application s abstract): This award will prepare Kathleen A. Brady, M.D., for a career as an independent investigator in HIV epidemiology with a special emphasis on the prevention and treatment of long term complications of HIV infection. She proposes a comprehensive, interdisciplinary program that will provide her with the skills and experience necessary for independent clinical research. The training component includes advanced education in clinical epidemiology and dual mentorship from an internationally known infectious disease epidemiologist and a highly experienced HIV clinical researcher. The research component will focus on herpes zoster in the HIV-infected host. Herpes zoster has been a well recognized complication of HIV infection since the early stages of the HIV epidemic. With the introduction of protease inhibitors several years ago combination antiretroviral therapy has become routine and has improved the clinical course of HIV infection. However although many other opportunistic infections have significantly declined with these powerful new therapies, herpes zoster remains a problem for HIV-infected patients. The precise magnitude of this problem has not been determined. The proposed research will: (a) examine the impact of combination antiretroviral therapy on the incidence of herpes zoster in HIV-infected adults; (b) establish the risk factors for herpes zoster in these same patients; and (c) utilize this information to design a safety and immunogenicity trial of live-attenuated varicella vaccine in patients infected with HIV.
