Research on HIV/AIDS

Background

HIV/AIDS is a major public health issue on a global scale. In the last decade, the use of HAART (highly active antiretroviral therapy) has changed the landscape of the epidemic. The study of HIV pathogenesis has revolutionarised our understanding of virus immunology. Social and behavioural research are continuing to provide new insights of the how's and why's of HIV spread.

In Hong Kong, the HIV prevalence is low. Access to HAART is satisfactory. The potential risk of HIV dissemination would however continue to be with us. There is currently relatively little systematic effort to integrate clinical and public health tools for enhancing the effectiveness of HIV prevention and control. While standard treatment is available, it is not sufficiently optimized for the benefit of patients in the community. In this connection, Hong Kong is uniquely positioned to function as a regional hub of HIV research, both because of the early public health responses to the epidemic , and the practical strategies embodied in these responses. It is against these backgrounds that an HIV Research Group is formed, under the auspices of the Stanley Ho Centre for Emerging Infectious Diseases (CEID), The Chinese University of Hong Kong.

The HIV Research Group has adopted an interdisciplinary approach to studying HIV epidemiology and vulnerability at community levels.

Objectives

The CEID HIV Research Group aims to excel in clinical and public health HIV research. Specifically the Group's objectives are, to:

• innovate in HIV surveillance and epidemiology research;
• explore means of optimising HIV treatment;
• build knowledgebase in the transmission dynamics of HIV in the population;
• identify best practices in HIV prevention, treatment and control.

Our Scope

MSM studies

In Hong Kong and other parts of the world, HIV transmission in men having sex with men (MSM) has been increasing. The Group explores HIV epidemiology in MSM through:

1. social network analysis methodology for assessing partnership patterns and exposure risks
2. qualitative research for characterizing group sex parties
3. molecular studies for tracking HIV transmission in Hong Kong, with a regional perspective
4. operation research for evaluating programme effectiveness.

HIV vulnerability in CSW

We conduct research on HIV vulnerability in CSW (commercial sex workers). Projects include investigator-led research as well as commissioned studies. Research has covered community surveillance of HIV infection in CSW, mapping of commercial sex. Sexually transmitted infection (STI) screening is incorporated in a clinic-based research project.

Therapeutic drug monitoring

In collaboration with Department of Microbiology, a therapeutic drug monitoring (TDM) programme is established to determine blood levels of commonly used antiretroviral drugs in Hong Kong. Over 10 compounds (belonging to protease inhibitor, non-nucleoside reverse transcriptase inhibitor, or integrase inhibitor) can now be tested. The programme supports research on the pharmacokinetics of antiretroviral in our predominantly Chinese patient population. Results for individual patient are also important for supporting clinicians in developing treatment plans. We have also been participating in an international Quality Control programme.

Host genetic and HIV treatment

The aims of HAART are twofolds, to improve clinical outcome, and to achieve public health control of HIV infection. At CEID, studies are conducted to explore the impacts of host genetics on treatment outcome, with focuses on (a) CYP45, a key metabolizing enzyme system for main antiretroviral compounds, and (b) metabolic complications arising from antiretroviral therapies.

IDU and harm reduction

The HIV prevalence in injecting drug users (IDU) in Hong Kong has remained low, a phenomenon partly attributable to the operation of methadone clinics for achieving harm reduction. Studies have been conducted to examine the impacts of methadone treatment services, using GIS (Geographic Information System), multilevel statistical approaches. A community level HCV prevalence study is in place in view of the common risk factors associated with the infection alongside HIV.

Selected Publications

Coordinator

Professor SS Lee
Stanley Ho Centre for Emerging Infectious Diseases
The Jockey Club School of Public Health and Primary Care
The Chinese University of Hong Kong
Prince of Wales Hospital
Shatin, Hong Kong

Tel:	(852) 2252 8812
Fax:	(852) 2635 4977
Email:	sslee@cuhk.edu.hk