HIV Infections Clinical Trial
Official title:
Clinical, Laboratory and Epidemiologic Pilot Studies of Individuals at High Risk for Viral-Associated Cancers
This protocol presents the rationale, 25-year historical review, and methods for
multidisciplinary, low-risk studies of individuals referred to the NCI Viral Epidemiology
Branch (VEB). Referrals are generally for unusual types of cancer or related conditions,
known, or suspected to be related to viruses. Kaposi's sarcoma in two homosexual men
evaluated in 1981 is a classic example. These referral cases provide the basis for pilot
studies that generate hypotheses, the development of protocols for formal investigations of
promising leads, and help to set priorities for VEB.
A VEB investigator who is a Staff Member at the NIH Clinical Center, interviews each subject,
performs a physical examination, draws a blood sample, and, when appropriate for the disease
or virus under study, obtains other clinically indicated biological specimens, such as urine,
sputum, saliva, tears, semen, Pap smear, or cervical, anal, oral, or nasal swabs. On
occasion, other relatively non-invasive studies may be indicated. Skin testing with
conventional, licensed antigens for assessment of cellular immunity may be performed, and
skin lesions may be biopsied or excised. Tumor or other tissue biopsies may be obtained when
biopsy or surgery is clinically indicated for other reasons. Otherwise no surgery is
performed, and no therapy is administered. Clinical referral to other components of NCI, NIH,
or the private sector are made as needed. The biological specimens are frozen or otherwise
preserved to be batch tested in current assays or future assays that will be developed. Such
laboratory testing is performed either at VEB's own support laboratory, or collaboratively in
other NCI, NIH, or extramural laboratories that have the needed expertise for the disease or
virus under study.
Occasionally, repeated or more long-term evaluation is required. More often, a single
evaluation in the NIH outpatient clinic, or either at a collaborating physician's office or
other suitable site in the field, is sufficient. The VEB investigator provides counseling
relevant to the virus or disease under study, and about the interim study results. He or she
makes appropriate referral if needed (e.g., to the Genetic Epidemiology Branch for genetic
counseling). Clinically relevant results and the VEB investigator's interpretation of these
results, are provided in writing to the subject's primary caregiver. Confidentially of the
information that is obtained is carefully protected. The results of the study are summarized
for publication in the peer review literature.
This protocol presents the rationale, 25-year historical review, and methods for
multidisciplinary, low-risk studies of individuals referred to the NCI Viral Epidemiology
Branch (VEB). Referrals are generally for unusual types of cancer or related conditions,
known, or suspected to be related to viruses. Kaposi's sarcoma in two homosexual men
evaluated in 1981 is a classic example. These referral cases provide the basis for pilot
studies that generate hypotheses, the development of protocols for formal investigations of
promising leads, and help to set priorities for VEB.
A VEB investigator who is a Staff Member at the NIH Clinical Center, interviews each subject,
performs a physical examination, draws a blood sample, and, when appropriate for the disease
or virus under study, obtains other clinically indicated biological specimens, such as urine,
sputum, saliva, tears, semen, Pap smear, or cervical, anal, oral, or nasal swabs. On
occasion, other relatively non-invasive studies may be indicated. Skin testing with
conventional, licensed antigens for assessment of cellular immunity may be performed, and
skin lesions may be biopsied or excised. Tumor or other tissue biopsies may be obtained when
biopsy or surgery is clinically indicated for other reasons. Otherwise no surgery is
performed, and no therapy is administered. Clinical referral to other components of NCI, NIH,
or the private sector are made as needed. The biological specimens are frozen or otherwise
preserved to be batch tested in current assays or future assays that will be developed. Such
laboratory testing is performed either at VEB's own support laboratory, or collaboratively in
other NCI, NIH, or extramural laboratories that have the needed expertise for the disease or
virus under study.
Occasionally, repeated or more long-term evaluation is required. More often, a single
evaluation in the NIH outpatient clinic, or either at a collaborating physician's office or
other suitable site in the field, is sufficient. The VEB investigator provides counseling
relevant to the virus or disease under study, and about the interim study results. He or she
makes appropriate referral if needed (e.g., to the Genetic Epidemiology Branch for genetic
counseling). Clinically relevant results and the VEB investigator's interpretation of these
results, are provided in writing to the subject's primary caregiver. Confidentiality of the
information that is obtained is carefully protected. The results of the study are summarized
for publication in the peer review literature.
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