Liver disease has emerged as a major source of morbidity and mortality in the United States with a disproportionate representation in some identifiable groups. Furthermore, unique management and treatment issues are associated with """"""""special populations"""""""". This K-24 application demonstrates the candidate's focus on mentorship that is needed to develop the next generation of investigators who can perform patient-oriented research in populations with viral hepatitis and HIV infection. The etiologies of progressive liver disease are multifactorial and include viral hepatitis, drug toxicities including those associated with highly active antiretroviral therapies (HAART), alcohol, and variable levels of immunosuppression. Evidence is provided that the candidate is well equipped to provide mentorship of junior faculty and trainees within the context of his programmatic goals. This proposal includes a) Description of the candidate's commitment to patient-oriented research b) Characterization of key aspects of a mentorship program that incorporates elements of didactic training, involvement of trainees and junior faculty in ongoing research activities, and ongoing interaction between candidate and mentee to develop nascent patient based research careers .c) Review of the specific research activities funded by NIH and the pharmaceutical industry that serve as a structural framework for patient-oriented research. These experiences include all aspects of study design, statistical and data management, research ethics, research patient management, analysis, and publication. Most mentees are introduced to advanced laboratory techniques that utilize patient-derived samples in an effort to merge bed and bench experiences.
Liver disease is an important cause of morbidity and mortality in those with HIV infection. Research into pathobiologic mechanisms and study of treatment interventions is critical to future management paradigms. This grant serves as a vehicle to train the next generation of researchers in the context of an active patient-oriented research agenda focused on these issues.
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