June 2005

Hopkins residents train for medical missionary work in Africa

Last month, Anne Mullally, a medical resident at The John Hopkins University, traveled to Uganda as part of a special Hopkins program at the Infectious Disease Institute (IDI) in Kampala, Uganda. For one month, she provided care to hundreds of HIV/AIDS patients and experienced what interests her firsthand.

“By offering direct training in Kampala, the Hopkins service gives young physicians a chance to focus their knowledge and skills in treating infectious diseases in Africa, primarily HIV,” said Thomas Quinn, MD, professor of medicine and international health and deputy director of the division of infectious diseases at the Johns Hopkins University School of Medicine.

IDI opened in October 2004 as a specialized AIDS treatment center and is affiliated with both Hopkins and Makerere University in Kampala.

Mullally cared for as many as 10 to 15 patients per day, some of the 200 or more patients who line up each weekday morning at the center. Uganda has more than one million people living with HIV, many on complex antiretroviral regimens. There are also high rates of AIDS-related tuberculosis and cancer.

Mullally, a third-year internal medicine resident who came to Hopkins after completing medical school in her native Ireland was one of several who have participated in the program over the past two years.

Scott Kim, MD, from Silver Spring, Md., was the first Hopkins resident to participate in the program in October 2003, as a 27-year-old in his second year of medical residency. Kim says he was surprised by the logistical challenges of providing effective antiretroviral therapy in a developing nation. – Tara Grassia

Source: David March, BSc, MHA

Researcher honored by National Foundation for Infectious Diseases

John G. Bartlett, MD, professor and chief of the division of infectious diseases at The Johns Hopkins University School of Medicine, received the 2005 Maxwell Finland Award for scientific achievement from the National Foundation for Infectious Diseases.

“This is a tremendous honor for John Bartlett and a fitting tribute to his quarter century of truly groundbreaking work at Hopkins,” said Edward D. Miller, MD, dean of the medical faculty at Hopkins and chief executive officer of the school of medicine. “The spread of infectious diseases, such as HIV and Ebola virus, have been effectively challenged by medical leaders of his caliber, and our continued efforts depend upon others following his lead.”

Bartlett, who also is the Stanhope Baynes Jones Professor of Medicine at John Hopkins, has for 25 years led the school of medicine’s worldwide efforts to understand, prevent and treat AIDS. He was the first to direct clinical trials in Baltimore of new treatments that prevent HIV from replicating, and he pioneered the development of dedicated inpatient and outpatient medical care for patients with HIV.

Bartlett co-chaired the national committee that drafted the first and all subsequent treatment guidelines for HIV-infected patients. Bartlett has authored 470 articles, 282 book chapters and 61 editions of 14 books.

Bartlett received his undergraduate degree from Dartmouth University in 1959 and earned his medical degree at Upstate Medical Center in Syracuse, N.Y., in 1963. He then completed his training in internal medicine at the Brigham Hospital in Boston and the University of Alabama in Tuscaloosa. Bartlett received his fellowship training in infectious diseases at University of California, Los Angeles, where, in 1970, he joined the faculty. He later moved to the faculty of the school of medicine at Tufts University in Boston, where he served as associate chief of staff for research at the Boston VA Hospital. – Tara Grassia

Abuse and HIV status linked to suicidal risk

Women who have HIV and are abused are more likely to think about or attempt suicide, according to a study by researchers from the Johns Hopkins Bloomberg School of Public Health in Baltimore, George Washington University in Washington and St. Michael’s Hospital in Toronto.

This study, published in Women’s Health Issues, sheds new light on the extent to which being in an abusive relationship compounds suicide risk for women with HIV in particular.

“Given that suicide is the fourth leading cause of death for women ages 15-44, there is a need for further research on risk and opportunities for prevention,” said Andrea C. Gielen, ScD, ScM, lead author of the study and deputy director of the center for injury research and policy at the Bloomberg School of Public Health.

The researchers used data from Project WAVE (Women, AIDS and the Violence Epidemic) to examine the rates of suicidal thoughts and attempts as well as to gauge anxiety and depression. They also set out to learn how these outcomes differed based on women’s HIV and abuse experiences. The women were all living in low-income, urban neighborhoods in Baltimore.

Of the 611 women interviewed, 31% reported having thought about suicide and 16% reported having attempted suicide. Abused women were four times more likely than non-abused women to have thought about suicide. The researchers also found that, among women with HIV, those recently diagnosed thought about suicide more frequently.

In addition, one-half of the study participants reported problems with depression and 26% reported problems with anxiety. Of HIV-negative, non-abused women, 24% suffered depression, whereas 72% of abused women with HIV reported the same.

These abused women living with HIV were seven times more likely to report problems with depression, 4.9 times more likely to have problems with anxiety, 3.6 times more likely to have thought about suicide and 12.5 times more likely to have attempted suicide, when compared with HIV-negative, non-abused women. – Tara Grassia

Primate center scientist studies AIDS and the immune system

The Tulane National Primate Research Center received a five-year grant of more than $2 million from the National Institute of Allergy and Infectious Diseases (NIAID) to study the ability of some monkey species to resist developing AIDS.

The study seeks to answer the question of how African green monkeys, when infected with simian immunodeficiency virus (SIV) are resistant to the development of AIDS, compared with humans and other monkeys.

The host and virus seem to have developed a relationship over time, through evolution, so the infection isn’t as harmful to this type of monkey as it is in other monkeys such as the rhesus macaque, said Andrew Lackner, center director.

Scientists once thought natural hosts of SIV, such as African green monkeys, did not become sick with AIDS when infected with the virus, says Ivona Pandrea, principal investigator of the study. However, recent research shows that the natural hosts can progress to AIDS after a prolonged period of SIV infection without symptoms.

While a rhesus monkey typically develops AIDS two to four years after infection, Pandrea said, a human may not develop AIDS for five to 10 years after infection and the African monkeys may not develop AIDS for 20 years, if ever. – Tara Grassia