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ALIVE-Supported Studies and Collaborations

The ALIVE Study serves as a platform for other related investigations. Several ongoing studies also represent opportunities for student involvement.

Pilot Smoking Cessation Trial
PI: Brad Drummond
Funder: American Thorasic Society Foundation
Summary: In preparation for a larger randomized trial, this grant supports pilot evaluation of contingency management vs. personalized education based on lung age to improve smoking cessation in HIV-infected injection drug users.

The Progression of Hepatitis C Among IDUs
PI: Dave Thomas
Funder: NIH-NIDA
Summary: This grant investigates the rate of progression of liver disease among HCV-infected IDUs in ALIVE to identify markers of fibrosis progression and to identify HCV-infected IDUs at greatest risk of disease.

North American AIDS Cohorts Collaboration on Research and Design (NA-ACCORD)
PI: Richard Moore
Summary: This proposal created a North American consortium of 50 sites and 60,000 HIV-infected or at risk patients emphasizing evaluation of HAART failure, treatment guidelines, non-AIDS outcomes, and other emerging issues in HIV research.

Center for Metabolic Research on HIV and Drug Use
PI: Sherwood Gorbach, Tufts University
Funder: NIH-NIDA
Summary: The Tufts Nutrition Collaborative - Center for Drug Abuse and AIDS Research works to raise awareness of the importance of nutritional and metabolic disorders on outcomes in the drug using population and to encourage investigators to include studies of nutritional and metabolic status in their research in drug using populations.

Early-Stage Chronic Kidney Disease in HIV-Infected Individuals
PI: Greg Lucas
Funder: NIH-NIDA
Summary: The aims of our study are to 1) determine the implications of HIV infection and albuminuria for changes in GFR (determined by serial measures of iohexol clearance) and for changes in carotid intima-media thickness (a surrogate marker of cardiovascular disease), 2) evaluate novel biomarkers of kidney injury and GFR in this population, and 3) assess potential pathogenic mechanisms of HIV-related CKD (including viral burden measured in urine and immune activation). This cohort study includes equal numbers of HIV-infected and HIV-negative individuals with normal kidney function, recruited from the Johns Hopkins HIV Clinical Cohort and the ALIVE study.

Mechanisms of Immune Evasion by Hepatitis C Virus
PI: Andrea Cox
Summary: This proposal is focused on investigation of hepatitis C virus (HCV) immune evasion mechanisms and protective immunity. Specifically, we plan to 1) compare the kinetics, frequency, and type of escape mutations in CD8 T cell epitopes in the hyper-acute phase of infection and re- infection among individuals who clear HCV infection and those who progress to chronic infection 2) test the hypothesis that expression of PD-1 and CD127 affects the function of CD8 T cells specific for non-mutated HCV epitopes and evaluate mechanisms of regulation of their expression and 3) determine the role of PD-1 and CD127 in the response of memory T cells to repeated HCV exposure.

Baltimore Acute Hepatitis C Cooperative Center
PI: Andrea Cox
Summary: The early infection of Hepatitis C Virus is hard to detect. The Center studies a unique cohort of people at high risk for HCV infection and focus on the early immune response to HCV. Injection drug users followed on a monthly basis, thereby allowing high frequency detection of de novo acute HCV infection and longitudinal evaluation of infection outcome. The research brings together unique patient resources with leaders in the study of HCV-specific T cell and humoral immune responses and HCV sequence evolution.

Laboratory and Statistical Development of Cross-Sectional HIV Incidence Assays
PI: Susan Eshleman
Summary: Our goal is to develop and validate accurate, cost-effective methods for cross-sectional HIV incidence determination. We will focus on analysis of HIV incidence in both subtype B (the major subtype driving the HIV/AIDS epidemic in the United States) and subtype C (the major subtype driving the HIV/AIDS epidemic in sub-Saharan Africa); other subtypes prevalent in sub-Saharan Africa will also be analyzed.

Using mHealth To Respond Early to Acute Exacerbations of COPD in HIV m-Reach
PI: Greg Kirk
Summary: This clinical trial planning grant evaluates the feasibility, acceptability and defines optimal trial elements for an m-Health intervention to identify early exacerbations in HIV-COPD to improve management and clinical outcomes.

Technology-Enhanced Peer Navigation to Improve IDUs’ Engagement in HIV Care
PI: Greg Kirk, Ryan Westergaard
Funder: NIH-NIDA
Summary: This clinical trial planning grant evaluates the feasibility, acceptability and preliminary efficacy of an m-Health, smartphone-delivered, peer navigation intervention to improve retention and adherence among out-of-care HIV-infected IDUs.

