This is a renewal of the ACTG unit for the Los Angeles area, coordinated at UCLA Medical Center and Children's Hospital of Los Angeles (CHLA) . The consortium of clinical centers now includes units at UCLA, CHLA, Harbor/UCLA General Hospital, Memorial Medical Center of Long Beach, Cedars-Sinai Medical Center, the network of Kaiser Hospitals, and Martin Luther King Hospital, all of which have therapeutic centers for HIV+ children and collectively take care of over 60% of the HIV+ children in LA County. NIH-supported clinical research centers are used at UCLA and Harbor/UCLA Hospitals. Additional centers joining our Consortium will be in South Central LA, and possibly Hawaii and Las Vegas. We plan to enroll 78 patients on therapeutic trials in the first year and similar numbers in subsequent years. Centers for HIV+ pregnant women are located at six of these sites. The Consortium has developed effective liaisons with an LA County surveillance study, community health centers performing screening of pregnant women, a county-wide social service network for HIV+ children, and community representatives. Special emphasis will be on developing protocols and entering patients on trials to prevent maternal-fetal transmission, to assess HIV vaccine efficacy, and to prevent or overcome antiviral drug resistance. Scientific liaisons with virology, immunology, pharmacology and neurodevelopmental function are well developed throughout the Consortium and nested protocols are included for developmental research, core pediatric virology, an immunology core support program component, and a pharmacology core support research component. Developmental research components for immunology, virology and neurodevelopmental function are included. Overall this effort will include 32 clinicians and basic scientists as well as administrative personnel involved in data management and statistics. The overall goal is to shorten the time between basic scientific advances and clinical applicability.
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