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Where to Go - Answer
Nov 13, 2002

Dear Doctors, I'd like to respond to the "Where to Go" question in Chicago. This is - by no means - a comprehensive description of HIV treatment available in the Chicago area. For that I would recommend getting in touch with the people at BEHIV:

BEHIV (Better Existence with HIV) 6924 N. Glenwood Ave. Chicago, IL 60626 Ph: 773-381-6300 website: www.behiv.org

...or: Test Positive Aware Network (TPAN) 5537 North Broadway Chicago, IL 60640 Ph: 773-989-9400 Webpage: www.tpan.com

...or any one of the other large Community Based Organizations (CBOs) in Chicago.

Note: TPAN annually publishes a comprehensive "Chicago Area HIV Services Treatment Directory". I was just there this weekend, and saw a stack of them near the receptionist's desk.

RUSH ------------ I've been "going" to both Rush and Northwestern for HIV services and clinical trials over the past 16 years.

Both hospitals have excellent HIV knowledgeable staff. Both hospitals have doctors who regularly present papers at the major HIV/AIDS/Infectious Disease/Medical conferences. Rush's Harold Kessler, MD was a coauthor of the first (that I am aware of) paper which documented that healthcare workers, who were exposed to HIV through sharps accidents, could clear HIV from the local site of infection - without sero-converting (getting systemic HIV disease). Harold Kessler, MD co-moderates the International AIDS Society meetings when they come to Chicago. Harold was the past Principal Investigator for Rush's Adult AIDS Clinical Trials Group (ACTG) unit - overseeing several HIV/AIDS clinical trials. Rush's Dr. Beverly Sha now has that responsibility.

Nearby Rush Medical College is home to Alan Landay, Ph.D, the AIDS Clinical Trials Group (ACTG)'s Immunology Research Chair. Rush has an "advanced immunology lab" on-site. They worked on the assay for the 32base pair deletion in the ccr5 co-receptor that prevents HIV from using it to enter specific white blood cells that "sprout" ccr5. They also worked on the assay for T cell Receptor Excision Circles (TREC) - the bits of genetic material inside a T cell that can indicate how many times a slected group of T cells have divided (presumedly in the presence of a specific antigen) indicating whether the cell has ever been stimulated by dendritic cells and clonally divided into many (hundred?) copies of itself - to kill cells infected with HIV. When the thymus is functioning, it will produce T cells that have high amounts of TREC. HIV-1-specific T cells with high amounts of TREC are an indication of both how well the thymus is functioning and that HIV disease is not killing these newly "minted" T cells (a very good thing). Note: Alan does not see patients.

Note: the doctors who publish the most medical papers and attend the most medical conferences are BOTH the most knowledgeable AND (often) the most difficult to get in touch with - in case of an emergency.

Rush holds Community meetings at their facility.

If one is coming from the South or Western suburbs of Chicago, Rush would be easier to get to than Northwestern. Rush runs a nearby parking garage (about 7.00 min.).

Negatives (there are two): 1)the upper management of Rush have made the entrance to their infectious disease clinic totally separate from the main hospital entrance. The only people who enter that ***clearly visible from far away*** door are people with STDs, #2) I pity the person who receives a call at work from his doctor or nurse (at Rush), as coworkers may be informed (by a common caller ID screen) that you just receivecd a call from Rush "INFECTIOUS DISEASES".

Northwestern ------------ I entered my first clinical trial (ACTG 019), in 1987 here, under chief of Infectious Disease John P. Phair, MD. John answered the call for more community outreach meetings at a time when local hospitals were filled with dying AIDS patients. When Chicago had a local "National ACTG Community Advisory Board (CCG) member", John worked closely with that person. John has since gone into semi-retirement, co-chairing local International AIDS Society meetings with Harold Kessler, MD, and moderating "Clinician's Update on HIV" meetings held at Northwestern.

Northwestern's Rob Murphy, MD now oversees the whole Chicago area AIDS Clinical Trials Group budget, which includes ACTG trials held at Rush, Cook County Hospital and the new Core Center (which is a dedicated, full service HIV/AIDS medical center).

Northwestern has more HIV/AIDS clinical trials running, at any given time, than any other hospital in the Chicago area.

Northwestern funds the local HIV/AIDS Community Advisory Board, often paying for meals and parking, and regularly sending a local person (sometimes two) to the semi-annual National Adult ACTG meetings held in Washington, D.C. (or Arlington, VA).

At last night's abbreviated CAB meeting, held in Rob Murphy, MD's Infectious Diseases conference room, three CAB members briefly discussed HIV clinical trials with the AACTG Trials coordinator, Baiba Berzins, MPH (312-695-5012). Rob was called away on a family emergency.

Following the CAB meeting, we were invited to attend a "Clinicians Update on HIV Disease" meeting.

At that meeting, Northwestern's Frank Palella, MD discussed his soon be published (in the Annals of Internal Medicine) paper that will re-open the discussion of when to start antiretroviral therapy for HIV disease. Frank's paper will provide data that supports starting treatment at higher CD4+ T cell counts than the present CDC and IAS guidelines call for (200 - 350 CD4+ T cells). I'm looking forward to reading Frank's paper.

Both Rush and Northwestern have clinical trials that the person wondering "Where to Go" may qualify for. Give Baiba Berzins, MPH (312-695-5012) at Northwestern a call, or call Rush's Clinical Trials number (312-942-3665) and talk with a study coordinator.

Good luck! And, if you talk with Baiba, ask her to inform you of the next Community Advisory Board (CAB) meeting.

Response from Dr. Young

Thanks for the information.. BY



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