Cohen Steps Down at Division of Infectious Diseases, Appointed to Fogarty Advisory Board

After 30 years of contribution, UNC CFAR Associate Director Myron “Mike” Cohen, MD will step down from his position as Chief of UNC Division of Infectious Diseases. Learn more about Cohen’s influential career, including his recent appointment to the National Institute of Health Fogarty Advisory Board, where he will join other researchers and policymakers providing oversight to global research projects. Cohen will continue directing the Institute for Global Health and Infectious Diseases (IGHID), serving as Associate Vice Chancellor for Global Health, and working with UNC CFAR.

The incoming Chief of UNC Division of Infectious Diseases is Joseph Eron, MD, who also serves as director of the UNC CFAR Clinical Core, professor of medicine, and adjunct professor of epidemiology.

 

Intervention Improves Adherence, Decreases Mortality

Irving Hoffman

Irving Hoffman, PA, MPH, co-led the HPTN 074 study.

UNC researchers were part of a team that found an integrated intervention increased HIV medication uptake and decreased mortality among people living with HIV who inject drugs at three international sites. Their results were published in The Lancet.

The study, HIV Prevention Trials Network (HPTN) 074, assessed an integrated intervention combining psychosocial counseling and supported referrals for antiretroviral therapy at any CD4 cell count and substance use treatment for people living with HIV who inject drugs compared to the locally available standard of care. The trial was conducted among people who inject drugs in Ukraine, Indonesia and Vietnam. At 52 weeks from enrollment, participants in the intervention arm nearly doubled their antiretroviral therapy usage, viral suppression and substance-use treatment usage compared to the standard of care arm. Mortality was also reduced by more than half with the intervention.

“I believe this very effective, but simple intervention could be applied to populations of people who inject drugs in most settings around the world, and I believe this would result in lives saved and a reduction in HIV transmission,” said Irving Hoffman, PA, MPH, study co-chair and a professor of medicine in the UNC Division of Infectious Diseases.

Overall, 502 people living with HIV and 806 HIV uninfected people with whom they injected drugs entered the study over 15 months and were followed for 12 to 24 months after enrollment. The median age was 35 years. Eighty-five percent of participants enrolled were men; most of the women who participated in the study were enrolled in Ukraine. At week 26, intervention arm participants were twice as likely to report antiretroviral therapy use compared to the standard of care arm participants and twice as likely to achieve an undetectable viral load. The effects persisted at week 52. Among intervention arm participants at week 52, self-reported substance use treatment uptake was higher compared to the standard of care arm participants. Mortality was significantly lower among intervention arm participants and their partners compared to the standard of care arm participants and their partners. Though the study was underpowered to prove the effect of the intervention on HIV transmission no new HIV infections were observed among the partners in the intervention arm, while seven were observed among partners in the standard of care arm.

“The HPTN 074 study assessed the feasibility of an integrated intervention for people living with HIV who inject drugs to reduce HIV transmission to their HIV-uninfected injection partners,” said Myron Cohen, MD, HPTN co-principal investigator and director of the UNC Institute for Global Health and Infectious Diseases. “These study findings related to antiretroviral therapy use and HIV prevention are promising, and this and other interventions are needed to get people living with HIV who inject drugs into care for their own health and to stop transmission of the virus.”

HPTN 074 is funded by the U.S. National Institute of Allergy and Infectious Diseases (NIAID), and the U.S. National Institute on Drug Abuse (NIDA), both part of the U. S. National Institutes of Health (NIH).

 

 

PrEP Open House

NCATEC will be hosting “PrEP Open House: What Doctors Need to Know; What Patients Need to Ask” on Friday June 29 from 2pm to 3:30pm in the first floor auditorium of the Bioinformatics Building (130 Mason Farm Road) on the campus of UNC-Chapel Hill.  Public parking is available across the street.

This training will address clinical PrEP basics for those interested in prescribing this one-pill-a-day regimen for the prevention of HIV.  The presentation will also cover questions that consumers would want to ask themselves about their readiness to take PrEP and whether or not PrEP is right for them.  The training center will review its online PrEP resources for providers and consumers and review PrEP materials available in English and Spanish.

Please register early as we expect a strong interest in this training.

Ryan White Remembered

April 8 marks the 28 year anniversary of Ryan White’s death.

