Research

Introduction
Among patients living with HIV, hepatitis B and C have become major causes of morbidity and mortality. My team and I have been involved in patient-oriented research involving the epidemiology, clinical outcomes, and treatment of hepatitis B and C in patients co-infected with HIV. My clinical research focus has been on how to improve treatment outcomes in patients who are co-infected with HIV and hepatitis B or C. In addition, our clinical research team has also focused on HIV prevention, treatment and outcomes.

Hepatitis B (HBV)
We have examined the role of HBV genotype in liver disease progression, clinical outcomes, and we have examined how HIV providers monitor HBV disease.  As a co-investigator in the NIH Hepatitis B Network, we are examining different treatment strategies to optimize clinical response for HBV. 

Hepatitis C (HCV)
We have been focusing on understanding the impact of both HIV and race on treatment response. One of our first clinical trials examined early viral kinetics in patients with HCV and HIV/HCV.  In addition, we have examined the PK/PD of ribavirin and pegylated interferon in HIV/HCV patients treated for HCV. Furthermore, we plan to continue our work in HCV treatment by focusing on the new HCV protease inhibitors and the impact that these drugs will have on clinical outcomes, immune activation, and HCV resistance.  In addition, my team is also working on understanding the barriers to HCV treatment among HIV/HCV and HCV infected patients in order to change health seeking behavior.

Hepatocellular Cancer
We are involved in a multi-center network which is trying to characterize the clinical manifestation of HCC in patients with HIV.

HIV Prevention and Treatment
More recently, we have focused our interest on HIV prevention and early treatment.
Our research unit is involved in two large scale NIH sponsored studies. We are one of the sites for a multi-center NIH vaccine trial (HVTN 505) which examines the safety and efficacy of a two HIV vaccine strategy in HIV-negative high risk individuals. We are also a site for the international multi-center START study, which examines the clinical outcomes in patients with CD4 >500 who are started on treatment compared to those who delay therapy until CD4 reaches current guideline threshold. 

To provide access for our HIV-infected patients to cutting edge new HIV treatment and salvage therapies, our research unit has conducted several studies sponsored by pharmaceutical companies which include HIV naïve and salvage studies and those which involve co-morbidities such as peripheral neuropathy, HCV, and others.

 HIV Trials Link: http://www4.utsouthwestern.edu/idlabs/Jain/HIVStudies.html