Clinical Science Core

The main mission of the Clinical Sciences Core (CSC) is to create knowledge related to key intersecting goals of minimizing HIV comorbidities and eradicating or suppressing HIV reservoirs in people living long term with treated HIV. To achieve these goals, the CSC facilitates clinical and translational investigation focused on people living with HIV on antiretroviral therapy (ART), who can expect nearly normal life expectancy, but who experience excess non-AIDS comorbidities and who require chronic HIV treatment to stay immunologically healthy. Issues related to extended survival necessitate focus on the gaps in our understanding of the epidemiology, etiologies, and needed interventions for complications of treated HIV. A better understanding of these long-term complications – including frailty, cancer, co-infections, neurological and cardiovascular diseases – would enable progress in optimizing health for people in the US and globally. The interaction between comorbidities and HIV persistence is poorly understood but is of vital importance to people who hope for HIV remission but are now on life-long ART. Yale and UPR have multiple mutual synergies that make them uniquely positioned to achieve these goals. The CSC builds on the following four key strengths: (1) Access to diverse patients and well-established cohorts linked to Yale and UPR, including numerous international cohorts and unique cohorts for studies of women and children, (2) Existing academic partnerships, (3) Strengths in translational investigation, (4) Existing strong links between UPR and Yale.

1. Enable clinical, basic and translational science, and behavioral investigators to gain appropriate and ethical access to and participation of study participants, biological specimens, and clinical and behavioral data across institutions. a) Leverage the current structure and operation of existing clinics, networks, and research cohorts to create a centralized data library that enables investigators access to study participant clinical data in existing cohorts and biorepository samples. b) Provide core services for participant recruitment, demographic and clinical data, sample acquisition and processing, and database management for pilot projects. c) Include PLH meaningfully in research to ensure ethical and patient-centered approaches towards abundant participant opportunities for minorities, persons who inject drugs, women.
2. Create a Methods sub-Core, a resource for biostatistical support for pilot studies and grant proposals. Leverage existing resources at Yale and UPR for methods support for HIV studies and provide expert consultation for design and interpretation of studies through a dedicated and collaborative effort of biostatisticians, epidemiologists, and others with expertise in HIV research.
3. Enhance synergies between trainees, basic scientists, clinicians and implementation scientists through formalized interactive programs. Seminars and consultative workshops will provide a real time service and roadmap for the integration of implementation science opportunities with clinical and basic science. Innovative collaborative efforts spawn novel mentoring opportunities to recruit investigators into the HIV field and promoting new avenues of joint investigation.

The Yale-UPR D-CFAR CSC is focused on the support of novel and transformative investigation into major knowledge and implementation gaps regarding HIV persistence and comorbidities associated with long-term HIV infection.