Before HIV transmission was well understood, factor 8, a protein important to blood clotting, was often pooled from hundreds of untested blood donations.  This exposed hemophilia patients like Ryan White to HIV; in an article for PBS Newshour, Dr. Howard Markel recalls that “virtually every hemophiliac [he] treated in the mid-1980s has since died from AIDS.”

Ryan White was a teenager living with hemophilia during this time period.  He was diagnosed with HIV in December, 1984, and became an eloquent spokesperson for people living with HIV.  Among other forms of stigma, Ryan White was initially not permitted to attend school after his HIV diagnosis.  After winning a court case to resume in-person attendance at school, Ryan and his family faced intense hostility from community members, and relocated to Cicero, Indiana.

Photo by L. Cohen/WireImage

Homophobia and misinformation about HIV transmission were rampant sources of prejudice against people living with HIV; Ryan White’s advocacy helped dispel some of the misinformation about the nature and transmission of HIV/AIDS.

Months after Ryan White’s death on April 8, 1990, President George H. W. Bush signed the Ryan White CARE Act to help cities, states, and community organizations to develop comprehensive systems of care; the legislation targeted the poorest people living in the United States with HIV/AIDS.

Myron Cohen Interviewed for The Body

Myles Helfand interviewed Associate CFAR Director Myron Cohen in a series for The Body.

In a short video interview with The Body, an HIV/AIDS-specific service of Remedy Health Media, Dr. Myron Cohen, MD, Associate CFAR Director & International Core Associate Director,  shares a personal anecdote about a patient whose wellbeing was rapidly transformed with the introduction of antiretroviral therapy (ART).

“It was an amazing realization that this medicine, which we’d been told could stop the replication of HIV, I was seeing it before my eyes, and that was really something I’ll never forget.” -Myron Cohen

Myron Cohen interviewed for The Body

This interview is part of a series of interviews conducted by Myles Helfand on behalf of The Body.  Helfand asked HIV care providers to share anecdotes about the most inspiring moments in their careers.

He also interviewed Dr. David Wohl, the Co-Director of the North Carolina AIDS Training and Education Center (NCAETC) and Dr. David Margolis, the Director of the UNC HIV Cure Center and Principal Investigator at Collaboratory of AIDS Researchers for Eradication (CARE).

Research Assistant Earns Impact Award

Thibaut Davy-Méndez earns Impact Award

Thibaut Davy-Méndez, photo by Amy Stern

Each department may nominate three current masters or doctoral students or recent graduates per year for the Impact and Horizon Award.  Their research should have direct impact on North Carolina.  

Impact Award

On Thursday, April 5, Thibaut Davy-Méndez will receive one of the 2018 UNC Graduate Education Advancement Board Impact Award for his work related to antiretroviral therapy resistance.  Of particular import was his contributions to a study whose findings were presented at the 2017 Conference Conference on Retroviruses and Opportunistic Infections (CROI): resistance to newer classes of antiretroviral drugs was significantly lower than older classes of drugs.  These findings, Davy-Méndez believes, will help UNC HIV care providers inform their clinical practice.

CFAR Connection

A Research Assistant with the UNC CFAR Clinical Core, Davy-Méndez credits the support of his mentors Joe Eron, MD, and Sonia Napravnik, PhD.

Learn More

For a more extensive story about Thibaut Davy-Méndez’ Impact Award, please visit the UNC Institute for Global Health & Infectious Diseases website.

 

Sarah Graham Kenan Distinguished Professorship

The Sarah Graham Kenan Award recipients will receive five-year, renewable terms, and are subject to a rigorous review process.

Sarah Graham Kenan Awardees

Last week, Ada Adimora, MD, MPH; David Margolis, MD; and Janet Rubin, MD; were named Sarah Graham Kenan Distinguished Professors.  Dr. Adimora co-directs the UNC CFAR Developmental Core, and Dr. Margolis directs the HIV Cure Center.Dr. Ada Adimora

The Review Process

As the Sarah Graham Kenan Distinguished Professorship is one of the most prestigious awards given my the UNC Chapel Hill School of Medicine, each candidate was subject to a rigorous review process.  After a preliminary review by a committee of distinguished School of Medicine professors, the Dean’s Advisory Committee, the University’s Health Sciences Advisory Committee, the UNC Chapel Hill Board of Trustees, and the Appointment, Promotion, and Tenure Committee evaluated the accomplishments of each professor.Dr. David Margolis

For more details about the history of the Sarah Graham Kenan Award, as well as information about each of the awardees’ accomplishments, please visit the UNC Health Care and School of Medicine Newsroom.

