Research & Evaluation

Our Commitment to Research

One of our key mandates is to foster and perform research. As a multi-disciplinary team, and as individual health care professionals, we are committed to promoting quality clinically relevant research.

Our research priorities include:

prevention of perinatal HIV transmission
antiretroviral therapies in pregnancy
gender issues in HIV
cervical cytologic abnormalities in HIV-positive women
metabolic and other toxicities of antiretroviral therapy
nutritional and micronutrient deficiencies
quality of life in HIV-positive women and children.

We are also committed to the long-term follow-up of non-infected children of HIV-positive women exposed to antiretroviral therapy in pregnancy and the peripartum period.

The Oak Tree Clinic is a satellite site of the Canadian HIV Trials Network (CTN). http://www.hivnet.ubc.ca/List1Frame.html. We can facilitate access to CTN trials and trials running at the BC Centre for Excellence and HIV/AIDS. If you are interested in any research study, please contact Evelyn Maan at (604) 875-2463.

Currently Enrolling Studies

Neurodevelopmental Effects of Perinatal Exposure to Antiretrovirals (ART) in HIV Uninfected Children

This BC Medical Services Foundation supported study is looking at the neurodevelopment of infants that are not HIV infected, but were exposed in utero to antiretrovirals. We want to see if there are any long-term effects on children's development when their mothers took HIV drugs in pregnancy. All HIV UNINFECTED children whose mothers took antiretrovirals during pregnancy can participate in the study.

Principle Investigator: Dr. Jack Forbes

Contraceptive Decisions of HIV-Positive Women

This BC Medical Services Foundation funded study is designed to investigate the contraceptive and reproductive choices being made by HIV-positive women throughout B.C. All HIV-positive women can participate in the study.

Principle Investigator: Dr. Gina Ogilvie

Perinatal Exposure to Antiretroviral Therapy in Infants Born to HIV Infected Mothers: Evaluation of Toxicity Using Mitochondrial DNA and Lactate Levels

This is a joint study between the Hospital For Sick Kids in Toronto, the Oak Tree Clinic, and the BC Centre for Excellence in HIV/AIDS. It is funded through a Priority Initiatives Project Grant from the Ontario HIV Treatment Network. It will look at mitochondrial DNA and lactate levels in antiretroviral exposed infants born to HIV infected women, and control infants.

Principle Investigators: Drs. Susan King, Jack Forbes and Ariane Alimenti

Children Living Positively

This qualitative study is investigating the needs/issues of adolescents living with HIV.

Principle Investigators: Sarah Fielding, Lori Sheckter

Recently Completed Studies

Impact of Antiretroviral Therapy (ART) on Bone Density and Osteoporosis in HIV-Positive Canadian Women

This CANFAR funded study looked at osteoporosis (weakening of bones) and bone metabolism in women with HIV. The study took place in eight centres across Canada and is a collaboration with the Canadian Multicentre Osteoporosis Study and the Canadian Women's HIV Study. We are interested in how HIV drugs may affect bone health. We hope to find out which women are at highest risk for bone problems.

All HIV infected women, over 18 years of age, not pregnant, on ART for either less than seven days or for more than one year, were eligible to participate. Enrollment for this study closed October, 2003.

Principle Investigator: Dr. David Burdge

Canadian Women's HIV Study (CWHS)

The main purpose of this study was to follow the health and symptoms of women living with HIV infection. Most studies on HIV and AIDS have focused on men with less attention on women's concerns. Gynaecological disorders (like vaginal and cervical problems, or sexually transmitted diseases) may play an important role in women with HIV and this study helped improve our understanding of various aspects of HIV in women, and helped improve the care of women with HIV infection.

Principle Investigator: Dr. Catherine Hankins

This study was a multicentered Canadian study which resulted in multiple peer-reviewed publications. The funding has now expired, and the study has been closed.

South-Asian Women's Experiences of Living with HIV/AIDS

The purpose of the study was to better understand the unique experiences of South-Asian women around treatment and care living with a diagnosis of HIV/AIDS.

Principle Investigator: Wally Hiebert

The results of this study has been published as a thesis “Weathering the storm: Women's experiences of living with HIV/AIDS” .

Psychometric Testing of the MQOL-HIV in HIV Infected Women

The purpose of this study was to test the reliability and validity of a Quality of Life instrument in HIV infected women.

Principle Investigator: Valencia Remple

Remple VP, Hilton BA, Ratner PA, Burdge DR. Psychometric assessment of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV) in a sample of HIV-infected women. Accepted for publication June 2003 by the Journal of Quality of Life Research. In press.

