Faculty
Susan Cu-Uvin
Professor:
Obstetrics and Gynecology
Phone: +1 401 793 4775
Phone 2: +1 401 793 4775
Susan_Uvin@Brown.EDU
Read Susan Cu-Uvin's full Faculty Research Profile.
Dr. Cu-Uvin's research focuses on Human Immunideficiency Virus (HIV) in women primarily in understanding the effect of antiretroviral therapy on HIV shedding in the female genital tract. She is also involved in research on Sexually Transmitted Diseases (STDs): human papilloma virus (HPV, genital warts) in the cervix and anal canal of HIV infected women, cervical/anal dysplasia or cancer, HPV vaccines, herpes and bacterial vaginosis. She collaborates on studies of microbicides to prevent HIV transmission.
Biography
Dr. Susan Cu-Uvin is an Professor of Obstetrics and Gynecology and Medicine at Brown University. She is the Director of the Immunology Center at the Miriam Hospital, Brown University, a clinic that serves almost 1,200 HIV infected patients. She is also the director of the Women and AIDS Core, for the Center for AIDS Research (CFAR) at Brown University. She is director of the Research program of the Brown/ Women and Infants Hospital Center of Excellence in Women's Health. She devotes 100% of her time to HIV related care and clinical research. She was the Chair of the Women's Health Committee of the Adult AIDS Clinical Trials Group (AACTG) from 2004-2006. She is the Principal Investigator of an RO1 to assess antiviral therapy and HIV in the female genital tract (AI40350), an co-PI of an RO3 to assess HIV-1 genital tract shedding among Cambodian women (TW6981), and a World AIDS Foundation grant to establish a HIV women's clinic in Cambodia and provide training to Cambodian health care professionals for research readiness for future projects related to HIV in women. She is a co-investigator of the CDC funded study to understand the natural history of HIV and AIDS in the era of highly active antiretroviral therapy (SUN).She served on the Institute of Medicine's Committee on Perinatal Transmission of HIV to investigate interventions to decrease vertical transmission of HIV within the United States. She chaired the NIH advisory committee on HIV related research in women and girls in 2008 and is a member of the NIH advisory committee on HIV related research in microbicides. She is also a member of the Global Microbicide Project scientific advisory group. She is a member of the Fogarty Executive Committee at Brown University and has been a very active mentor for international trainees in HIV/AIDS care and research.
Interests
Antiviral Therapy and Human Immunodeficiency Virus (HIV)-1 in the Genital Tract of Women
Hypotheses:
1. In the presence of antiretroviral therapy, viral replication within the female genital tract may lead to the development of drug resistant mutants that is different from blood plasma.
2. Antiretroviral drug levels in the female genital tract may often be lower than in the blood plasma. Differences in drug exposure may be associated with differences in virus replication and selection of resistant HIV-1 variants during drug failure.
3. HIV can be recovered in vitro from cells in the female genital tract during successful therapy and it may be genetically different from the HIV variants recovered from the blood cell latent reservoir.
Specific Aims:
1. To understand the relative dynamics of viral failure and viral replication in the female genital tract.
1a. To compare drug resistance mutations and other measures of genetic relatedness between HIV-1 in blood versus genital secretions.
1b. To determine whether virologic failure occurs earlier in the blood or genital tract in women who are being propectively followed during successful rescue therapy.
1c. To determine whether drug resistant mutations are acquired earlier in blood or genital tract.
1d. To determine whether different genital tract subcompartments (endocervix, ectocervix, vagina) differ in viral load response to rescue therapy or in genetic changes in HIV-1 pol, including resistance mutations.
2. To assess drug exposure and patterns of drug resistance in the female genital tract.
2a. To characterize drug exposure in the genital tract as well as in blood.
2b. To determine whether differences in blood and genital tract drug exposure are associated with differences in drug resistance mutations.
2c. To determine whether differences in blood and genital tract drug exposure are associated with differences in viral load.
3. To evaluate cellular reservoirs of HIV in the female genital tract.
3a. To determine whether viral load in the genital tract is intermittently detectable during effective Highly Active AntiRetroviral Therapy (HAART) and to examine whether this coincides with transiently detectable viral load ("blips") in the blood compartment.
3b. To determine whether viruses can be recovered in vitro from cells in genital tract when cell-free genital tract and blood viral load are undetectable.
3c. To compare the sequence relatedness of cell-associated virus recovered from female genital tract to that of virus recovered from blood cells.
