Genital HIV-1 Shedding among Women Starting Second-Line Antiretroviral Therapy

开始二线抗逆转录病毒治疗的女性中生殖器 HIV-1 脱落

• 批准号: 7649410
• 负责人: Susan Marie Graham
• 金额: $ 12.64万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-05 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7649410
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adherence; Adverse effects; Africa South of the Sahara; Anti-Retroviral Agents; Applications Grants; Area; Blood; CD4 Lymphocyte Count; Clinic; Cohort Studies; Communicable Diseases; Country; Data; Developed Countries; Developing Countries; Development; Diagnosis; Didanosine; Disease Progression; Drug resistance; Early Diagnosis; Effectiveness; Enrollment; Environment; Epidemiologic Studies; Epidemiology; Failure; Fellowship; Female; Future; General Population; Genital system; Goals; Grant; Guidelines; HIV Infections; HIV therapy; HIV-1; High Prevalence; High Risk Woman; Income; Internal Medicine; International; International AIDS; Kenya; Kinetics; Laboratories; Lamivudine; Lopinavir/Ritonavir; Mentors; Monitor; Nevirapine; Nucleosides; Outcome; Patients; Penetration; Plasma; Policy Maker; Population; Prevalence; Prevention; Prospective Studies; Protease Inhibitor; Public Health; Publishing; RNA; Recording of previous events; Recruitment Activity; Research; Research Infrastructure; Research Personnel; Research Training; Resistance; Resources; Reverse Transcriptase Inhibitors; Site; Source; Stavudine; Time; Training; Training Programs; Treatment Failure; Treatment Protocols; Universities; Viral; Viral Load result; Washington; Woman; Zidovudine; antiretroviral therapy; base; career development; clinical epidemiology; cohort; cost; drug resistant virus; experience; genital secretion; non-nucleoside reverse transcriptase inhibitors; pill; prognostic indicator; prospective; response; scale up; sex; success; transmission process; virology

DESCRIPTION (provided by applicant): Candidate: Susan Graham, MD, MPH, is a Senior Fellow in Infectious Diseases at the University of Washington (UW) with training in internal medicine and public health and over 4 years of experience in international research. During her fellowship, she has studied HIV-1 genital tract shedding among antiretroviral-treated women in Kenya. Her immediate goals are to complete several prospective cohort studies of the impact of antiretroviral therapy on genital tract shedding, and to complete a doctoral degree in epidemiology. Her long-term objective is to become an independent investigator, leading a research team on the clinical epidemiology, prevention, and treatment of HIV infection in resource-limited settings. Environment: The UW, with its Center for AIDS Research, International AIDS Research and Training Program, and outstanding graduate-level training programs, is ideal for career development in international HIV/AIDS research. Dr. Graham will be supervised by her current mentors, Drs. King Holmes and Scott McClelland, and will collaborate with Dr. Julie Overbaugh's HIV-1 virology laboratory. The Mombasa field site provides administrative infrastructure, strong laboratory support, and a record of having successfully conducted many large epidemiologic studies. A cohort of HIV-1 seropositive patients established by Dr. Graham in a new clinic north of Mombasa provides ample opportunities for development of future projects. Research: In resource-limited settings, patients who fail first-line antiretroviral therapy have limited options and may transmit drug-resistant virus. The proposed prospective cohort study will evaluate the effectiveness of second-line therapy at suppressing HIV-1 replication in both plasma and genital tract secretions. We will evaluate resistance at failure of first-line therapy, subsequent viral suppression by second-line therapy, and correlates of continued HIV-1 genital shedding. Unique aspects of this study include the focus on women at high risk for transmission, enrollment from two ongoing cohorts with data on first-line therapy history, and our group's extensive research experience in studies of HIV-1 genital shedding. Relevance: We propose to study HIV-1 in blood and genital secretions of high-risk women starting second-line antiretroviral therapy. As HIV therapy is scaled up, research on drug resistance and the success of second-line treatment is crucial, and Dr. Graham is poised to make an important contribution in this area..

描述（由申请人提供）： 候选人：Susan Graham，医学博士、公共卫生硕士，是华盛顿大学 (UW) 传染病高级研究员，接受过内科和公共卫生方面的培训，并拥有 4 年以上的国际研究经验。在她的研究期间，她研究了肯尼亚接受抗逆转录病毒治疗的妇女的 HIV-1 生殖道脱落情况。她的近期目标是完成几项关于抗逆转录病毒治疗对生殖道脱落影响的前瞻性队列研究，并完成流行病学博士学位。她的长期目标是成为一名独立研究者，领导一个研究小组，研究资源有限环境下艾滋病毒感染的临床流行病学、预防和治疗。环境：华盛顿大学拥有艾滋病研究中心、国际艾滋病研究和培训计划以及出色的研究生水平培训计划，是国际艾滋病毒/艾滋病研究职业发展的理想场所。格雷厄姆博士将受到她现任导师 Drs. 的监督。 King Holmes 和 Scott McClelland 将与 Julie Overbaugh 博士的 HIV-1 病毒学实验室合作。蒙巴萨现场提供行政基础设施、强大的实验室支持以及成功开展许多大型流行病学研究的记录。 Graham 博士在蒙巴萨北部的一家新诊所建立了一群 HIV-1 血清阳性患者，为未来项目的开发提供了充足的机会。研究：在资源有限的环境中，一线抗逆转录病毒治疗失败的患者的选择有限，并且可能传播耐药病毒。拟议的前瞻性队列研究将评估二线疗法在抑制血浆和生殖道分泌物中 HIV-1 复制方面的有效性。我们将评估一线治疗失败时的耐药性、随后二线治疗的病毒抑制以及持续的 HIV-1 生殖器脱落的相关性。这项研究的独特之处包括关注传播高风险的女性、从两个正在进行的队列中招募并提供一线治疗史数据，以及我们小组在 HIV-1 生殖器脱落研究方面的丰富研究经验。相关性：我们建议研究开始二线抗逆转录病毒治疗的高危女性的血液和生殖器分泌物中的 HIV-1。随着艾滋病毒治疗规模的扩大，耐药性研究和二线治疗的成功至关重要，格雷厄姆博士准备在这一领域做出重要贡献。