The rapid rollout of antiretroviral therapy (ART) in resource limited settings (RLS) with high rates of TB, diverse HIV subtypes and limited ART options urgently calls for research to define optimal treatment strategies. There is unprecedented interest among young health care professionals to pursue research careers in this area. The complexities and risks of conducting research in RLS require experienced investigators with protected time to adequately mentor these individuals. In this K24 renewal, Dr. Havlir proposes to train young investigators seeking academic careers in HIV related research in RLS. Dr. Havlir's initial K24 permitted her to acquire skills to design and conduct HIV research in RLS, to establish an NIH funded multidisciplinary research program in Kampala, Uganda, and to successfully compete for a T32 grant to support training of patient based research in HIV. With these resources in place, she proposes to mentor new US and international investigators through NIH funded network studies, and through "add on" studies that leverage funded cohort studies. She will also develop web based mentoring that links expertise of experienced investigators to young investigators from RLS. Dr. Havlir's research program over the next 5 years will include a leadership role in three large trials. 1. Randomized clinical trial (RCT) to define optimal timing of ART in the setting of active TB (ACTG 5221) 2. RCT to determine if early ART (CD4 >350) reduces AIDS, TB and death compared to standard of care (HPTN 052/ACTG 5245) 3. RCT to define optimal second line antiretroviral treatments. A series of pilot studies led by junior investigators to characterize drug resistance among treatment failures on first line therapy will precede the development of the study of second line therapies. The overarching goal of this proposal is to train the next generation of researchers that will address issues in RLS while addressing contemporary critical research questions. Secondarily, optimal and innovative ways to mentor young investigators working in RLS will be developed and evaluated.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AI051982-11
Application #
8238377
Study Section
Acquired Immunodeficiency Syndrome Research Review Committee (AIDS)
Program Officer
Livnat, Daniella
Project Start
2002-04-15
Project End
2014-03-31
Budget Start
2012-04-01
Budget End
2014-03-31
Support Year
11
Fiscal Year
2012
Total Cost
$133,342
Indirect Cost
$9,877
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Kotwani, Prashant; Balzer, Laura; Kwarisiima, Dalsone et al. (2014) Evaluating linkage to care for hypertension after community-based screening in rural Uganda. Trop Med Int Health 19:459-68
Moyers, Brian S; Secemsky, Eric A; Vittinghoff, Eric et al. (2014) Effect of left ventricular dysfunction and viral load on risk of sudden cardiac death in patients with human immunodeficiency virus. Am J Cardiol 113:1260-5
Tseng, Zian H; Moyers, Brian; Secemsky, Eric A et al. (2013) PR Interval and sudden cardiac death in patients with HIV infection. J Infect Dis 207:199-200
Kay, Jenna; Wanzira, Humphrey; Sandison, Taylor et al. (2012) Virologic suppression in nevirapine-exposed HIV-infected infants initiating antiretroviral therapy in rural Uganda. J Trop Pediatr 58:194-9
Charlebois, Edwin D; Das, Moupali; Porco, Travis C et al. (2011) The effect of expanded antiretroviral treatment strategies on the HIV epidemic among men who have sex with men in San Francisco. Clin Infect Dis 52:1046-9
Dowdy, David W; Geng, Elvin H; Christopoulos, Katerina A et al. (2011) Mortality among antiretroviral-eligible patients in an urban public clinic. J Acquir Immune Defic Syndr 57:297-300
Cohen, Myron S; Chen, Ying Q; McCauley, Marybeth et al. (2011) Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 365:493-505
Ruel, Theodore D; Zanoni, Brian C; Ssewanyana, Isaac et al. (2011) Sex differences in HIV RNA level and CD4 cell percentage during childhood. Clin Infect Dis 53:592-9
Haubrich, Richard H; Riddler, Sharon A; Ribaudo, Heather et al. (2011) Initial viral decay to assess the relative antiretroviral potency of protease inhibitor-sparing, nonnucleoside reverse transcriptase inhibitor-sparing, and nucleoside reverse transcriptase inhibitor-sparing regimens for first-line therapy of HIV infection AIDS 25:2269-78
Geng, Elvin H; Kahn, James S; Chang, Olivia C et al. (2011) The effect of AIDS Clinical Trials Group Protocol 5164 on the time from Pneumocystis jirovecii pneumonia diagnosis to antiretroviral initiation in routine clinical practice: a case study of diffusion, dissemination, and implementation. Clin Infect Dis 53:1008-14

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