Ann C. Collier

My current research activities include clinical investigations about multiple aspects of human immunodeficiency virus (HIV) and AIDS. The major long-term goal of my work is to improve antiretroviral therapy for HIV, by understanding the pathogenesis of HIV infection/disease, and to alter the inexorable clinical progression of HIV which occurs in most infected individuals. In order to further this goal, I conduct phase I, II, and III studies of promising antiretroviral agents and combination regimens. I give priority to studies of agents which inhibit HIV by novel mechanisms, in addition to performing studies which optimize the use of the four licensed reverse transcriptase inhibitors. Multiple antiretroviral therapies are under investigation at the UW, including HIV protease inhibitors, a novel antisense compound which targets HIV gag, and a variety of reverse transcriptase inhibitors. Ongoing treatment trials are both single and multicenter in nature; the latter treatment trials are sponsored primarily by the NIAID-sponsored AIDS Clinical Trials Group, as well as by private sponsors. Local studies focus on understanding the utility of viral quantification in management of HIV.

Other ongoing clinical research projects at the University of Washington AIDS Clinical Trials Unit include studies of prophylaxis and therapy for HIV-associated complications.

A collaboration between Dr. Christina Marra and me focuses on understanding the natural history of HIV-associated neurological complications, and studying treatments for HIV-associated neurological complications, including peripheral neuropathy and progressive multifocal leukoencephalopathy.

A multicenter project for which I am the UW Principal Investigator, sponsored by NHLBI, is evaluating the virological and clinical effects of blood transfusion in advanced HIV. This project is being conducted in collaboration with Dr. Terry Gernsheimer of the Puget Sound Blood Center. It is exploring the hypothesis that leukocytes contained in red blood cell transfusions upregulate HIV and cytomegalovirus in patients with advanced HIV undergoing transfusion, and that this process alters the clinical course adversely. I am the Chairperson of the Clinical Committe for this project.

Other ongoing collaborations include projects with Dr. Robert Coombs (correlation between virologic markers and lymphocyte subsets; effects of antisense therapy on HIV-1 infectivity, effects of blood transfusion on HIV-1 infectivity); with Drs.Lawrence Corey and Tim Schacker (naturalhistory of primary HIV, interactions between HSV-II nad HIV).