The use of opioids, methamphetamines, cocaine and other stimulants is the second-most-common cause of exposure to HIV among those in the United States diagnosed with the virus that causes AIDS.
Thanks to a new $16 million, five-year grant from the National Institute on Drug Abuse of the National Institutes of Health, Case Western Reserve University is launching a multi-institutional research effort dedicated to deepening understanding of the relationship between substance use and HIV.
The Case Western Reserve University Center for Excellence on the Impact of Substance Use on HIV will be established at the School of Medicine as a resource for scientists across the university, at the four university-affiliated hospital systems in Cleveland, and among researchers around the country.
To advance, grow and support the university's rapidly expanding portfolio of funded cutting-edge research in substance use and HIV, the Center for Excellence will provide access to advanced computer-based, cell biological, genomic and biochemical technologies and fully characterized patient populations.
"This center will investigate the biology, physiology, pathology, and social conditions for people who are carrying the HIV virus and using substances," said center leader Alan D. Levine, a professor of molecular biology and microbiology, medicine, pediatrics, pathology and pharmacology at the School of Medicine, and recipient of the prestigious NIDA-sponsored Avant Garde award.
Jonathan Karn, the Reinberger Professor of Molecular Biology and chair of the Department of Molecular Biology and Microbiology, and Mark Chance, vice dean for research, professor of nutrition, Distinguished University Professor and director of the Center for Proteomics and Bioinformatics, will serve as co-directors. Ann Avery, director of infectious diseases at The MetroHealth System, will lead the new center's clinical activity.
This innovative effort to understand the intersection of social determinants of health in the HIV-infected and treated population of individuals who are at risk and have substance use disorder will engage a systems-mapping approach to identify key environmental and social factors that impact substance use and risks for dependency. This information will uncover optimal interventions to reduce substance use and dependency and improve the overall health of persons with HIV."
Stan Gerson, Dean, School of Medicine and the Asa and Patricia Shiverick–Jane Shiverick (Tripp) Professor of Hematological Oncology
Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV), a sexually transmitted infection that can also be spread by infected blood. By damaging the immune system, HIV interferes with the body's ability to fight infection and disease. There is no cure, but medications can slow the progression.
"More than 30% of people with HIV have multiple substance -use issues," Levine said, "and it is poorly understood how these substances might combine with the HIV virus to further endanger and damage human health."
Case Western Reserve has a long history of exceptional research, community and clinical support for the HIV/ AIDS crisis. The School of Medicine and its affiliated hospitals were among the first in 1982 to treat patients with HIV, and remain at the cutting edge of research to find a cure. CWRU's existing NIH-funded Center for AIDS Research (CFAR) is one of 17 nationally and just one of two in the Midwest.
"We are establishing this new center to address substance-use disorder nationally, offering our advanced technologies to researchers across the country, and have included internationally recognized thought leaders on our external advisory board," Levine said. "Since we have a very strong HIV research team here on campus, we felt that this was the next logical step. Many people with HIV have substance-use issues, and the implications for their health are a major concern for our country."
The center's research will involve collaboration among the School of Medicine, University Hospitals Cleveland Medical Center, MetroHealth, Cleveland Clinic, the Louis Stokes Cleveland VA Medical Center, the Jack, Joseph and Morton Mandel School of Applied Social Sciences and its Begun Center for Violence Prevention Research and Education at CWRU, and the Cuyahoga County, Lorain County, and City of Cleveland health departments.
Work will begin in December on the center's administrative components and then to coordinate with the directors of the 10 other Centers for Excellence nationally, Levine said.
The goal, he said, is to share knowledge, cutting-edge technology, and other resources with scientists across the country. The center focuses on three key tissue types that are dramatically impacted by both substance use and HIV persistence: the brain, white blood cells and gut.
The center will provide investigators with centralized and state-of-the art resources in biological and computational technologies to define mechanisms of action, not otherwise be available to substance use in HIV researchers.
The center will also accelerate the development of junior and under-represented faculty in medicine and encourage experienced faculty to enter substance use research to support the next generation of investigators, Levine said.
"In addition, affiliating with MetroHealth will allow the Center for Excellence to partner with community groups to enhance effective dissemination of research findings and make mental health, violence and victimization, trauma and behavioral health intervention services available to those affected by substance use in our community," Levine said.