HIV-1 Genital Tract Shedding and Asymptomatic HSV-2 Infection Among HIV-Seropositive Women on Highly Active Antiretroviral Therapy
Asymptomatic genital HSV-2 shedding will increase HIV-1 in the genital tract of HIV-infected women on HAART.
Chronic suppression of asymptomatic HSV-2 with acyclovir will reduce the presence and/or the quantity of HIV-1 RNA shedding from the female genital tract among women on HAART.
Primary Specific Aim 1:
To measure the presence and quantity of HIV-1 RNA genital tract shedding among asymptomatic HSV-2 seropositive women on HAART who are receiving acyclovir for chronic HSV-2 suppression compared to similar women not receiving acyclovir.
Secondary Specific Aim 2:
To correlate the quantity of HIV-1 RNA with the quantity of HSV-2 DNA in women shedding both viruses simultaneously.
Degrees
MD
Teaching
UNIVERSITY TEACHING ROLES
1996- Fogarty HIV/AIDS Fellowship Faculty Mentor
1997- Speaker, Annual Brown University AIDS Program Forum
2000- Lecturer, BC 107, Burden of Disease in the Developing World
2002- Lecturer, Biomed 282, Pathophysiology, Infectious Diseases
2003- Preceptor, Brown Medical School and Lifespan Academic Medical Center, Internal Medicine Community Based Teaching Program
2003- Course Director, Brown University AIDS Program and New England
AIDS Training Center, Annual HIV in Women Symposium
HOSPITAL TEACHING ROLES
1996-present Immunology Center Attending, The Miriam Hospital, Providence, RI, 3-4 clinic sessions per week
1996-present Inpatient and On-call Rounding, The Miriam Hospital, Providence, RI, one week per month
1996-present Preceptor, Brown Medical School students, The Immunology Center, The Miriam Hospital, Providence, RI
2000- present Lecturer, Brown University Infectious Disease Fellowship
2004-present Lecturer, Core Curriculum, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI
OTHER TEACHING ROLES
1996- Preceptor, Brown University Undergraduate Independent Study Projects
1997- Mentor, Summer Research Asssistantships, Undergraduate and Medical Students
2000- Mentor, Summer Undergraduate Teaching and Research Assistantship (UTRA)
2000- Thesis Adviser, Undergraduate students, Brown University
2005- Mentor, Research Supplement for Underrepresented Minorities
2005- Thesis Adviser, MPH candidate, Brown University
2005- Mentor, The Women and Infants /Brown National Center of Excellence in Women's Health
FOGARTY INTERNATIONAL TRAINEES
1996- present
Philippines:
Dr. Nymia Simbulan, Professor of Sociology, University of the Philippines
Dr. Guadalupe Natividad-Villanueva, Asst. Professor, Dept. of OB-GYN, University of the Philppines
Dr. Katherine Juliano Remollino, Asst. Professor, Dept. of OB-GYN, University of the Philippines
Dr. Maria Conception Manalo, Asst. Professor, Dept. Of Pediatrics, University of the Philippines
Dr. Dorothy Agdamag, Director, Microbiology and STD Research Laboratory, San Lazaro Hospital, Manila, Philippines
Dr. Josefina Tayag, Professor of Sociology, University of the Philippines
Dr. Reynaldo Imperial, Professor of Sociology, University of the Philippines
India:
Dr. Purnima Madhivanan, YRG Care, Chennai, India, PhD student, Univ. of California, Berkely
Dr. Sheila Shyramprasad, Director, Dept. of OB-GYN, C.S.Rainy Hospital, Chennai, India
Dr. Jessie Lionel, Associate Professor, OB-GYN, Christian Medical College, Vellore, India
Dr. Nomita Chandiok, OB-GYN, Microbicide Project, Indian Council of Medical Research
Cambodia:
Dr. Sok Pheng, Director, Sihanoukville Hospital, Cambodia
Dr. Theng Theany, Chief of OB-GYN, Sihanoukville Hospital, Cambodia
Dr. Lim Kruy, Director, Women's HIV Clinic, Center of Hope, Phnom Penh, Cambodia
Brazil:
Dr. Ana Lucia Ribeiro de Vasconcelos, Ministry of Health, National Program for HIV/AIDS
Dr. Angela Andrade, Dept. Of OB-GYN, Fio Cruz Hospital, Rio de Janeiro, Brazil
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