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SEARCH is a partnership that began in 2005 with a goal of accomplishing mutual objectives in HIV/AIDS research and training in the South East Asia region among three partners: The Hawaii AIDS Clinical Research Program of the John A. Burns School of Medicine, University of Hawaii at Manoa in Honolulu (UH), The Thai Red Cross AIDS Research Centre (TRCARC) in Bangkok, and The Armed Forces Research Institute of Medical Sciences (AFRIMS) in Bangkok, Thailand.
SEARCH conducts its activities in Thailand under the TRCARC with close guidance from three co-directors: Professor Praphan Phanuphak (TRCARC), Professor Cecilia Shikuma (UH), and Col. Associate Professor Jerome Kim (AFRIMS).
With the expertise and experience of SEARCH personnel and partners in performing HIV/AIDS clinical studies, both in Thailand and in other countries, SEARCH serves as a coordinating center for studies by developing protocols, identifying suitable collaborating sites, providing training for site staff, submitting studies to relevant regulatory bodies, managing and monitoring the study, and performing statistical analysis and reporting of study results.
SEARCH is interested in various aspects of HIV/AIDS and related infectious diseases. Within the short period since its inception, SEARCH has been involved in the following areas of studies.
The University of Hawaii offers expertise in neuroAIDS, and particular interest is in HIV dementia. Two studies are ongoing at Phramongkutklao Hospital site. One study is to compare clinical dementia and peripheral blood macrophage activation in HIV negative and positive Thais, and the other is to establish normative neuropsychological parameters in HIV negative Thais. Both studies will be completed by 2007. A joint study with HIV-NAT, an organization within TRCARC, to evaluate the prevalence of HIV dementia in Thai patients who have had long term viral suppression has commenced.
Particular interests are mitochondrial, cardiovascular and metabolic complications from HAART, especially in the aging population. The University of Hawaii offers expertise in identifying mitochondrial toxicity at a cellular level. A study with the TRCARC and Queen Savang Vadhana Memorial Hospital in collaboration with University of Hawaii to evaluate different strategies of using NRTIs in combination with NNRTIs as first line regimens to limit hematologic, mitochondrial and neurologic complications is being reviewed by funding agencies. This study will have high impact on the first line treatment strategies for developing countries.
SEARCH is working closely with the Anonymous clinic of the TRCARC to establish an acute seroconverter cohort. A pilot study evaluating the prevalence of persons infected with HIV within the past three weeks has begun in September 2006. Follow up studies are planned to assess mucosal immunity and dual HIV infections, as well as possible interventions to slow HIV disease progression. Also in the planning stages are studies to evaluate dual HIV infections and resistance in high risk cohorts at the Anonymous clinic which will have impact on vaccine development for Thais. AFRIMS brings expertise to SEARCH in immunologic, virologic and vaccine studies.
SEARCH is interested in the issues of female and male sexual health, particularly contraceptions, microbicides, sexually transmitted diseases, human papilloma virus infection, and cervical and anal cancers. SEARCH is working closely with the Anonymous clinic at the TRCARC in developing standard sexual health care programs for persons with HIV infection.
SEARCH is collaborating with Columbia University, HIV-NAT, and Bamrasnaradura Institute in developing a protocol to evaluate immune markers in predicting immune reconstitution syndrome in HIV and TB co-infected patients treated with antiretrovirals. A similar study is planned in the near future in Vietnam. SEARCH is also working with the University of Maryland in formulating a protocol to limit mother-to-child hepatitis B transmission in HIV negative mothers.
SEARCH is the Thailand coordinating center working with five collaborating organizations (University of Hawaii, Rajavithi Hospital, Queen Sirikit National Institute of Child Health, HIV-NAT and AFRIMS) on an ACTG study to evaluate strategies to prevent the emergence of resistance in mothers after receiving antiretrovirals for mother-to-child HIV transmission prevention.
SEARCH currently renders advice to partner and other organizations in developing and conducting studies in children with HIV, especially on neuropsychologic, immunologic and antiretrovirals issues, as well as provides consultation on clinical case management. Moreover, SEARCH provides service to the World Health Organization in creating a pediatric antiretroviral treatment clinical manual for clinicians in the South East Asia region.
SEARCH has been involved in setting up training programs for Vietnamese military doctors in Thailand with the University of Hawaii and AFRIMS as part of the President's Emergency Plan for AIDS Relief (PEPFAR) by offering opportunities for hands-on as well as didactic training at different hospitals and collaborating organizations according to the needs of the trainees. In early 2007 SEARCH held an intensive six-week HIV/AIDS training course in Thailand for physicians in India and Indonesia who cared for adults and children with HIV. Because of the success of this first course, an annual training workshop is being planned for physicians in South and South East Asia.
Through the research studies mentioned previously, SEARCH provides training to research staff at collaborating sites on good clinical practice, research protocols/standard operating procedures/manual operating procedures, as well as offers specialized training through our partner organizations, including neuropsychological testing, neurologic examinations, colposcopy and anoscopy, and methods of advanced immunologic and virologic laboratory testing.
In addition, SEARCH is devoted to the training of nurses from South East Asian countries on delivering HIV/AIDS care and to HIV/AIDS education for the community and persons living with HIV.
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