Researchers at Children’s Hospital of Philadelphia (CHOP), working with the Botswana Harvard Health Partnership, have identified differences in brain tissue patterns between newborns exposed to HIV during pregnancy but not infected and those with no HIV exposure. The findings were published in Early Human Development.
The study focused on infants born to mothers who are HIV-positive and on antiretroviral therapy. Each year, more than one million such infants are born worldwide, many classified as HIV-exposed uninfected (HEU). Previous research has indicated that HEU infants may face a higher risk of developmental delays compared to HIV-unexposed (HU) infants.
The CHOP research team, led by Laith Sultan, MD, MPH, along with Hansel Otero, MD, and Elizabeth D. Lowenthal, MD, MSCE, FAAP, AAHIVS, performed brain ultrasounds on 33 newborns—20 HEU and 13 HU. Using radiomic analysis to examine microscopic texture variations in the basal ganglia and periventricular white matter—regions important for movement, learning, and communication—the researchers found changes that could be associated with long-term neurodevelopmental outcomes.
The authors emphasized that while these results are preliminary and do not confirm brain injury or developmental harm, they highlight the need for further investigation into how in-utero HIV exposure might affect brain development.
“Early detection through affordable and accessible imaging methods like ultrasounds could allow for closer developmental monitoring and earlier interventions for at-risk children,” said Sultan. “Our study highlights the potential of radiomics as a low-cost, non-invasive tool to assess newborn brain health, especially in low-resource settings where HIV prevalence is high.”
Future plans include following the participating infants to see if the detected textural differences correspond to later cognitive or motor outcomes. This work was supported by a grant from the Penn Center for AIDS Research (CFAR), an NIH-funded program.
Sultan et al. “Brain ultrasound radiomics identify textural differences in basal ganglia and white matter between full term newborns HIV-exposed uninfected and HIV-unexposed in Botswana.” Early Human Development. Online August 6, 2025. DOI: 10.1016/j.earlhumdev.2025.106368.
