My research interest focuses around HIV infection. Our projects are primarily clinically based but many of them have important laboratory components.

Over the past few years I have participated in a number of clinical trials involving: a) Therapy of human immunodeficiency virus infection including nucleosides, non-nucleosides, protease inhibitors, fusion inhibitors, and integrase inhibitors; b) Management of complications of HIV therapy including lipid abnormalities, and lipodystrophy.

Some studies are developed by pharmaceutical companies and we participate as one enrolling center in national and international multi-center trials. Other studies have been designed by myself and my collaborators and enrol patients in either our center alone or multi-center across Canada as part of the Canadian HIV Trials Network. My completion of a Masters degree in Clinical Epidemiology has aided me in the design and conduct of clinical trials. Currently I am the elected National Chair of the Scientific Steering Committee and Co-director of the Clinical Management Core of the Canadian HIV Trials Network.

I also have interest in studies of HIV in women. In the past we have participated in studies evaluating the epidemiology and psychosocial issues affecting women living with HIV in Ontario. I was the Toronto Co-investigator of a multi-center Canadian study which evaluated the relationship between cervical abnormalities, human papilloma virus and the immunosuppression of HIV. I am now a Co-investigator of a multi-center trial evaluating the response of women and girls with HIV to the human papilloma virus vaccine. We are also involved in studies evaluating fertility desires of women living with HIV and in studies of the pharmacokinetics of antiretroviral drugs in women. Finally, we will be evaluating the role of switch strategies in dealing with the body fat redistribution of lipodystrophy in women.

Our more recent work focuses upon co-infection between HIV and other viral infections including hepatitis C, hepatitis B, and herpes simplex virus. We are participating in a large national Cohort evaluating the impact of HAART therapy on the outcomes of hepatitis C and liver disease. We are also evaluating the durability of the immune response to the hepatitis B vaccine in persons living with HIV and whether or not amnestic responses develop or whether or not boosters are required. Finally, our new work is exploring the role of herpes simplex virus in accelerating the course of HIV disease. Specifically we will be determining whether or not the rate of CD4 cont decline is increased in those with co-infection and whether or not co-intervention with anti-herpes therapy could defer the need for the initiation of HAART. In addition we will evaluate the impact of HAART on a symptomatic herpes simplex shedding in those co-infected with both viruses.