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The main focus of Dr. Marconi's research is to identify the biological, social and behavioral conditions which lead to disparities in HIV treatment response for domestic and international populations. Results from these studies inform the design of interventional trials which attempt to mitigate these conditions in an experimental setting. The ultimate goals of this work are to improve patient care and further characterize the pathogenesis of HIV.
His domestic research activities have two primary components: (1) HIV immunopathogenesis as it relates to treatment response and (2) improving retention in care for patients receiving treatment for HIV/AIDS. The immunopathogenesis work includes an effort to discover the biological mechanisms associated with spontaneous HIV suppression and immunologic stability for Elite Controllers. A separate study is currently exploring the impact of periodontal disease on AIDS progression and HAART response. Additional studies are examining immunologic non-response to ART and HIV transmission among young, African-American men. Current research aimed at improving access to care include assessing the cost-effectiveness of HIV treatment in a free-access healthcare setting comparing VA and DoD cohorts, determining the impact of palliative care services for inpatients with HIV, and examining the role for financial incentives and comprehensive behavioral therapy for outpatients with HIV.
His current international research involves a longstanding collaboration with investigators from Durban, South Africa. This research seeks to identify the prevalence of and risk factors for HIV drug resistance after ART. These studies include examining clinical outcomes after subsequent therapy, adherence and pharmacy refill patterns, and the contrast between urban and rural settings. Additional work involves identifying the impact of minority resistance variants on treatment response for patients in South Africa.
CFAR Involvement• Member:
Drs. Brian Agan, Sunil Ahuja, John Altman, Rama Amara, Wendy Armstrong, Danny Branstetter, Steve Deeks, Carlos del Rio, Rachel Friedman, Jodie Guest, Eric Hunter, Brent Johnson, Sunil Kannanganat, Colleen Kelley, Daniel Kuritzkes, Jeff Lennox, Minh Nguyen, Igho Ofotokun, Jason Okulicz, Mirko Paiardini, Tim Read, David Reznik, Dave Rimland, Guido Silvestri, Henry Sunpath, Bruce Walker, Amy Weintrob, Ling Yue