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AIDS Research at the NHLBI: A Program in Evolution. NHLBI AIDS Team June 7, 2013. AIDS Research at the NHLBI. Changing Profile of AIDS NHLBI AIDS Program Key Actions in 2012-13 NHLBI AIDS Program The Future.
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AIDS Research at the NHLBI: A Program in Evolution NHLBI AIDS Team June 7, 2013
AIDS Research at the NHLBI • Changing Profile of AIDS • NHLBI AIDS Program • Key Actions in 2012-13 • NHLBI AIDS Program • The Future
Adults and Adolescents Living with an AIDS Diagnosis, by Sex, 1993-2009 – United States and 6 U.S. Dependent Areas
AIDS – An Evolving Population AIDS Patients Face Downside of Living Longer, January 2008 The number of people 50 and older living with HIV in U.S. has increased 77% from 2001 to 2005.1 By the year 2015, HIV patients aged 50 and older will account for half of all HIV/AIDS cases in the U.S.1 Chronic disease conditions such as cardiovascular disease are an increasing important health issue in this population. 1www.cdc.gov
Many Age-Associated Diseases More Common in Treated HIV Disease Than in Age-Matched Controls Multiple factors likely explain this increased risk, including co-morbid conditions and antiretroviral drug toxicity Cardiovascular disease COPD Anemia Liver failure Kidney failure Cognitive decline Frailty Immune system Cancer (non-AIDS) Bone fractures/osteopenia Chronic inflammation may underlie many of these conditions
National Heart, Lung, and Blood Institute Mission: Provide global leadership for research, training, and education programs to promote the prevention and treatment of heart, lung, and blood diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives.
NHLBI AIDS Program: Key Facts • Independent Budget • 2013 – $64 million • Separate Payline • 2013 – Comparable to Early Stage Investigator • AIDS Specific Receipt Dates • AIDS Specific Review • AIDS Study Sections • Clinical trials reviewed in CLTR
Key Actions in 2012-13 • Team • Mission Statement • Working Group • Initiatives • Website • Professional Meetings • Key Large Projects
Key Action: NHLBI AIDS Program Organized Team
Key Action: NHLBI AIDS Program Developed Mission Statement
NHLBI AIDS Program – Mission Statement The NHLBI AIDS Program provides global leadership for research, training, and education programs to promote the prevention and treatment of HIV-related cardiovascular, pulmonary, and hematologic disease. The NHLBI AIDS Program believes that critical research in this area will result in discovery that enhances the survival and quality of life of patients with HIV, and may also lead to knowledge that benefits all patients with heart, lung, and blood disease.
Key Action: NHLBI AIDS Program Conducted Working Group
AIDS WG: Recommendations http://www.nhlbi.nih.gov/meetings/workshops/AIDSworking.htm
Key Action: NHLBI AIDS Program Developed New Initiatives
AIDS Initiatives: Guiding Principles • Disseminate goals of NHLBI AIDS Program • Recognize NHLBI as a primary funding Institute for AIDS research • Focus on scientific gaps identified at workshop • Broadly stimulate science • Promote multi-disciplinary collaboration • Encourage peer-review • Timeline • NIH Guide Fall 2013 • January 2014 receipt date
Key Action: NHLBI AIDS Program Developed AIDS Website
Key Action: NHLBI AIDS Program National Presentations
National Presentations • 2013 – Conference on Retroviruses and Opportunistic Infections • 2013 – American Heart Association • 2013 – American Thoracic Society
Key Action: NHLBI AIDS Program Publications and Activities
Key AIDS Programs: Heart • Key Publications • HIV Infection and the Risk of Acute Myocardial InfarctionFreiberg, M, JAMA Internal Medicine, 2013 • HIV infection associated with 50% increased risk of AMI beyond that explained by recognized risk factors. • Arterial Inflammation in Patients with HIV • Grinspoon, JAMA, 2012 • Increased arterial wall inflammation by PET in HIV pts. vs. non-HIV controls with similar cardiac risk factors; associated increased markers of monocyte & macrophage activation. http://www.hivcvd.org/ Project Officer (PO): Cheryl McDonald, MD
Key AIDS Programs: Blood PO: Simone Glynn, MD Shimian Zou, PhD
NHLBI AIDS Program: The Future • Increasing burden of HIV-related HLB disease • NHLBI uniquely poised to support research in this area • NHLBI AIDS Program – Long Term Plan • Develop NHLBI AIDS portfolio • Enhance communication and collaboration • Cultivate HIV-HLB scientific community • Results • Research that improves outcomes for HIV patients – and all patients with HLB disease