The goals of the pediatric HIV research effort are to conduct translational research aimed at developing improved therapies for children with HIV infection and HIV-associated malignancies, to understand the pathogenesis of pediatric HIV disease, and to study the impact of pediatric HIV disease on the patients and their families. Both antiretroviral and immunologic approaches for HIV therapy are currently being investigated. As a result of strategic changes in priority, this project has been substantially reduced in scope since FY2005. However, some meritorious work is continuing, being done largely by Dr. Rohan Hazra (an Adjunct member of HAMB) and Julia Purdy (a member of the HAMB Office of the Chief). We have closed the protocols on the use of tenofovir, a nucleotide analog reverse transcriptase inhibitor, in HIV-infected children who have failed previous regimens and have multidrug resistant virus began to yield published results. We are now in the process of analyzing the results of this study and writing it up. Dr. Hazra has initiated a protocol to study CNS disease in HIV-infected children in the HAART era. This CNS study will take advantage of a collaboration with NINDS and the Clinical Center's Departments of Diagnostic Radiology and Laboratory Medicine and will include brain MRI and magnetic resonance spectroscopy and examination of virologic and neuroinflammatory factors in the CSF. It also expands upon a longstanding effort within the group to understand the neuropsychological dimensions of pediatric HIV disease. Other recently completed neuropsychologic studies include a published report on the coping styles of families of HIV-infected children and a recently completed protocol examining the relationship between psychological variables and adherence to HAART. We have also engaged in a longstanding effort to understand the psychosocial dimensions of pediatric HIV disease. Several clinical trials in this project were recently terminated, and the overall level of effort in this project was decreased substantially. The needs of patients with regard to this transition have been studied in an attempt to understand the ability of pediatric HIV patients and their families to adjust to such changes and to assist them in the transition. The work is 100% AIDS research.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Intramural Research (Z01)
Project #
1Z01SC010084-37
Application #
7735398
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
37
Fiscal Year
2008
Total Cost
$22,090
Indirect Cost
Name
National Cancer Institute Division of Clinical Sciences
Department
Type
DUNS #
City
State
Country
United States
Zip Code
Purdy, Julia Bilodeau; Freeman, Alexandra F; Martin, Staci C et al. (2008) Virologic response using directly observed therapy in adolescents with HIV: an adherence tool. J Assoc Nurses AIDS Care 19:158-65
Purdy, Julia B; Gafni, Rachel I; Reynolds, James C et al. (2008) Decreased bone mineral density with off-label use of tenofovir in children and adolescents infected with human immunodeficiency virus. J Pediatr 152:582-4
Hazra, Rohan; Jankelevich, Shirley; Mackall, Crystal L et al. (2007) Immunologic, virologic, and neuropsychologic responses in human immunodeficiency virus-infected children receiving their first highly active antiretroviral therapy regimen. Viral Immunol 20:131-41
Harada, Shigeyoshi; Hazra, Rohan; Tamiya, Sadahiro et al. (2007) Emergence of human immunodeficiency virus type 1 variants containing the Q151M complex in children receiving long-term antiretroviral chemotherapy. Antiviral Res 75:159-66
Schwartz, Lynnae; Civitello, Lucy; Dunn-Pirio, Anastasie et al. (2007) Evidence of human immunodeficiency virus type 1 infection of nestin-positive neural progenitors in archival pediatric brain tissue. J Neurovirol 13:274-83
Taylor, Perdita; Worrell, Carol; Steinberg, Seth M et al. (2004) Natural history of lipid abnormalities and fat redistribution among human immunodeficiency virus-infected children receiving long-term, protease inhibitor-containing, highly active antiretroviral therapy regimens. Pediatrics 114:e235-42
Srivastava, Sunil; Taylor, Perdita; Wood, Lauren V et al. (2004) Post-surgical scleritis associated with the ganciclovir implant. Ophthalmic Surg Lasers Imaging 35:254-5
Martin, S C; Wolters, P L; Klaas, P A et al. (2004) Coping styles among families of children with HIV infection. AIDS Care 16:283-92
Hazra, Rohan; Balis, Frank M; Tullio, Antonella N et al. (2004) Single-dose and steady-state pharmacokinetics of tenofovir disoproxil fumarate in human immunodeficiency virus-infected children. Antimicrob Agents Chemother 48:124-9
Feng, Y R; Biggar, R J; Gee, D et al. (1999) Long-term telomere dynamics: modest increase of cell turnover in HIV-infected individuals followed for up to 14 years. Pathobiology 67:34-8

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