The Triglyceride-Lowering Effect of Omega-3 Fatty Acid in HIV Infected Individuals Receiving Protease Inhibitor (PI)-Containing Antiretroviral Regimens

The purpose of this BC Medical Services Foundation funded study was to see whether supplementing the diet with omega-3 FA can help lower triglycerides (TG) levels (above three mmol/L) in HIV infected people, and to compare the TG-lowering effect between people taking PI medications and those not taking PI medications to treat their HIV.

Principle Investigator: Dr. David Burdge

The results were presented in Abstract form at the XIV World AIDS Conference ( Barcelona ) D.Peabody, V. Remple, T. Green, A. Kalmar, J. Frohlich, J. DeWet, D. Burdge. The triglyceride-lowering effect of omega-3 fatty acids in HIV-infected patients on HAART. Abstact ThPeB7343 Vol 2, pg 419-420.

Metabolic Abnormalities Associated with Protease Inhibitor (PI) Uuse in HIV Infected Children

The purpose of this research study was to see if children with HIV who are treated with protease inhibitor drugs (nelfinavir, ritonavir, saquinavir, indinavir, Kaletra) (for at least three months) are at risk for certain complications. These complications may include diabetes, hardening of the arteries, heart disease, increased body fat, and increased fats in the blood.

Principle Investigator: Dr. Susan King

Assessment of Plasma, Vaginal and Cervical Viral Load Measurements Throughout the Menstrual Cycle in Women Infected with Human Immunodeficiency Virus (HIV-1)

This CANFAR funded study has been completed and published.

Principle Investigators: Drs. Deborah Money and David Burdge

Money DM, Arikan YY, Remple V, Sherlock C, Craib K, Birch P, Burdge DR. Genital tract and plasma human immunodeficincy virus viral load throughout the menstrual cycle in ovulatory women who are infected with human immunodeficiency virus. Am J Obstet Gynecol 2003: 188:122-127.

Assessment of Lactic Academia in HIV Uninfected Infants Exposed to Perinatal Antiretroviral Therapy

This study is now complete, and forms the basis for the current study investigating mitochondrial DNA and lactates in infants. The results have been published.

Principle Investigator: Dr. Ariane Alimenti

Alimenti A, Burdge DR , Ogilvie GS, Money DM, Forbes JC. Lactic acidemia in human immunodeficiency virus-uninfected infants exposed to perinatal antiretroviral therapy. Pediatric Infect Dis J 2003; 22(9):782-788

Future Studies

Pharmacokinetics of Antiretrovirals in Pregnancy

The purpose of this study is to evaluate the pharmacokinetics (drug levels), safety, and tolerance of antiretroviral therapies in pregnancy. We plan to undertake this study with investigators at the BC Centre for Excellence in HIV/AIDS.

HIV infected pregnant women taking antiretrovirals are eligible to participate in the study.

Publications

Burdge DR, Money DM, Forbes JC, Walmsley SL, Smaill FM, Boucher M, Samson LM, Steben M, on behalf of the Canadian HIV Trials Network Working Group on Vertical HIV Transmission. CMAJ 2003; 168: 1683-8 Full Guidelines online at www.cmaj.ca

Burdge DR, Money DM, Forbes JC, Walmsley SL, Smaill FM, Boucher M et al. Canadian consensus guidelines for the management of pregnancy, labour and delivery and for postpartum care in HIV-positive pregnant women and their offspring (summary of 2002 guidelines) CMAR 2003;168:1671-4.
Burdge DR, Money DM, Forbes JC, Walmsley SL, SMaill FM, Boucher et al. Canadian consensus guidelines for the care of HIV-positive pregnant women: putting recommendations into practice. CMAJ 2003; 168: 1683-8.

Money DM, Arikan YY, Remple V, Sherlock C, Craib K, Birch P, Burdge DR. Genital tract and plasma human immunodeficincy virus viral load throughout the menstrual cycle in ovulatory women who are infected with human immunodeficiency virus. Am J Obstet Gynecol 2003: 188:122-127.

Remple VP, Hilton BA, Ratner PA, Burdge DR. Psychometric assessment of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV) in a sample of HIV-infected women. Accepted for publication June 2003 by the Journal of Quality of Life Research. In press.
Alimenti A, Burdge DR , Ogilvie GS, Money DM, Forbes JC. Lactic acidemia in human immunodeficiency virus-uninfected infants exposed to perinatal antiretroviral therapy. Pediatr Infect Dis J 2003; 22(9):782-788.

O'Connell JM, Braitstein P, Hogg RS, Yip A, Craib KJP, O'Shaughnessy MV, Montaner JSG, Burdge DR. Differences in virologic suppression among men and women enrolled in a population-based antiretroviral drug treatment program. Accepted for publication by the Journal of Antiviral Therapy. August 2003. In Press.

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