Medical Student Research Fellowship for Summer 2009
Mentor: Mamta K. Jain, MD, MPH
Department: Internal Medicine
Room number: Y7.312
Mail Code: 9113
Phone number: 8-9914
E-mail: mamta.jain@utsouthwestern.edu
Project I title: Cross-sectional analysis of Depression in those with HIV, HIV/HCV,
and HCV Patients.
Human subjects IRB approved project number (where applicable): 0803-493
Animal subjects IRB approved project number (where applicable): n/a
Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) clinical
Brief Description of Project:
Depression is associated with hepatitis C (HCV) and with HIV. We hypothesize that the prevalence of depression is higher in those who are co-infected with HIV and HCV. Over the past 5 year, we have collected quids depression score on patients with HIV/HCV co-infection. The project would entail gathering two comparison groups one with HIV alone and one with HCV alone to examine the prevalence of depression in the three groups. The student will be responsible with determining eligibility, consenting patients, and administering a depression survey. The information collected will then be placed into a database. The student will learn to use an Access database. The student will also learn how to examine overall scores in the three groups and then also individual questions. At the end of the project, the student will be able to determine if HIV/HCV co-infected patients have a higher prevalence of depression. The student will also examine the relationship of specific types of questions (those dealing with fatigue, energy, mood, etc) and specific disease states. For example, those with HCV were more likely to have higher scores on questions which addressed fatigue. Thus, the student will perform some basic functions of clinical research and collect prospective data and use pre-existing data to complete this data.
Project II title: Determine the impact of CD4 count change and HCV viral load changes.
Human subjects IRB approved project number (where applicable): 0803-493
Animal subjects IRB approved project number (where applicable): n/a
Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) clinical
Brief Description of Project:
There is a complex inter-relationship between CD4 cell count changes and HCV
viral after the initiation of anti-retroviral therapy for the treatment HIV
in those with HIV and HCV co-infection. It is assumed that lower CD4 cell counts
are associated with higher HCV RNA levels. HCV viral loads are associated with
treatment response in a manner in which higher loads are associated with poorer
response. Do HCV viral loads decrease significantly when the CD4 cell counts
goes up? We hypothesize that as the immune system improves with HIV therapy,
there is a decrease in HCV Viral load. To date, the studies regarding this question
have given contradictory information. One reason may be the duration of time
that elapsed from initial to subsequent CD4 cell count level. Perhaps longer
periods of observation are needed to see changed in HCV viral load.
We have an observational database of 225 patients with HIV/HCV that we can examine the association of HCV load and CD4 changes over time. The student will collect data which includes HCV viral load, HIV viral load, CD4 cell count from electronic medical records. The student will plot the patterns in HCV viral load and CD4 cell count changes. The student will examine the time to change in HCV viral load. Also, is the change in HCV viral load significant (>0.5 log)? The student will review the literature and try to develop a theoretical framework to help explain his findings. In addition, the student will evaluate what factors may help predict change in HCV viral load.
Previous Research Activities or Publications with Medical Students:
1. Rathi Pillai, MSII, 5/04-8/04: Organized HIV/HBV Database on Access, obtained
serum samples, analyzed data, wrote abstract, and presented poster in January,
2005 at UT Southwestern.
a. Abstract: Jain MK, Osuagwu C, Opio C, Pillai R, Keiser P, and Lee W. HIV
Providers Neglect to Monitor for Hepatitis B Therapy Responses in HIV/HBV Patients
Treated with HAART. 13th Conference on Retroviruses and Opportunistic Infections.
Denver, February 5-9, 2006.
b. Paper: Jain MK, Opio CK, Osuagwu CC, Pillai R, Keiser P, Lee WM. Do HIV Providers
Appropriately Manage Hepatitis B in Coinfected Patients Treated with Antiretroviral
Therapy? Clin Infect Dis 2007;44:996-1000.
2. Jonathan Boyd, MSII, 5/06-8/06: Developed and organized an Access database
of liver biopsies from 2000- 2005.
a. Abstract: Jain MK, Neak E, Limerick M, Boyd J, Lee WM. Prevalence of Fibrosis
Similar in Those with HIV/Hepatitis C Virus Compared to Hepatitis C Virus Alone.
16th Conference on Retroviruses and Opportunistic Infections. Montreal, Canada
February 8-11 2009.
3. Shahed Shakouri, MSII, 5/06-8/06: Analyzed a cohort of 1465 HIV-infected
patients to determine who had died after 6 years of follow-up. Developed an
Access database to record findings.
a. Abstract chosen for an oral presentation at the 45th Annual UT Southwestern
Medical Student Research Forum, January, 2007.
b. Manuscript in preparation
4. Doan Dao (5/1/2007-5/31-2009). Examined a cohort of patients with HIV/HBV.
Collected serum samples and determined HBV viral load and HBV gentotype. Examined
the impact of HBV genotype on liver disease progression.
a. Abstract: Dao DY, Yuan HJ, Joshi R, Attar N, Lee WM, Jain MK. Non-A Hepatitis
B Genotypes are Associated with More Liver Fibrosis in HIV/HBV Patients. 59th
Annual Meeting of the AASLD, San Francisco, CA November 1-4, 2008.
b. Manuscript in preparation