The Study of HIV Infection in the Etiology of Lung Disease (SHIELD)
PI: Greg Kirk
Summary: SHIELD is a collaborative and systematic investigation of lung disease among HIV-infected persons and those at risk for HIV exposure within the ALIVE Study cohorts. At each ALIVE Study visit, all participants undergo an interviewer-administered respiratory questionnaire and spirometry test to obtain more detailed information regarding lifetime tobacco and other inhaled drug use as well as pulmonary functioning.

Effect of Cocaine and LTR Polymorphism on HIV-1 Pathogenesis
PI: Richard Markham
Funder: NIH-NIDA
Summary: Using a cohort of cocaine-using HIV-1 infected subjects followed at the Vanderbilt Clinical Care Center, we will address the hypothesis that cocaine users infected with HIV-1 carrying the Clade B HIV-1 LTR polymorphism with an AP-1 binding site will have higher viral loads, greater genetic diversity, and greater primary resistance to antiretrovirals than either cocaine users whose virus does not carry the LTR polymorphism or non-cocaine users.

Use of Clonal Genotyping to Predict Resistance Development in ART-Naive IDUs
PI: Richard Markham
Funder: NIH-NIDA
Summary: In cohorts from the Johns Hopkins and Vanderbilt Schools of Medicine of 150 HAART-naive drug users who rapidly failed HAART and 150 comparable subjects for whom therapy was successful, we will evaluate new technologies that will render anti-HIV-1 drug therapy more effective. This new technology will permit better characterization of the viral strains that are infecting an individual so that the therapy can be specifically targeted to those viruses.

Structural Models and Direct and Indirect Effects of Alcohol Use on HIV Infection
PI: Stephen Cole, University of North Carolina-Chapel Hill
Summary: The overall goal of this proposal is to use multiple preexisting NIH-funded data sources to adapt, apply and refine novel analytic epidemiologic methods to characterize the relation, and estimate the impact, of alcohol intake on risk of infection with Human Immunodeficiency Virus (HIV). The aims of the present proposal will be undertaken using the ALIVE, MACS, and WIHS cohort studies.

Hepatitis C Pathogenesis and the Human Genome
PI: Dave Thomas
Funder: NIH-NIDA
Summary: This grant examines the role of the host genome in the recovery from HCV infection. By comparing the DNA from persons who recovered from hepatitis C with DNA from those with viral persistence, the host genetic basis is explored.

Baltimore Oral Epidemiology, Disease Effects, and HIV Evaluation Study (BEEHIVE)
PI: Mark Macek & Gregory Kirk
Funder: National Institute of Dental Research
Summary: The study provides dental examinations to determine the extent of HIV status influence on access and utilization of oral health care services, self-reported and clinical oral health statuses, periodontitis progression, and periodontal disease-associated oral microbiome signature.

The Sentinel Study (mALIVE) 
PI: Becky Genberg
Funder: National Institute on Drug Abuse (NIDA)
Summary: The overall objective of the mALIVE Study is to monitor temporal trends in the patterns of drug use in Baltimore city and the surrounding counties using specific tools to gather data in real-time on the geolocation and types of drugs used, as well as the physiological signs of drug use, in a population with a history of drug use, followed in a non-treatment setting.

The Covid Health and Network Group Experience Sub-Study (CHANGES)
PI: Becky Genberg
Funder: National Institute on Drug Abuse (NIDA)
Summary: Using data collected and analyzed from qualitative in-depth phone interviews of over 25 ALIVE participants, a quantitative follow-up COVID-19 network survey tool was developed which evaluates changes in drug and social networks post COVID-19 and subsequent impacts on engagement in services

Frailty, HIV Infection, Injection Drug Use and the Inflammatory-Microbiome sub study
PI: Damani Piggott
Funder: National Institute on Aging
Summary: Started enrolling ALIVE participants in a frailty substudy related to bacteria and microbes in the gut which involved collecting a stool sample. MicroBiome-C is the second phase of the frailty substudy Participants provide a second stool sample and undergo a colonoscopy procedure to allow us to collect small samples from the lining of the colon and help us understand how bacteria and other microbes in the gastrointestinal tract may affect healthy aging in persons living with HIV or people who inject drugs undergo a colonoscopy. 

Study of HIV Infection in the Etiology of Lung Disease (SHIELD) Home substudy.
PI: Gregory Kirk
Funder: The National Heart Lung and Blood Institute (NHLBI)
Summary: Started studying sources of air pollution in homes in Baltimore to understand how air pollution affects the lungs.

Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO)
Summary: The ALIVE Study has continued to collaborate with the C3PNO consortium. C3PNO’s charge is to stimulate the use of the NIDA longitudinal cohorts’ data and address high-priority research on HIV/AIDS in the context of substance misuse.