Abstract

The goal of this project is to conduct high quality patient oriented research with HIV infected patients which focuses on answering clinical and pathogenesis based questions concerning antiretroviral therapy and evaluates new and emerging strategies to improve the clinical management of antiretroviral therapy. The central hypothesis of the project is that carefully planned and analyzed studies can not only answer questions about specific treatment combinations, but can also provide insight into the pathogenesis of treatment responses and define strategies to manage patients in the clinic. Mentoring young investigators (M.P.H. students, Infectious Disease fellows, and junior faculty) will be a central goal of this project. These goals will be accomplished by conceiving, designing, initiating, carrying out, and analyzing randomized controlled trials in collaboration with local (UCSD AVRC), statewide (California Collaborative Treatment Group [CCTG]), and national (AIDS Clinical Trials Group [ACTG]) clinical trials organizations. As the overall Principal Investigator of the CCTG, I will be able to continue the tradition of fostering the development of junior investigators through active participation in CCTG studies. The primary research theme is to understand the antiretroviral exposure-response relationship and its implications for the pathogenesis and management of HIV.
The specific aims are: ? ? 1) To examine the mechanistic pathways leading to therapeutic failure of TDF + ABC by evaluating ? nucleoside plasma and intracellular exposure-response relationships. The study will use a unique clinical trial design (cross-over, pharmacokinetic evaluation of short-term viral dynamics) to evaluate the interaction between TDF and ABC. ? ? 2) To define the role of antiretroviral exposure-response relationships in HIV therapeutics.
Aim 2 A: To evaluate the value of therapeutic drug monitoring (TDM) to improve the management and outcome of antiretroviral therapy.
Aim 2 B: To define the impact of genetic differences (defined by allelic variants of single nucleoside polymorphisms) on exposure and response to lopinavir, the antiretroviral agent. ? ?

  Funding Agency

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 #
1K24AI064086-01A1
Application #
7064358
Study Section
Acquired Immunodeficiency Syndrome Research Review Committee (AIDS)
Program Officer
Welsch, Sue A
Project Start
2006-03-15
Project End
2011-02-28
Budget Start
2006-03-15
Budget End
2007-02-28
Support Year
1
Fiscal Year
2006
Total Cost
$154,779
Indirect Cost

  Institution

Name
University of California San Diego
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093

  Publications

Hoenigl, Martin; Jain, Sonia; Moore, David et al. (2018) Substance Use and Adherence to HIV Preexposure Prophylaxis for Men Who Have Sex with Men1. Emerg Infect Dis 24:
Dan, Jennifer M; Massanella, Marta; Smith, Davey M et al. (2016) Brief Report: Effect of CMV and HIV Transcription on CD57 and PD-1 T-Cell Expression During Suppressive ART. J Acquir Immune Defic Syndr 72:133-7
Innes, Steve; Abdullah, Kameelah L; Haubrich, Richard et al. (2016) High Prevalence of Dyslipidemia and Insulin Resistance in HIV-infected Prepubertal African Children on Antiretroviral Therapy. Pediatr Infect Dis J 35:e1-7
Milam, Joel; Morris, Sheldon; Jain, Sonia et al. (2016) Randomized Controlled Trial of an Internet Application to Reduce HIV Transmission Behavior Among HIV Infected Men Who have Sex with Men. AIDS Behav 20:1173-1181
Paris, Robert M; Petrovas, Constantinos; Ferrando-Martinez, Sara et al. (2015) Selective Loss of Early Differentiated, Highly Functional PD1high CD4 T Cells with HIV Progression. PLoS One 10:e0144767
Karris, Maile Y; Haubrich, Richard H (2015) Antiretroviral therapy in the elite controller: justified or premature? J Infect Dis 211:1689-91
Krishnan, Supriya; Schouten, Jeffrey T; Atkinson, Benjamin et al. (2015) Changes in metabolic syndrome status after initiation of antiretroviral therapy. J Acquir Immune Defic Syndr 68:73-80
Massanella, Marta; Gianella, Sara; Schrier, Rachel et al. (2015) Methamphetamine Use in HIV-infected Individuals Affects T-cell Function and Viral Outcome during Suppressive Antiretroviral Therapy. Sci Rep 5:13179
Tashima, Karen T; Mollan, Katie R; Na, Lumine et al. (2015) Regimen selection in the OPTIONS trial of HIV salvage therapy: drug resistance, prior therapy, and race-ethnicity determine the degree of regimen complexity. HIV Clin Trials 16:147-56
Gianella, Sara; Smith, Davey M; Daar, Eric S et al. (2015) Genital Cytomegalovirus Replication Predicts Syphilis Acquisition among HIV-1 Infected Men Who Have Sex with Men. PLoS One 10:e0130410

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