CFAR Supplement Fiscal Year 2018

The UNC CFAR will conduct an internal review to select the four best candidates for Fiscal Year 2018 funding to move forward with the supplement application.

All interested applicants must submit for review the following:

Documents for internal CFAR review:

Brief proposal no more than 2 pages with specific aims and brief background.

Must have: One paragraph on how this supplement will be used as leverage for RO1 funding: the more specific the better.

Date of submission: Monday, April 2nd by 5:00 P.M.

Send submission to: Dr. Prema Menezes

Details about FY18 supplement opportunity for eligible CFARs:

The CFAR program would like to announce an FY18 supplement opportunity for eligible CFARs.  This year we have six scientific areas of interest.  Eligible CFARs may submit more than one application in any area BUT no more than four total applications per CFAR.  The Developmental Cores should review applications for feasibility and appropriateness of budget in addition to scientific merit as described in the attached announcement.

The NIH is interested in supplement applications from CFARs in the following scientific areas:

  • Basic Research on HIV Infection and Persistence
  • Infant Immunity for HIV Vaccine Development
  • Studies to Delineate Sex Differences in the Incidence of Heart, Lung, Blood, and Sleep Comorbidities in People Living with HIV
  • Formative Research on Behavioral Aspects of Novel Biomedical HIV Prevention and Treatment Regimens
  • The Evolving Opioid Epidemic and its HIV Consequences
  • Implementation of Evidence-Based HIV Interventions and Treatments for Health Disparity Populations

Please see the attached CFAR supplement announcement for more details on the above scientific areas of interest and NIH scientific contacts.   CFARs are encouraged but not required to support investigators who have not previously received a CFAR supplement.

The key aspects of this funding opportunity are:

  • Applications may be submitted for up to one year with maximum funding per application of up to $150,000 Direct Costs
  • Four total applications are permitted per CFAR
  • Project directors must be early career investigators who have never received an R-series research grant in HIV/AIDS or established investigators in non-HIV fields
  • Each CFAR should have an internal review process to submit the most competitive applications
  • CFARs with a high unobligated balance may be disapproved for supplemental funding – please include additional information per the announcement
  • CFARs in the first year of a competing renewal must contact program regarding additional requirements
  • CFARs in the last year of a competitive segment or in a bridge period are not eligible to apply but could collaborate with another CFAR
  • The deadline for applications to be received at NIAID is May 14, 2018
  • The earliest anticipated start date is 6/29/18 but may be delayed due to administrative issues

Please note that the number of applications that will be funded for this administrative supplement announcement will be based on funding availability, scientific merit, and program balance.  Applications must align with the NIH HIV/AIDS research priorities (NOT-OD-15-137).

Biostatistics Software for Analyzing Dilution Assays

Biostatistics Core Develops Software Tool for Analyzing Dilution Assays

UNC Center for AIDS Research Biostatistics Core graduate research assistant Ilana Trumble and former Core GRAs Andrew Allmon, Owen Francis, Pedro Baldoni, alumnus Dr. Joseph Rigdon, and Core Director, Prof. Michael Hudgens published a research paper in the November 2017 issue of the Journal of Immunological Methods, titled “SLDAssay: A software package and web tool for analyzing limiting dilution assays”.

In current HIV research, dilution assays are used to investigate strategies for eradicating the virus from latently infected cells in HIV positive individuals. This software package aids in the detection of the latent HIV reservoir by providing tools for analyzing data from dilution assays.

The R-package is found here .

MI Blog: Responding to Discord

Here is an excerpt from the most recent UNC CFAR Motivational Interviewing Blog:

“However, ‘discord’ can sometimes be caused by our mood or approach. Perhaps like any other human being, we may feel tired, stressed, overwhelmed, or distracted, and may bring some of these experiences into our sessions with our clients. It may also be that we, as clinicians, are working harder than the client, wanting change to occur badly for the client, and/or we are trying to move the client along faster than they are ready.” —Motivational Interviewing Questions: Responding to Discord

Click here to access the UNC CFAR Motivational Interviewing Blog homepage.