Forbes, Ari Bitnun, Joel Singer, Fatima Kakkar, Ariane Alimenti, Evelyn Maan, M. Lewis, Carole Gentile, Hélène Côté, Jason Brophy
DOI: 10.3390/v10020077

Mobile Text Messaging to Improve Medication Adherence and Viral Load in a Vulnerable Canadian Population Living With Human Immunodeficiency Virus: A Repeated Measures Study
Journal of Medical Internet Research
Elizabeth King, Karen Kinvig, Jonathan Steif, Annie Q Qiu, Evelyn J Maan, Arianne YK Albert, Neora Pick, Ariane Alimenti, Mary H Kestler, Deborah M Money, Richard T Lester, Melanie Caroline Margaret Murray
DOI: 10.2196/jmir.6631

Immunogenicity and Safety of the Quadrivalent Human Papillomavirus Vaccine in Girls Living with HIV
The Pediatric Infectious Disease Journal
Jason Brophy, Ari Bitnun, Ariane Alimenti, Normand Lapointe, Lindy Samson, Stanley Read, Christos Karatzios, Simon Dobson, Erin Moses, Sandra Blitz, Nancy-Grace Lipsky, Gina Ogilvie, Sharon Walmsley, Janet Raboud, Deborah Money
DOI: 10.1097/inf.0000000000001874

Leukocyte Telomere Length at Birth and During the Early Life of Children Exposed to but Uninfected With HIV After In Utero Exposure to Antiretrovirals
The Journal of Infectious Diseases
Abhinav Ajaykumar, Hugo Soudeyns, Fatima Kakkar, Jason Brophy, Ari Bitnun, Ariane Alimenti, Arianne Y K Albert, Deborah M Money, Hélène C F Côté, Neora Pick, Melanie Murray, Patricia Janssen, Joel Singer, Normand Lapointe, Jerilynn Prior, Michael Silverman, Mary Lou Smith, CIHR Team in Cellular Aging and HIV Comorbidities in Women and Children
DOI: 10.1093/infdis/jix618

HIV viral suppression results in higher antibody responses in HIV-positive women vaccinated with the quadrivalent human papillomavirus vaccine
Deborah M. Money, Erin Moses, Sandra Blitz, Shannon M. Vandriel, Nancy Lipsky, Sharon L. Walmsley, Mona Loutfy, Sylvie Trottier, Fiona Smaill, Mark H. Yudin, Marina Klein, Marianne Harris, Jeffrey Cohen, Wendy Wobeser, Ari Bitnun, Normand Lapointe, Lindy Samson, Jason Brophy, Christos Karatzios, Gina Ogilvie, François Coutlée, Janet Raboud, Ariane Alimenti, Simon Dobson, Catherine Hankins, Janet Hill, Mel Krajden, Jessica McAlpine, Neora Pick, Joel Singer, Sarah Stone, Marcie Summers, Darrell Tan, Laura Vicol, Julie van Schalkwyk
DOI: 10.1016/j.vaccine.2016.08.016

Guidelines for the Care of Pregnant Women Living With HIV and Interventions to Reduce Perinatal Transmission: Executive Summary
Journal of Obstetrics and Gynaecology Canada
Deborah Money, Karen Tulloch, Isabelle Boucoiran, Sheila Caddy, Mark H. Yudin, Victoria Allen, Celine Bouchard, Marc Boucher, Isabelle Boucoiran, Sheila Caddy, Eliana Castillo, Heather Gottlieb, V. Logan Kennedy, Deborah Money, Kellie Murphy, Gina Ogilvie, Caroline Paquet, Julie van Schalkwyk, Ariane Alimenti, Neora Pick
DOI: 10.1016/s1701-2163(15)30515-6

Prevention of Vertical HIV Transmission and Management of the HIV-Exposed Infant in Canada in 2014
Canadian Journal of Infectious Diseases and Medical Microbiology
Ari Bitnun, Jason Brophy, Lindy Samson, Ariane Alimenti, Fatima Kakkar, Valerie Lamarre, Dorothy Moore, Christos Karatzios, Sandra Seigel, Laura Sauve, Wendy Vaudry, Mark H Yudin, Deborah Money
DOI: 10.1155/2014/526019

Leukocyte Telomere Length in HIV-Infected Pregnant Women Treated With Antiretroviral Drugs During Pregnancy and Their Uninfected Infants
JAIDS Journal of Acquired Immune Deficiency Syndromes
Tuhina Imam, Marissa H. J. Jitratkosol, Hugo Soudeyns, Beheroze Sattha, Izabelle Gadawski, Evelyn Maan, John C. Forbes, Ariane Alimenti, Normand Lapointe, Valerie Lamarre, Deborah M. Money, Hélène C. F. Côté
DOI: 10.1097/qai.0b013e31825aa89c

Leukocyte Telomere Length in HIV-Infected and HIV-Exposed Uninfected Children: Shorter Telomeres with Uncontrolled HIV Viremia
Hélène C. F. Côté, Hugo Soudeyns, Anona Thorne, Ariane Alimenti, Valérie Lamarre, Evelyn J. Maan, Beheroze Sattha, Joel Singer, Normand Lapointe, Deborah M. Money, John Forbes, the CIHR Emerging Team in HIV therapy, aging (CARMA)
DOI: 10.1371/journal.pone.0039266

