Dr. John G. Bartlett

Enteric disease in patients with acquired immune deficiency syndrome (AIDS):This is a collaborative project involving Gastroenterology, Pathology, Microbiology, and Immunology. A study of 20 to 30 pathogens in patients at risk for AIDS and with AIDS has been completed. Current studies deal with the epidemiology of the diarrhea in patients with AIDS and intestinal biopsies for morphologic studies including in situ hybridization for human immunodeficiency virus (HIV) lymphocyte subset analysis and detection of various microbes such as Microsporidia, Mycobacteria avium and cytomegalovirus (CMV). Additional work deals with malnutrition and/or cachexia in AIDS patients with and without diarrhea.Clostridium difficile:This laboratory has a fifteen year history of studies with C. difficile including the initial description of this as an enteric pathogen, the toxin assay considered standard for disease detection, the presence of two distinct toxins (toxin A and toxin B), characterization of both toxins and studies of immune response. Continuing studies concern epidemiology studies, toxin detection and clinical features. New studies concern antibiotic- associated diarrhea not due to C. difficile.AIDS Clinical Trials Group (ACT):Hopkins is one of the 34 National Institutes of Health (NIH) funded sites for clinical trials of drugs for HIV infection. This is the worlds largest clinical trial network in terms of funding ($110 million/year), patients (17, 000) and protocols (200). The studies are in two categories: antiretroviral agents and drugs for treatment and prevention of opportunistic infections. The clinical sites of the Hopkins group include the Moore Clinic, Osler 8, Sexually Transmitted Disease Clinics and Maryland prisons.