3 medical schools collaborate on problems of HIV drug users
by C.W. Wolff

Tufts has received a $5 million, five-year grant to create a research center focused on the nutritional, endocrine and metabolic problems of HIV-positive, illicit drug users.

The center, funded by NIH's National Institute of Drug Abuse, will be a joint effort of Tufts, Brown and Johns Hopkins medical schools and their affiliated hospitals. It will be headed by Dr. Sherwood Gorbach, professor of family medicine and community health at Tufts, who has directed a 450-participant research program on nutrition and AIDS since 1994.

Dr. Sherwood Gorbach © Mark Morelli

Expanding research
"Drug abusers are the fastest-growing group of HIV-infected people in the country," notes Gorbach. However, little research exists on how they may differ from non-drug abusing HIV patients, especially in the effectiveness and side effects of antiretroviral drug therapies. There's also been a lack of research specific to other sub-groups of the HIV population, including women, Hispanics and African Americans, he says.

"The main function of the center is to bring researchers together to share research ideas, directions, approaches, findings," says Gorbach. "We will organize forums, but also use video conferencing and taped presentations that we can stream on the Internet."

A center web site is under construction to provide researchers, health care providers and the general public with information. And the center will make awards of up to $30,000 annually for pilot projects, especially for researchers already working with drug-using populations.

Sharing expertise
Each of the participating institutions has ongoing research on HIV-infected drug abusers, often focusing on a particular race or gender. Gorbach, for instance, has a nutritional-status study under way with 250 Hispanic HIV-positive drug users; Johns Hopkins has built a study cohort of between 2,000 and 3,000 individuals, especially African Americans; and Brown has developed a cohort of Caucasian drug abusers, with a focus on women.

Each institution will bring a special expertise to the center. Brown investigators have studied the best ways to recruit, interview and retain drug users as study participants and will serve the center as consultants and trainers. Johns Hopkins has expertise in endocrinology among HIV-positive and drug-using individuals.

Tufts investigators will provide expertise in nutrition and metabolism, as well as epidemiology and biostatistics. Dr. Christine Wanke, associate professor of family medicine and community health at Tufts, will direct the center's nutrition and metabolism core, providing advice on assessing body composition, resting energy expenditure, dietary intake, physical activity and quality-of-life outcomes.

Dr. Alice Tang, assistant professor of family medicine and community health and co-director of the center, will head the epidemiology and biostatistics core.

"I'm hoping that we can extend some of this research overseas," says Gorbach, possibly to China and southern India.

The new center needs a name. Gorbach has only come up with one so far—the OMEGA CDAAR (Origins of Metabolic, Endocrine and GI Abnormalities Center for Drug Abuse and AIDS Research). He's interested in other suggestions. If you have one, e-mail it to sherwood.gorbach@tufts.edu