San Francisco General Hospital is participating in several clinical research
studies involving HIV-infected patients with Pneumocystis carinii Pneumonia (PCP).

Studies include the following:

1. A multicenter molecular-epidemiology study investigating the association between P. carinii prophylaxis, P. carinii molecular genotype, and important clinical outcomes (in collaboration with the Centers for Disease Control and Prevention). Since human P. carinii cannot be cultured, this study seeks to address the question of whether human P. carinii develops evidence of resistance to PCP treatment and prophylaxis regimens.
2. Development and validation of several new molecular applications to PCP, including the use of a quantitative PCR assay from oropharyngeal wash specimens to diagnose PCP (in collaboration with the National Institutes of Health), development of P. carinii antigen and antibody assays (in collaboration with the National Institutes of Health and the University of Cincinnati), and development of a "cytokine flow cytometry" assay to detect P. carinii-specific CD4+ and CD8+ T cell immune responses (in collaboration with the Gladstone Institute if Virology and Immunology). New or emerging areas of investigation include: (1) A comprehensive molecular-epidemiology study to address the question of whether PCP in humans results from person-to-person transmission (as has been convincingly demonstrated from animal-to-animal laboratory studies) or from exposure to some environmental source (as has been suggested by recent studies) and whether disease results from reactivation of latent infection or from recent exposure and infection.
3. Creation of an international Pneumocystis network to enable researchers to pool resources and share data to answer questions of mutual interest.

Investigator: Laurence Huang, MD
Research Nurses: Joan Turner, RN; Cindy Merrifield, RN