This Durban CTU application is underpinned by a central administrative hub that serves the 3 HIV clinic research sites included in this application. They bring together 3 major disciplines, most affected by the rising morbidity and mortality from HIV/AIDS viz. adult medicine, pediatrics, and obstetrics and gynecology from the University of KwaZulu-Natal, to develop and promote research into translational drug research, optimization of clinical management and co-morbidities and to complement prevention and vaccine research programs in the region. The principal investigator Prof. Umesh Lalloo (also site leader for the Adult HIV Research Clinic)is supported by site experienced site leaders for the other reseach clinics proposed. Administration, Pharmacy, Lab Services and Data Management are the shared resources for all three sites.The long-term objectives are to: 1. Promote development of new strategies (drugs, immunomodulation, and regimens) to simplify the complex treatment of HIV/AIDS, given the immense impact of the epidemic in resource limited settings. This will ensure optimal treatment options in a Clade C HIV epidemic and where the threat of ARV drug resistance is serious and drug interactions are important, given the multiple comorbidities 2. Promote the development of optimal strategies to treatment the complications of HIV, which contributes to the rising morbidity and mortality 3. Promote the development of scientific and clinical research expertise in resource limited settings in individuals from previously disadvantaged groups
OF THE PROPOSED RESEARCH TO PUBLIC HEALTH The Province of KwaZulu-Natal has one the fastest growing HIV epidemics in the world and almost one in 3 adults and one in 15 children and infants are infected with HIV. The Clinical Trials Unit is unique because it includes infants, children and adults, and in particular has a research site that concentrates on health problems in HIV positive women, an area that is neglected in most HIV research programs. The epidemic has progressed to a stage where large numbers of people are experiencing complications of HIV and this Clinical Trials Unit will investigate translational drug research and optimal management strategies for common complications such as cryptococcal meningitis, tuberculosis, toxoplasmosis, viral hepatitis, pneumocystis, carinii pneumonia, and diarrhoeal diseases that cause considerable suffering and death.
