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Specific Aims
Research Projects
Project 1
Project 2
Project 3
Project 4
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Human
Retroviruses and Other Emerging Pathogens Activity
PROJECTS
Since acquired immune deficiency syndrome (AIDS) emerged as a
newly recognized infectious disease in 1981, population movements of
high-risk behavior groups have enormously accelerated the spread of the
AIDS virus, human immunodeficiency virus type 1 (HIV-1).
Of principal concern to Pacific island nations has been the
relationship between HIV-1 infection and international or recreational
travel, since their economies are heavily dependent on tourism.
In Hawaii, tourism itself may have provided the initial
introduction of HIV-1 from the continental United States in 1982, when
the first case of Kaposiâs sarcoma was reported in the Hawaii Medical
Journal. In 1989, in
anticipation of epidemic HIV-1/AIDS in Asia and the Pacific, a
Retrovirology Activity was conceived by former director Frederick C. Greenwood
as a new initiative of the Research
Centers in Minority Institutions (RCMI) program at the University of
Hawaii at Manoa to develop the infrastructure for basic and clinical
research on HIV-1 and other human retroviruses affecting ethnic minority
groups in Hawaii and the circum-Pacific region.  RCMI funding made possible the initial recruitment of Dr. Margo
Heath-Chiozzi, who, as director of the Hawaii AIDS Research Consortium
(HARC),
developed the Hawaii AIDS Clinical Trials Unit (ACTU).
Originally, HARC was designed to conduct community-based clinical
trials through an established consortium of primary care physicians in
the State of Hawaii. From
the experience gained through participation in ACTG protocols and
pharmaceutical company-sponsored trials, and with the improvements in
the research environment and the subsequent recruitment of a director
(Dr. Richard Yanagihara) for the RCMI-supported Retrovirology Research
Laboratory (RRL), the Retrovirology Activity was restructured in 1996 to
maximize existing resources, clinical expertise and technical
capabilities. As part of
the restructuring, the activity was renamed the Human Retroviruses and
Other Emerging Pathogens Activity to more accurately reflect its
expanded research scope which capitalizes on Hawaiiâs geographic
location as a natural sentinel post for monitoring AIDS and other
disease patterns throughout Asia and the Pacific.
In this regard, viewed within the context that the largest rise
in new AIDS cases will occur in Asia and the Pacific during this decade
and into the new millennium, Hawaiiâs role becomes even more critical
in monitoring the trends of HIV-1 infection within and beyond its
borders, as well as in clarifying the spectrum of clinical disease and
the molecular epidemiology of HIV-1 throughout the circum-Pacific
region.
In
addition, with an expanded research faculty and significant improvements
in the laboratory-based research environment, an ambitious,
multidisciplinary, clinical and basic science collaborative research
program has been implemented on new, emerging and re-emerging infectious
diseases, which disproportionately affect Asians and Pacific Islanders.
Thus, aside from HIV-1/AIDS, pilot projects have included
epidemiologic investigations of age-old pathogens (such as Mycobacterium
tuberculosis) and of newly identified microbes (such as GB virus
C/hepatitis G virus and TT virus), and studies targeting diseases of
suspected infectious etiology (such as Kawasaki syndrome and Viliuisk
encephalomyelitis). In
these and other investigations, there has been increasing reliance on
the infrastructural support available in the Clinical Research Center.
The natural convergence of scientific thought and renewed
commitment of bringing the laboratory to the clinical problem and vice
versa will enhance the professional development of a cadre of HIV-1/AIDS
and infectious disease investigators and will accelerate their ability
to develop hypothesis-driven, clinically relevant research proposals for
independent funding.
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RESEARCH PROJECTS
Despite
the disease-free prolonged survival afforded by highly active
antiretroviral therapy (HAART) for HIV-1 infection, the global picture
of AIDS has remained largely unchanged for the vast majority of the more
than 30 million people living with HIV-1/AIDS. Even in the United States, ethnic minorities and socially
marginalized groups have experienced no diminution in AIDS incidence.
Rather, the incidence of AIDS is still on the rise, particularly
among ethnic minority women. Mirroring such national trends, women of Asian or Pacific
Islander descent in Hawaii have shown startling increases in AIDS.
The challenge of undiminished AIDS and HIV-1 infection in Asian
and Pacific Islander populations is the targeted focus of the RCMI-supported
Hawaii AIDS Research Program, comprised of HARC and RRL.
Continued RCMI-support has made possible the implementation of a
multidisciplinary research program on human retroviruses and
AIDS-associated disorders, as well as new, emerging and re-emerging
infectious diseases, affecting Asians and Pacific Islanders and other
ethnic minority groups.
Each
of the four principal projects within the Human Retroviruses and Other
Emerging Pathogens Activity maximizes the clinical expertise and
laboratory resources in emerging infectious diseases.
In addition, these projects capitalize on Hawaiiâs strategic
geographic location as a natural sentinel post for the study of new and
re-emerging microbial threats.
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