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)对HIV疾病的流行病学和代谢并发症的影响进行原创性研究，(2)开发一个综合项目来指导有职业兴趣的以患者为导向的研究的学员，(3)扩展我的研究项目，包括国际部分。加州大学洛杉矶分校正在进行的艾滋病毒感染基础和临床研究的多样性以及临床艾滋病研究和教育中心的设施为我提供了丰富的资源，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鼓舞人心的氛围。K24奖将帮助我实现我的职业目标，为我提供大量的保护时间来指导我的学员，为我自己在生物统计学方面获得额外的培训，并专注于我自己的研究项目。这个申请描述了一个全面的培训计划，其中包括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患者胰岛素抵抗的自然史，并在代谢并发症的横断面研究中详细检查男性和女性胰岛素抵抗患病率和脂质异常的性别差异。一项前瞻性、匹配的队列研究将比较接受蛋白酶抑制剂治疗的HIV感染患者或未接受治疗的HIV感染患者与未感染HIV的患者的颈动脉内膜内侧厚度，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世界各地12个资源贫乏地区的受试者的三种抗逆转录病毒治疗方案，将提供机会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对HAART的改变反应。我的部门主任和系主任的大力支持，让我减少我的临床和行政责任，将极大地促进我成功地实现我的目标。

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.