Center for AIDS Intervention Research
Dr. Andrew Petroll is a clinical Infectious Disease Specialist and a faculty researcher at the Center for AIDS Intervention Research (CAIR). CAIR is a multidisciplinary HIV prevention research center that is supported by an AIDS research grant from the National Institute of Mental Health. CAIR also receives grant support from other sources, including the Centers for Disease Control and Prevention, the Wisconsin AIDS/HIV Program, and the Medical College of Wisconsin. The research center is based in the Department of Psychiatry and Behavioral Medicine of the Medical College of Wisconsin. The research mission of the CAIR is to develop, conduct, and evaluate new interventions to prevent HIV among persons most vulnerable to the disease.
Dr. Petroll's research interests include how patients' risk behaviors for HIV transmission are addressed in clinical settings, how patient-physician interactions affect the disclosure and discussion of HIV risk behaviors, and how patient and physician characteristics influence such discussions. He is interested in studying the effectiveness of interventions aimed at improving HIV risk behavior discussions between health care providers and both HIV-negative and HIV-positive patients, assessing HIV testing behaviors within high-risk populations, and intervening to increase HIV testing. He is currently conducting a study that is evaluating medical providers' attitudes and experience with prescribing HIV pre-exposure prophylaxis (PrEP) to patients at risk for acquiring HIV. Recent Publications
Research in the Coburn laboratory focus on pathogenic spirochetes, a group of bacteria that are able to cause persistent, disseminated infections in immunocompetent animals, including humans. We are currently working with Borrelia burgdorferi, which is maintained in a tick-animal cycle in nature. We also work with another pathogenic spirochete, Leptospira interrogans. Leptospires are maintained in infected animals in nature, but can also survive in water and mud. Since both pathogens are maintained in animal reservoirs in nature, both are referred to as zoonotic infections. The focus of our work with both Borrelia and Leptospira is to identify and then test the biologic significance of bacterial proteins that help the bacteria bind to mammalian cell surface receptors, to identify the mammalian cell surface receptors recognized by the bacteria, and ultimately the biological and pathologic significance of the bacterial-mammalian receptor interaction.
In the Borrelia work, we have two main projects ongoing in the lab. In one, we are trying to understand the mechanisms behind the requirement for the B. burgdorferi protein, P66, for the bacteria to cause infection in mammals. P66 binds to mammalian cell surface receptors called integrins and serves as a porin in the bacterial outer membrane. We know that the integrin binding function is important for the bacteria to cross endothelial layers and disseminate to different sites in the body. In another Borrelia project, we developed a new experimental model to determine the roles of bacterial adhesive proteins in how the bacteria colonize different tissues in mammals, and how they survive the mammalian defenses in the bloodstream.
In the Leptospira work, we also focus in how the bacteria interact with endothelial cells. In severe cases of leptospirosis, widespread endothelial damage is seen, and this is associated with hemorrhage. L. interrogans binds to an endothelial cell surface receptor called VE-cadherin, which helps the endothelial cells form cell-cell junctions that maintain the integrity of small blood vessels. We are currently determining how the bacteria disrupt cadherin-cadherin interactions, and determining whether the bacterial proteins that bind VE-cadherin are responsible for the endothelial disruption caused by the bacteria. In a second Leptospira project, we are working to identify the bacterial proteins that help the bacteria bind to kidney cells, as the kidneys are where the bacteria reside in a chronically infected animal and from where they are released into the environment.
