https://orcid.org/0000-0002-3959-5692My research interest focuses around HIV infection. Our projects are primarily clinically based but many of them have important laboratory components.
Over the past few years I have participated in a number of clinical trials involving: a) Therapy of human immunodeficiency virus infection including nucleosides, non-nucleosides, protease inhibitors, fusion inhibitors, and integrase inhibitors; b) Management of complications of HIV therapy including lipid abnormalities, and lipodystrophy.
Some studies are developed by pharmaceutical companies and we participate as one enrolling center in national and international multi-center trials. Other studies have been designed by myself and my collaborators and enrol patients in either our center alone or multi-center across Canada as part of the Canadian HIV Trials Network. A Master s degree in Clinical Epidemiology has aided me in the design and conduct of clinical trials. I am the elected National Chair of the Scientific Steering Committee and Co-director of the Clinical Management Core of the Canadian HIV Trials Network.
I have interest in studies of HIV in women. We have participated in studies evaluating the epidemiology and psychosocial issues affecting women living with HIV in Ontario. A previous multi-center Canadian study evaluated the relationship between cervical abnormalities, human papilloma virus and the immunosuppression of HIV. This paved the way to a multi-center trial evaluating the response of women and girls with HIV to the human papilloma virus vaccine. We also participate in studies evaluating fertility desires and pregnancy outcomes of women living with HIV. We have addressed issues related to the pharmacokinetics of antiretroviral drugs in women, and switch strategies for lipodystrophy in women. I co-chair the international workshop on HIV and women.
Current work focuses upon co-infection between HIV and other viral infections including hepatitis C, hepatitis B, and herpes simplex virus. A large national cohort is evaluating the impact of HAART therapy on the outcomes of hepatitis C and liver disease. We assessed the durability of the immune response to the hepatitis B vaccine in persons living with HIV. We continue to explore the role of herpes simplex virus in accelerating the course of HIV disease. An ongoing international trial is designed to determine whether or not co-intervention with anti-herpes therapy could defer the need for the initiation of HAART. We are also addressing whether inflammatory markers influence HIV progression, and the relationship of these markers to HSV, and the comorbidities associated with aging in the HIV population.