Kathleen Marie Powis

Biography

I am interested in optimizing the health of pregnant and postpartum women living with HIV and ensuring that their children, whether born HIV-infected or HIV-exposed yet uninfected, thrive in terms of health, growth and development. Much of my research has been based in Botswana where approximately 20% of all pregnant women are living with HIV-1. Under the guidance of Dr. Roger L Shapiro, Principal Investigator, we were able reduce vertical transmission of HIV to 1.1% in an NIH funded, randomized clinical trial, the Mma Bana study. The clinical trial enrolled pregnant women who were living with HIV but were HIV treatment naïve pregnant Botswana. Participants were randomized to receive either a triple nucleoside reverse transcriptase inhibitor antiretroviral treatment regimen or a protease inhibitor(PI)-based triple antiretroviral regimen initiated between the 26th and 34th week of gestation and continued for up to six months postpartum, covering the period of exclusive breast feeding.

Using data from the Mma Bana study we identified that PI-based antiretroviral (ARV) regimens were associated with an increased risk of preterm delivery. Poor maternal weight gain in the one month period after ARV initiation among women randomized to the PI-based regimen may represent one of the mechanisms responsible for preterm delivery. Using data from the Mma Bana study along with a second clinical trial conducted through the Botswana Harvard Health Partnership (BHP), we determined that in utero exposure to maternal triple antiretroviral treatment (ART) regimens resulted in lower mean birth weight for HIV-exposed uninfected infants as compared with in utero exposure to zidovudine monotherapy. Using longitudinal date, we identified that in utero ART exposed infants experienced improvement in weight by the second month of life, but that length-for-age z-scores were significantly lower through two years of life. This was the first longitudinal analysis of growth patterns among infants HIV-exposed uninfected that evaluated differences in the in utero exposure, either AZT alone or triple ARVs.

The Mma Bana study was one of the studies that led the World Health Organization to recommendation immediate initiation of ART in pregnancy for any persons living with HIV, regardless of their HIV disease stage. Since 2010, over 1 million children are born each year HIV-exposed but uninfected. The majority of these children are born in low resourced setting and continue to experience higher risk of morbidity and mortality compared with children born to women who are HIV seronegative. The source of this increased risk is multifactorial, including biological, social, and structural mechanisms. Identifying the mechanistic pathways for the increased risk and testing interventions to ameliorate the risk is the main focus of my current research efforts. I have also worked closely with the World Health Organization, UNICEF, and the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) to ensure that significant findings from my research and that of others results in adaptations to health policing and programming.

Awards and Honors

• R21 - Evolution of Gut Microbiome among HIV-Exposed Uninfected Infants in Botswana, 2015 - 2017
  NIAID
• K23 - Growth Trends and Mortality Risks Among HIV-exposed Infants in Botswana, 2012 - 2017
  NIH
• Scholar Award, 2011 - 2012
  Harvard Center for AIDS Research
• Young Investigators Award, 2011
  Conference on Retroviruses and Opportunisitic Infections
• Botswana Clinical and Research Fellow, 2010 - 2011
  Harvard Institute for Global Health; Harvard Center for AIDS Research
• Young Investigators Award, 2010
  Conference on Retroviruses and Opportunistic Infections
• Botswana Clinical and Research Fellow, 2009 - 2010
  Harvard Institute for Global Health
• L. Beverly Chaney Scholarship, 2003
  Medical College of Virginia
• Alpha Omega Alpha, 2003
  Virginia Commonwealth University - Medical College of Virginia
• Stuart and Lillian Moore Scholarship, 2001 - 2002
  Medical College of Virginia

Publications

• Low placental growth factor levels mid-gestation predict small for gestational age in pregnant women with HIV.

  Dunk CE, Powis KM, Legbedze J, Sun S, Mmasa KN, Kgole SW, Masasa G, Moyo S, Mohammed T, Yee LM, Mmalane MO, Makhema JM, Jao J, Serghides L. J Acquir Immune Defic Syndr 2025 Apr 03

  PMID: 40179283

• Predictive markers for sustained viral suppression on dual bNAbs during ART interruption in children.

  Banga J, Nelson BS, Ajibola G, Mohammed T, Maphorisa C, Boleo C, Moyo S, Batlang O, Sakoi-Mosetlhi M, Maswabi K, Holme MP, Powis KM, Lockman S, Hughes MD, Makhema J, Kuritzkes DR, Litcherfeld M, Shapiro R. J Acquir Immune Defic Syndr 2025 Mar 26

  PMID: 40136003

• Pharmacokinetics and Safety of Bictegravir in Pregnant and Postpartum Persons With HIV and Their Infants.

  Powis KM, Pinilla M, McMorrow F, Stek A, Brooks KM, Shapiro DE, Knowles K, Eke AC, Greene E, Agwu A, Topete L, Browning R, Chakhtoura N, Arora P, Huang X, Best BM, Mirochnick M, Momper JD. J Acquir Immune Defic Syndr 2025 Mar 01

  PMID: 39813286

• Neurodevelopmental outcomes in children exposed in utero to dolutegravir- or efavirenz-based antiretroviral treatment.

  Cassidy AR, Mayondi G, Williams PL, Moabi K, LeMahieu A, Kamanga N, Powis KM, Isquith P, Ramaabya D, Banda FM, Makhema J, Kammerer B, Lockman S. AIDS 2025 Apr 01

  PMID: 39764770

• Adverse birth outcome research case definitions associated with maternal HIV and antiretroviral drug use in pregnancy: a scoping review.

  Dube KR, de Beer ST, Powis KM, McCaul M, Slogrove AL. BMC Pregnancy Childbirth 2024 Dec 21

  PMID: 39709379