About the Division of Infectious Diseases
The Division of Infectious Diseases also remains a lead member of the California Collaborative Treatment Group (CCTG), which is funded by the State of California University Wide AIDS Program. The CCTG is the largest collaborative HIV clinical research group in California and has been continuously funded for more than two and a half decades. Dr.Dubé is the Principal Investigator of the USC component of the CCTG. Under his leadership, the CCTG was recently awarded $1.6 million to lead a large four-year CCTG project at USC and the other collaborative research sites to improve patient retention in HIV care and to provide HIV pre-exposure prophylaxis (PrEP) to individuals at high risk of acquiring HIV.
The Rand Schrader Health and Research Center has been under the medical leadership of the Division (Drs. Sattler, Cadden and Dubé) since 1986 and has been a national flagship for the outpatient care of persons with HIV. The Clinic was conceived around a model whereby all care would be facilitated at a single site, the “medical care home.” Up to 40 USC faculty from virtually all specialties provide primary care and consultation during 11 weekly clinics session (Monday through Friday AM and PM as well as Tuesday evenings for patients who work during the daytime). A primary care provider, a registered nurse and a social service case manager constitute the Medical Care Coordination team for each patient; they facilitate all aspects of patient care in and away from the Clinic (including in the patient’s home).
Specialty clinics have included Pulmonary, Hematology-Oncology, Neurology, Psychiatry, Ophthalmology, Colorectal and Nutrition-Metabolism. Two new clinics have been created to meet the changing face of chronic HIV infection. The Dermatology service staffs a weekly Lipodystrophy Clinic, whereby patients receive autologous fat transfer for facial wasting, or liposuction to relieve pain and suffering associated with buffalo humps or other fatty depositions. The other new clinic is the Hepatitis Treatment Evaluation Clinic for patients co-infected with HIV and HCV or HBV. The goal of this clinic is to treat all patients co-infected with HBV and HCV at increased risk for liver related complications, especially now as multiple oral agents are available.
The Rand Schrader Health and Research Clinic also sponsors a broad range of education programs in HIV for the faculty, staff, ID fellows and other house officers rotating through the adult and pediatric ID services. As just one example, a Resistance Workshop is held monthly where patients with complex HIV resistance profiles and multiclass drug-resistance profiles are presented. Attendees use cART treatment histories along with HIV phenotypes and genotypes and work with an expert facilitator to arrive at treatment recommendations. The Clinic also serves as the primary site for OPD continuity care for ID fellows who learn all aspects of ambulatory care of HIV.
The Infectious Diseases Solid Organ Transplant Consultation Service was created in the spring of 2010 to provide complex ID consultation for a large number of solid organ transplants (heart-lung, liver, pancreas and kidney) at Keck Hospital. Dr. Emily Blodget serves as the lead consultant with assistance from Drs. Cadden, Geiseler and Sattler in creating the first dedicated infectious diseases transplant service at Keck Hospital. This addition provides a unique and focused training experience for infectious diseases fellows, house officers and students rotating through the ID consultation service.
The unique tripartite training in Infectious Diseases at USC offers an unparalleled clinical experience in three very different settings. First, the new training experience in transplantation infectious diseases is complemented by existing training provided by highly experienced faculty on the inpatient general ID consultation services at two private university hospitals (Keck Hospital and Norris Hospital), serving privately insured patients. The second involves the very busy ID consultation service at LAC+USC, which provides care to the underserved population of the greater Los Angeles Basin, many of whom are recent immigrants and travelers who bring from their home countries infections not routinely seen in the United States. The third component involves unparalleled opportunities for training in HIV medicine at the 33,000-square-foot, fully dedicated Rand Schrader Health and Research Clinic, which provides primary and specialty HIV care for approximately 2,500 HIV infected individuals. LAC+USC and the Rand Schrader Clinic provide care for a largely underserved minority population (60-70% Latinos and 12-15% African-Americans). The clinical and racial/ethnic diversity make ID fellowship training at USC one of the truly unique programs in the U.S.
Dr. Brad Spellberg, previously a faculty member at Harbor UCLA, was recruited to USC to serve as Chief Medical Officer for LAC+USC Medical Center. He is also an active member of the Division of Infectious Diseases, attends regularly on the ID consult services and participates in all other teaching functions in the Division (including weekly cases conferences, ID grand rounds and CPCs, journal club, and research seminars—see below). Dr. Paul Holtom now serves as Director of Infection Control and and Prevention at LAC+USC Medical Center and is the founder and leader of the Orthopedic ID service at the facility; Dr. Holtom like Dr. Spellberg attends and participates in all of the teaching activities of the ID Division.
The mission of the Division of Infectious Diseases is to advance the development of therapies to improve health through clinical and translational research in infectious diseases; promote excellence in the education of medical students, house officers and clinical fellows; deliver compassionate, evidence-based, state-of-the-art care to the large, diverse, multicultural community of Southern California served by LAC+USC Medical Center, Keck Hospital of USC and the USC Healthcare Centers.
A primary research mission of the Division of Infectious Diseases for more than three decades has been to investigate strategies to prevent and treat HIV and its complications. The NIH supported AIDS Clinical Trials Group (ACTG) is a major focus of research in the Division. Dr. Fred Sattler serves as Principal Investigator. The ACTG Clinical Research Site (CRS) at USC is in its 28th year and recently successfully re-competed to be funded for another seven-year cycle. The USC ACTG CRS has continuously performed at a very high level and has been second in enrollment of total research subjects amongst 72 domestic and international sites. It is also the leading site in the continental U.S. for enrolling minorities and women. Moreover, USC faculty (Drs. Sattler and Dubé,) continue to hold important scientific and administrative leadership positions during the current funding cycle. These key positions enabled faculty from our Division to contribute to and facilitate the scientific agenda and productivity of this world leading HIV collaborative research group. Tuberculosis, hepatitis C and cryptococcal meningitis, along with complications of chronic inflammation and immune activation including cardiovascular and lipid disorders and neurocognitive impairment, and aging-related disabilities including frailty have been areas of leadership by ID faculty. Drs. Dubé and Sattler are members of the Inflammation and End-Organ Transformative Science Group and have developed a number of concept proposals that are either under review or are being implemented for studies. Dr. Sattler is Chair of the Exercise Focus Group and Dr. Dubé is a member of the Data Monitoring Committee.