Blood mitochondrial DNA mutations in HIV-infected women and their infants exposed to HAART during pregnancy
Marissa H.J. Jitratkosol, Beheroze Sattha, Evelyn J. Maan, Izabelle Gadawski, P. Richard Harrigan, John C. Forbes, Ariane Alimenti, Julie van Schalkwyk, Deborah M. Money, Hélène C.F. Côté
DOI: 10.1097/qad.0b013e32835142eb

A national review of vertical HIV transmission
John C. Forbes, Ariane M. Alimenti, Joel Singer, Jason C. Brophy, Ari Bitnun, Lindy M. Samson, Deborah M. Money, Terry C.K. Lee, Normand D. Lapointe, Stanley E. Read
DOI: 10.1097/qad.0b013e328350995c

Somatic AgC/TgG mitochondrial DNA mutations in HIV-infected pregnant women and their infants exposed to HIV antiretroviral therapy during pregnancy
Marissa Jitratkosol, Beheroze Sattha, Izabelle Gadawski, Evelyn Maan, R. Richard Harrigan, Ariane Alimenti, John Forbes, Deborah Money, Hélène C.F. Côté¿
DOI: 10.1016/j.mito.2011.03.080

Evaluation of an Emergency Prevention Program for Mother to Child Transmission of HIV in British Columbia
Journal of Obstetrics and Gynaecology Canada
Sarah J. Saunders, Laura E. Weingarten, Evelyn Maan, Tessa Chaworth-Musters, John C. Forbes, Ariane Alimenti, Jill Mahy, David R. Burdge, Julie van Schalkwyk, Gloria Tsang, Carlo Quaia, Robert S. Hogg, Deborah M. Money
DOI: 10.1016/s1701-2163(16)34851-4

Perinatal Exposure to Antiretroviral Therapy Is Associated with Increased Blood Mitochondrial DNA Levels and Decreased Mitochondrial Gene Expression in Infants
The Journal of Infectious Diseases
Hélène C. F. Côté, Janet Raboud, Ari Bitnun, Ariane Alimenti, Deborah M. Money, Evelyn Maan, Adriana Costei, Izabelle Gadawski, Christina Diong, Stanley Read, Sandy Shen, P. Richard Harrigan, David R. Burdge, Susan M. King, John C. Forbes
DOI: 10.1086/591253

Growing up: Perspectives of children, families and service providers regarding the needs of older children with perinatally-acquired HIV
S. J. Fielden, L. Sheckter, G. E. Chapman, A. Alimenti, J. C. Forbes, S. Sheps, S. Cadell, J. C. Frankish
DOI: 10.1080/09540120600581460

A Prospective Controlled Study of Neurodevelopment in HIV-Uninfected Children Exposed to Combination Antiretroviral Drugs in Pregnancy
A. Alimenti, J. C. Forbes, T. F. Oberlander, D. M. Money, R. E. Grunau, M. P. Papsdorf, E. Maan, L. J. Cole, D. R. Burdge
DOI: 10.1542/peds.2006-0525

Lactic acidemia in human immunodeficiency virus-uninfected infants exposed to perinatal antiretroviral therapy
The Pediatric Infectious Disease Journal
DOI: 10.1097/01.inf.0000086400.93257.74

Cardiac and autonomic evaluation in a pediatric population with human immunodeficiency virus
Clinical Cardiology
D. Plein, G. Van Camp, B. Cosyns, A. Alimenti, J. Levy, J.-L. Vandenbossche
DOI: 10.1002/clc.4960220112

Detection of virus in vertically exposed HIV-antibody-negative children
The Lancet
M-L Newell, D Dunn, C Peckham, A De Maria, A Ferrazin, A De Rossi, C Giaquinto, J Levy, A Alimenti, A Ehrnst, A-B Bohlin, R Ljung
DOI: 10.1016/s0140-6736(96)90401-8

Quantitation of HIV-1 in whole blood of infected children
Ariane Alimenti, Katherine Luzuriaga, John L. Sullivan, Chantal Van den Borre, Georges Zissis, Jack Levy
DOI: 10.1097/00002030-199407000-00005

Secondary infection with parvovirus B19 in an HIV-positive patient
J. A.G. Bremner, S. Beard, B. J. Cohen, A. Alimenti, J. Levy
DOI: 10.1097/00002030-199308000-00021

Excellent sensitivity and specificity of HIV-1 cultures using whole blood
A. Alimenti, J. L. Sullivan, J. Levy, K. Luzuriaga
DOI: 10.1097/00002030-199308000-00017

Diagnosis of Vertical Human Immunodeficiency Virus Type 1 Infection byWhole Blood Culture
Journal of Infectious Diseases
A. Alimenti, M. O'Neill, J. L. Sullivan, K. Luzuriaga
DOI: 10.1093/infdis/166.5.1146


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.

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

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.