Clinical research focusing on new HIV treatment strategies continues to this day, now led by Dr. John Mellors. In 1989, a dedicated HIV Primary Care Unit, the Pittsburgh AIDS Center for Treatment (PACT) began providing comprehensive care to HIV-infected men and women. Today over 1000 patients receive their care at the University of Pittsburgh, and almost 200 patients are currently enrolled in studies sponsored by the NIH and industry. In January 2000, the University of Pittsburgh became a site of the NIH-funded Adult AIDS Clinical Trials Group (AACTG), under the leadership of Dr. John Mellors and assisted by Dr. Sharon Riddler, who serves as the Medical Director of the Clinical Trials Unit, and Dr. Deborah McMahon, who is the Medical Director of PACT. The University has a very strong research base, currently ranking in the top ten institutions in funding from the NIH, attesting to its prominence in many areas of research, including HIV/AIDS.
HIV Treatment is enhanced by federal funds received by the University through the Ryan White Care Act. Ryan White Title III funding allows the program to care for all HIV infected individuals regardless of their ability to pay for their care, including diagnostic laboratory tests, medications and specialty services. Ryan White Title IV funds allows the program to focus on the special needs of women, children, youth and families through a Network of providers including Magee Womens Hospital, the Children's Hospital of Pittsburgh and the Family Health Council.Top of Page
The HIV/AIDS Program has established as its mission excellence in HIV-related patient care, education, and research. The achievement of this mission is guided through the following goals:
The University of Pittsburgh Medical Center demonstrated its continuing strong commitment to the HIV/AIDS clinical programs by providing 6400 sq. feet of newly renovated space for both the research and primary care units on the 7th floor of the Falk Medical Building, UPMC campus in January 1999. The contiguous space facilitates communication and cross-referral of patients between the Primary Care and Research Units. The Falk Medical Building is located centrally on the UPMC campus, and is connected by an interior walkway to the main hospitals (Presbyterian and Montefiore), and is also one block away from the Graduate School of Public Health and Scaife Hall, where laboratories of several HIV/AIDS investigators are located. The building is handicapped accessible and is easily reached by public transportation.Top of Page
Clinicians and investigators, in both basic and clinical research, have a wealth of resources available to them in the HIV primary care clinic (PACT) staffed by 5 physicians (three from the Infectious Disease Division - Dr. McMahon, Dr. Riddler, and Dr. Vergis) where patients are seen 5 days/week in 10 sessions with 24 hour physician coverage. Other PACT support staff includes an on-site pharmacist, a social worker, physician assistant, a nurse practitioner who focuses on adherence issues, and a home care nurse coordinator. Mental health and gynecologic services are available on-site as well. Viral load and viral resistance testing are considered standard of care.
The Pittsburgh AIDS Clinical Trials Unit implements studies from NIH and industry as investigator-driven studies. When appropriate, pharmacokinetic studies and Phase I trials may be conducted in the NIH-funded General Clinical Research Center (GCRC) located in the UPMC. Study drugs are stored and dispensed by the UPMC's Investigational Drug Service. The Clinical Trials Unit is staffed by a clinic manager, study coordinators, data manager, data entry clerk, medical assistant, regulatory affairs administrator, administrative assistant, and receptionist.
The Pittsburgh Retrovirus Laboratory provides comprehensive laboratory support for clinical trials and basic research and is currently centered in the Graduate School of Public Health. The laboratory is certified to conduct viral load testing on clinical specimens. Study specimens, including peripheral blood mononuclear cells (PBMC's) and samples for specialized immunologic testing, are processed and stored here. The Flow Cytometry Laboratory is ACTG-certified and capable of performing tricolor analyses.
There are collaborators in epidemiology, molecular biology, immunology, neuro-imaging, behavioral sciences, nursing, and simian research within the university. Infectious Diseases fellows are encouraged to seek a mentor within the first year of their fellowship and develop a research project.Top of Page
The HIV/AIDS Program is supported with funding from the National Institutes of Health (NIH), Health Resources Services Administration (HRSA), and industry. Dr. Mellors leads the Pittsburgh AIDS Clinical Trials Unit of the Adult AIDS Clinical Trials Group (ACTG), funded for the period 2000 - 2004. Dr. McMahon is the Director of the HRSA-funded Pitt HIV Early Intervention Project, supported with over $1 million per year of HRSA's Ryan White Title III funds which enhance HIV primary care services at UPMC. Dr. Mellors and Dr. Riddler are also co-investigators on the Pittsburgh site of the NIH-funded Multicenter AIDS Cohort Study (MACS), and the NIH-funded Novel Therapies Program Project. There are multiple industry-funded Phase I, I/II and III antiretroviral and vaccine trials ongoing as well.Top of Page
Faculty from the Infectious Disease Division are affiliated with the HRSA-funded Pennsylvania/Mid-Atlantic AIDS Education and Training Center (PA AIDS ETC). The ETC provides educational forums for regional health care providers regarding HIV/AIDS, mini-residency training for interested physicians, and will shortly implement an internet-based consultation service for physicians. Infectious Diseases fellows acquire longitudinal primary HIV care through a weekly clinic at PACT under the mentorship of an ID faculty member. Faculty also teach medical school students, medical residents, and serve on various hospital and university committees.