This is a proposal to create an AIDS Clinical Research Group (CRG) at the Indiana University School of Medicine in Indianapolis. Although the number of cases of HIV infection has been relatively low in Indiana so far, it is now starting to increase, and we anticipate that during the proposed period of funding it will be more than adequate to permit us to evaluate experimental therapies for HIV infection and some of its complications. Specifically, we propose to evaluate the pharmacokinetics, toxicity, and efficacy of new anti-viral agents which have in vitro activity against HIV. Agents to be evaluated would include those provided by NIAID and synthetic oligonucleotides developed under a collaborative arrangement with Purdue University. Members of the proposed CRG have successfully established a rat pneumocystis model and an in vitro culture system for rat pneumocystis. It is now proposed to identify virulence markers including those for antibiotic resistance for different strains of pneumocystis, and to couple these with clinical evaluation of the efficacy and toxicity of agents (or combinations of agents) in the treatment of pneumocystis. In addition, antigen detection methods would be employed for diagnosis of disseminated histoplasmosis in order to better define its prevalence in patients with AIDS and to evaluate efficacy and toxicity of available, or newly developed, anti-fungal regimens. We also propose to prospectively follow a series of immune markers in order to identify those which may be predictive of progression of immunological deficit and/or disease, and to define optimum points for potential intervention with anti- viral chemotherapy. In conjunction with these studies there will be an evaluation of the cost-effectiveness of close medical follow-up of individuals with asymptomatic HIV infection and of home health versus hospital based care. In addition, we propose to expand and further evaluate a program which is designed to reduce the risk of transmission of HIV infection by providing photo identification cards which contain information on an individual's HIV antibody status. The formation of this group would focus the attention of a number of skilled investigators at Indiana University on the problem of HIV infections and would permit infected individuals in this region of the country to participate in the evaluation of new therapeutic modalities.
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