Candidate: I am a U.S. citizen and a non-clinician MD. After completing my MD degree, I completed two terminal degrees: a Masters in Public Health (2004) and a Doctorate in Public Health (2008), both completed from the University of North Texas Health Science Center, Fort Worth. During the time-periods that I was completing my doctorate degree, I served as a teaching assistant, and also provided biostatistical support for a project on HIV antiretroviral therapy at the Dallas VA (11/7-5/2008). I provided biostatistical support for other projects till April 2009 (see resume). In April 2009, I was recruited as a post-doctoral fellow in the VA Center for AIDS and HIV infection at the South Texas Veterans Health Care System (STVHCS) where I have worked under the direct mentorship of Dr. Sunil Ahuja. Under Dr. Ahuja's mentorship I have learnt new biostatistical tools and principles of HIV pathogenesis, and has been conducting genetic-epidemiology research. Because of my high potential, industry and talent I was promoted to an assistant professor on June 1, 2010. I am 2.5 years out from my DrPH. and and I am committed to an independent VA-based career in academic medicine. This CDA-2 will greatly enhance and refine my skills in statistical genetics, epidemiology and biostatistical research that has direct relevance to improving our understanding of HIV pathogenesis and improving health outcomes of VA HIV-infected patients. Environment. Dr. Sunil Ahuja will serve as my primary mentor and will be assisted by additional co-mentors and a career advisory team outlined. Dr. Ahuja is a highly accomplished nationally/internationally-recognized physician scientist who has extensive experience in the training and mentorship of junior faculty. Dr. Ahuja's role as a mentor and scientist was recently recognized by the receipt of the prestigious Doris Duke Distinguished Clinical Scientist Award as part of the goals of this award are to support and train young clinician- and non-clinician scientists. He is also supported by a NIH MERIT award and a VA MERIT award. My training will occur within the context of a highly supportive and intellectually rich scientific environment at the VA HIV/AIDS Center which oversees large Cores (E.g. Genetics core) that will also support my research. Research: There is burgeoning data demonstrating that virologic and immunologic events initiated during primary HIV infection play an influential role in setting the tempo of HIV disease course. For this reason, in this study, I will evaluate a large and intensively monitored acute/early infection cohort for evidence that during the proximal-most stages of HIV infection, immunologic and virologic control are partly dissociated, such that contemporaneous setpoints for CD4 cell counts and viral load are established during early infection. I will use candidate gene and genome-wide association studies to identify genetic determinants that underlie CD4-VL dissociation and factors controlling CD4 cell counts during acute/early infection. These investigations will build on the expertise of the nominee and the strong genetic infrastructure at the STVHCS and will enhance the basic science, translational, biostatistical and epidemiological research at the STVHCS.
The specific aims are tailored to enable the applicant to become an independently-funded researcher within the VA system. The studies will test novel hypotheses using state-ate of the art genetic and statistical approaches. These techniques will have broad applicability for other diseases, thus, expanding the ability of the nominee to address the growing needs of biostatistical expertise for personalized/genomic medicine within the VA. The studies proposed will facilitate and foster multi-disciplinary research at the local VA and improve health care of HIV infected patients by identifying critical host factors that influence CD4+ T cell loss during HIV disease and the CD4+ T cell recovery after initiation of potent antiviral therapy.