In response to increased activity of HIV related disease in greater Cincinnati, Dr. Frame, Director of the UC AIDS Related Disorders Clinic, and faculty of the Department of Internal Medicine, are organizing an AIDS Clinical Studies Group (UC- AIDS-CSG). The keystone of the CSG is a Core Patient Management Unit (CPMU) which will serve as a resource for epidemologic, clinical, virologic, immunologic, treatment, and other studies of HIV infection. This proposal details the elements and functions of the CPMU, led by Dr. Frame, and contains several innovative protocols which are the first of a long series of studies to be supported by the CPMU. Through a variety of outreach programs followed by testing and physical examination, the CPMU will develop and define four cohorts of individuals (CDC stage O = uninfected, I = primary infection, II and III = asymptomatic, IV = symptomatic or opportunistic disease) to be followed during the entire five year duration of the program. The CPMU will periodically gather epidemiologic, clinical, and virologic data on these cohorts, with special emphasis on stage I infection. The descriptive data gathered and organized by the CPMU will be available to relate to the research programs included in this proposal, as well as those of other investigators who wish to pursue scientific questions related to HIV infection. We propose two studies of therapeutic agents: Dr. Walzer's proposal to coordinate a multicenter trial to study the treatment of Pneumocystis carinii pneumonia, and Dr. Wong's proposal for a multicenter placebo controlled trial to assess the effect of antiviral therapy on the asymptomatic stages of HIV infection (I- II-III). Linked to the PCP treatment trial are Dr. Baughman's continuing investigations into the diagnosis of PCP and other opportunistic lung pathogens. With a specific focus on early (stage I) HIV infection, Dr. Deepe's laboratory will study the reactivity of T lymphocytes from HIV infected subjects to specific antigens of the virus and to PC antigens developed in Dr. Walzer's laboratory; and Dr. Bullock's laboratory will study the effects of HIV and its antigens on IL-1 production, chemotaxis, and adherence-promoting surface glycoprotein expression of macrophages. The basic epidemiology of HIV infection in a medium sized midwestern city in the late 1980's will be investigated in Dr. Linnemann's study, including the effect of the factors which will influence high risk behavior over the 5 year period of this program.
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