I am a Clinical Associate Professor in Medicinein the Renal Division at Mount Sinai School of Medicine, and currently funded as a co-investigator in the program project grant entitled """"""""Pathogenesis of HIV-Associated Nephropathy"""""""" (PO1 DK56492). I supervise a tissue repository and clinical database for human subjects with HIV-1 related kidney disease. This supports studies on the genetic, viral, and host-viral interactions in the molecular pathogenesis of HIV-associated nephropathy. This is an extremely strong environment in which to translate basic discoveries in HIVAN pathogenesis into well‑designed clinical studies. HIV-associated nephropathy (HIVAN) is the third leading cause of ESRD in young blacks. Our studies have shown that the initial event in disease pathogenesis is HIV-1 entry in to renal epithelial cells. We have also shown that a pool of replicating virus exists in the kidney during highly active antiretroviral therapy (HAART). My studies during this award will reassess the prevalence of HIVAN in the HAART era, and analyze the determinants of progression to ESRD. I have designed a randomized-controlled clinical trial to test the effects of viral suppression, with and without converting enzyme inhibitors, on the rate of decline in GFR. Long term studies are planned to determine how the viral reservoir in the kidney contributes to the plasma viral load and subsequent morbidity and mortality. I have a strong record of performing patient‑oriented research and considerable mentoring experience. I will matriculate in a postgraduate program for biostatistics and patient‑oriented research, which will help advance my career. The studies provide an exciting clinical framework in which to mentor junior investigators. Studies can be completed within the 5 year term and they provide close interactions between basic scientists and clinical investigators, both at Mount Sinai and through the AACTG. The environment for clinical research training at Mount Sinai is strong. The mentoring program will be structured to provide active participation in clinical research, and didactic work through conferences and clinical research educational programs. The award is structured to allow me to intensify my efforts in clinical research, develop new research skills through postgraduate work, and mentor trainees in clinical epidemiology, clinical trials and outcomes research.
| Gupta, Samir K; Eustace, Joseph A; Winston, Jonathan A et al. (2005) Guidelines for the management of chronic kidney disease in HIV-infected patients: recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 40:1559-85 |
| Schwartz, Elissa J; Szczech, Lynda A; Ross, Michael J et al. (2005) Highly active antiretroviral therapy and the epidemic of HIV+ end-stage renal disease. J Am Soc Nephrol 16:2412-20 |
| Szczech, Lynda Anne; Gupta, Samir K; Habash, Ramez et al. (2004) The clinical epidemiology and course of the spectrum of renal diseases associated with HIV infection. Kidney Int 66:1145-52 |
