Metabolic Complication of HIV Infection

描述（由申请人提供）：在接下来的5年里，我的职业目标包括（1）进行艾滋病毒疾病的流行病学和代谢并发症的影响的原创性研究，（2）开发一个全面的计划，以指导学员与职业兴趣，以病人为导向的研究，（3）我的研究计划的扩展，包括国际组成部分。加州大学洛杉矶分校正在进行的关于艾滋病毒感染的基础和临床研究的丰富多样性以及临床艾滋病研究和教育中心的设施提供了巨大的资源，以提高我作为临床研究者的经验，并为我的学员提供了一个激励的氛围。K24奖将帮助我实现我的职业目标，为我提供大量受保护的时间，用于指导我的学员，为自己获得生物统计学方面的额外培训，并专注于我自己的研究计划。本申请描述了一个全面的培训计划，研究员，其中包括在生物统计学和临床研究方法的正式培训。此外，还介绍了四个研究项目。拟议的研究将调查一组长期HAART患者的胰岛素抵抗自然史，并详细研究参与代谢并发症横断面研究的男性和女性胰岛素抵抗和脂质异常患病率的性别差异。一项前瞻性、匹配、队列研究将比较接受蛋白酶抑制剂治疗或未接受治疗的HIV感染患者与未感染HIV的患者之间的颈动脉内膜中层厚度测量值，以检验蛋白酶抑制剂治疗与亚临床动脉粥样硬化风险增加相关的假设。一项随机临床试验比较了三种抗逆转录病毒治疗方案，这些方案在世界各地资源匮乏的12个地点招募的受试者中进行，这将提供一个机会来检查与免疫重建综合征发展相关的因素，并确定这些综合征是否预示着HAART反应的改变。我的部门主管和部门主任的大力支持，使我能够减少我的临床和行政责任，这将大大有助于我成功实现我的目标。

DESCRIPTION (provided by applicant): Over the next 5 years my career goals include (1) conducting original research on the epidemiology and impact of metabolic complications of HIV disease, (2) developing a comprehensive program to mentor trainees with career interests in patient-oriented research, (3) the expansion of my research program to include an international component. The rich diversity of ongoing basic and clinical research on HIV infection at UCLA and the facilities available in the Center for Clinical AIDS Research and Education provide tremendous resources to enhance my experience as a clinical investigator and provide a stimulating atmosphere for my trainees. The K24 Award will help me to achieve my career goals by providing me with a significant amount of protected time to devote to mentoring my trainees, gaining additional training for myself in biostatistics and focusing on my own research program. This application describes a comprehensive training program for fellows, which includes formal training in biostatistics and clinical research methods. In addition four research projects are described. The proposed research will investigate the natural history of insulin resistance among a cohort of well-characterized patients on long term HAART and examine in detail gender differences in prevalence of insulin resistance and lipid abnormalities in men and women enrolled in a cross-sectional study of metabolic complications. A prospective, matched, cohort study will compare measurements of carotid intima medial thickness between patients with HIV infection treated with a protease inhibitor or no therapy to patients without HIV infection in order to test the hypothesis that protease inhibitor therapy is associated with an increased risk of subclinical atherosclerosis. A randomized clinical trial comparing three antiretroviral regimens among subjects enrolled at twelve sites located in resource poor settings around the world will provide the opportunity to examine the factors associated with the development of immune reconstitution syndromes and to determine whether these syndromes predict an altered response to HAART. The strong support from my Division Chief and Department Chair to allow me to reduce my clinical and administrative responsibilities will greatly facilitate my success in achieving my goals.