Pilot Award

A point-of-care (POC) test that could be implemented at peripheral levels of the health system in low-income countries has been predicted to reduce tuberculosis (TB)-related mortality by one-third. However, no truly POC test is in the diagnostic pipeline. For maximum impact, a POC test should have high specificity such that a positive test result can be followed by the immediate initiation of treatment. However, a highly sensitive but less specific POC test is a more realistic short-term goal and could be used as an important screening tool in peripheral health care settings ?

Remarkable advances have helped to determine how immune responses act to contain HIV-1 infection, but precise immune correlates of protection still remain largely uncharacterized. The HLA region is a major determinant of genetics linked to viral control. HLA-B*57+ individuals are known to progress slowly to disease, and this allele is overrepresented in elite controllers. My preliminary results show a reduced replicative capacity of HIV-1 in PBMC from seronegative HLA-B*57+ subjects, in comparison to PBMC from subjects carrying HLA-B*35, an allele associated with rapid disease progression.

Remarkable advances have helped to determine how immune responses act to contain HIV-1 infection, but precise immune correlates of protection still remain largely uncharacterized. The HLA region is a major determinant of genetics linked to viral control. HLA-B*57+ individuals are known to progress slowly to disease, and this allele is overrepresented in elite controllers. My preliminary results show a reduced replicative capacity of HIV-1 in PBMC from seronegative HLA-B*57+ subjects, in comparison to PBMC from subjects carrying HLA-B*35, an allele associated with rapid disease progression.

A key challenge of large-scale intervention trials is to adequately describe the social, cultural and operational factors that influence study findings. Qualitative research methods are particularly useful for elucidating the processes through which such trials may affect primary clinical outcomes through social and behavioral change at the community level. This pilot award would launch the qualitative evaluation of a large "test and treat" intervention, the Sustainable East Africa Research in Community Health (SEARCH) trial.

A key challenge of large-scale intervention trials is to adequately describe the social, cultural and operational factors that influence study findings. Qualitative research methods are particularly useful for elucidating the processes through which such trials may affect primary clinical outcomes through social and behavioral change at the community level. This pilot award would launch the qualitative evaluation of a large "test and treat" intervention, the Sustainable East Africa Research in Community Health (SEARCH) trial.

As the prevalence of metabolic syndrome and obesity rises, and as more effective HCV treatments become available, fatty liver disease will likely become a leading cause of liver disease in persons living with HIV. The purpose of this study is to determine the association of metabolic, host genetic, and viral factors with hepatic steatosis (Aim 1) and hepatic fibrosis (Aim 2) in HIV-infected adults with and without HCV coinfection.

As the prevalence of metabolic syndrome and obesity rises, and as more effective HCV treatments become available, fatty liver disease will likely become a leading cause of liver disease in persons living with HIV. The purpose of this study is to determine the association of metabolic, host genetic, and viral factors with hepatic steatosis (Aim 1) and hepatic fibrosis (Aim 2) in HIV-infected adults with and without HCV coinfection.

This one-year study addresses a neglected topic in HIV research in Africa: the HIV prevention needs of female migrants. The study will address critical gaps in research on methods to obtain valid probability based samples of migrant women and to estimate HIV prevalence in this population at high HIV acquisition and transmission risks. It provides data needed to enhance the study "Identifying Opportunities for HIV Prevention Among Female Migrants in Western Kenya" (K01MH093205-02, Camlin), a qualitative study of factors that facilitate HIV risks among female migrants.

This one-year study addresses a neglected topic in HIV research in Africa: the HIV prevention needs of female migrants. The study will address critical gaps in research on methods to obtain valid probability based samples of migrant women and to estimate HIV prevalence in this population at high HIV acquisition and transmission risks. It provides data needed to enhance the study "Identifying Opportunities for HIV Prevention Among Female Migrants in Western Kenya" (K01MH093205-02, Camlin), a qualitative study of factors that facilitate HIV risks among female migrants.

HIV treatment can improve health and longevity and prevent transmission to sexual and injection drug contacts of persons with HIV. However, realizing the benefits of treatment requires consistent engagement in clinical care and adherence to anti-retroviral medication. Both HIV infection and aging are associated with neurocognitive decline. There may also be synergistic effects between HIV infection and aging that accelerate declines in cognitive function. Cognitive impairment may limit individuals? ability to engage in care, particularly in populations where co-morbidities are common.