Dr. Kron presently serves as the principal investigator on an NIH-NIAID funded collaborative study to identify actinomycete-derived natural compounds that might be useful in treating human filiarial diseases, which infect millions of persons in tropical regions of the world. This research includes cooperation among an international network of laboratories, including MCW, Michigan State University Department of Biochemistry and Molecular Biology, European Molecular Biology Laboratory-Grenoble in France, Goeteborg University and Umea University in Sweden, and the University of the Philippines. The researchers are working to identify novel chemical scaffolds that inhibit recombinant parasite aminoacyl-tRNA synthetase (AARS). Dr. Kron had led a group focused on the natural products and biodiversity issues of terrestrial and marine organisms in the Philippines, which, with 7,100 islands, is considered one of five biodiversity hotpots worldwide. Dr. Kron has a broad array of international health work in his career, including as a consultant to the NIH-MSU-Sudan Medical Parasitology Program in Khartoum, fellow in the Division of Infectious Diseases and Geographic Medicine at Case Western Reserve University, a member of the core faculty for the MSU Genetics Program Center for Latin American and Caribbean Studies, and as a visiting scientist for the NIH-Philippines Tropical Medicine Research Center in Manila. Dr. Kron has served as an advisor to the World Health Organization Special Program in Tropical Diseases, and has been a member of three National Institute of Allergy and Infectious Diseases study sections on infectious diseases. He holds five MSU-U.S. patents related to assay development and anti-parasite drug discovery. In 2013-2014 Dr. Kron was appointed as a Senior Science Advisor to the US Department of State, Bureau of East Asian and Pacific Affairs, and supported USG activities related to the 2014 International AIDS Conference in Melbourne, Australia. For more information please visit the Kron Lab page. Recent Publications
As an academic institution, the Froedtert Hospital Infectious Disease clinic is able to offer opportunities to participate in a variety of clinical trials. MCW faculty are engaged in a variety of clinical research trials conducted in collaboration with research networks and industry sponsored-trials. Faculty also practice at the AIDS Resource Center of Wisconsin and are able to offer most of the clinical trials through that location as well.
INSIGHT | PI: Michael Frank, MD
The Medical College of Wisconsin's Division of Infectious Diseases has been an affiliate site for the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) as an enrolling site for the SMART trial (Strategies for the Management of Anti-Retroviral Therapy) which investigated whether it was better to treat patients with HIV continuously with antiretrovirals or to treat them episodically based on immune function.
In 2010, the START trial (Strategic Timing of Anti-Retroviral Treatment) began in order to determine the optimal timing of initiation of antiretroviral therapy (ART) with regard to morbidity and mortality among HIV-1 infected patients who are naïve to ART and have CD4 + cell counts greater than 500 cells/mm3. The START study has enrolled over 4,600 participants worldwide. This study randomizes participants into two study arms:
- Immediate initiation of ART
- Deferred ART until the participant’s CD4+ cell count decreases to less than 350 cells/mm3
Enrollment began in April 2009 and ended on December 23rd, 2013 with 4,688 participants. In May 2015, enough data was collected to determine the optimal time to initiate antiretroviral therapy. Previous guidelines recommended earlier initiation of ART, but no randomized-control trials had been done to address this important question prior to the START study.
INSIGHT is one of six HIV/AIDS clinical trial networks funded in 2006 by the National Institute of Allergy and Infectious Diseases, a component of the National Institutes of Health. INSIGHT's mission is to define optimal strategies for the management of HIV and other infectious diseases through a global clinical research network. INSIGHT conducts studies worldwide.
REPRIEVE Study | PI: Michael Frank, MD
In 2015, enrollment in a random trial to prevent cardiovascular disease (CVD) in people with HIV began at MCW’s division of Infectious Diseases. People living with HIV are 50-100% more likely to develop CVD than people who do not have HIV.
MCW is working with the AIDS Clinical Trials Group (ACTG) and National Institute of Allergy and Infectious Diseases (NIAID) on this trial. Pitavastatin is FDA approved to lower cholesterol along with diet and exercise. The REPRIEVE trial tests whether Pitavastatin can prevent heart disease in people living with HIV.
Up to 6,500 people between the ages of 40 and 75, who have been on ART for at least six months, and who have no history of heart disease will enroll in this study. Participants are expected to make three visits per year for four years. The study is expected to run for 72 months (6 years).
Please visit the REPRIEVE Trial website for more information.
Industry Sponsored Trials
A number of faculty serve as Principal Investigators for industry-sponsored trials. These trials are often done to determine if drugs are safe and effective. Ongoing trials involve the following investigational agents:
- Stribild for HIV | PI: Andrew Petroll, MD
- STR Containing Tenofovir Alafenamide | PI: Andrew Petroll, MD
For more information about any of our HIV clinical trials, please contact Sonija Parker, Research Coordinator, at (414) 805-0708 or at firstname.lastname@example.org or Nancy Grey, Research Assistant, at (414) 805-0747 or at email@example.com.