AIDS Research at the NIH: A Critical Review

1. $1.2M to vascular cell proliferation in KS;
2. $3M for HIVIG clinical trials to prevent vertical transmission during the third trimester;
3. $310,000 for work on anti-HIV gene therapy;
4. $1 M to study the etiology and mechanisms of non-infectious HIV pulmonary complications;
5. $1 M to develop methods of inactivating viruses in blood and blood products;
6. $73,000 to buy an electrospray attachment for a mass spectrometer for intramural research on the
structure of HIV peptides which may be candidate targets for vaccines;
7. $1.5M to investigate whether transfusions from CMV-negative donors reduce active CMV in PWAs.
8. $1.2M to study myocarditis and dilated cardiomyopathy in children with AIDS;
9. $1.2M to study lung immunocytes in children with AIDS and pulmonary disease;
10. $4M to extend the Pulmonary Complications of AIDS natural history study.
11. $1 M to assess the efficacy of thin section computerized tomography in the early diagnosis and
management of the lung complications in pediatric HIV infection.
12. $1.5M to investigate, post-mortem, the conduction system of the heart in children with AIDS.
NHLBI also asked for funding to add 5 new AIDS FTEs, which would bring their total to 44. With the
President's parsimonious budget for FY 1993, NHLBI will barely be able to support its current commitments.
Few of these new initiatives are likely to see the light of day.
Recommendations:
* Congress should fully fund NHLBI's budget request and its wish list for FY 1993;
* NHLBI should not be forced by budgetary constraints to decrease its natural history studies in the
pulmonary complications of AIDS to support similar pediatric studies. If Congress wants pediatric
studies, they should appropriate extra money for the institute;
* NHLBI should fund studies of MTB in HIV infection, and Congress should give them the money;
* NHLBI should investigate lymphoid interstitial pneumonia in children with HIV;
* NHLBI's program on thrombocytopenia purpura in HIV infection should be expanded to focus more
explicitly on platelet abnormalities seen in people with HIV;
* NHLBI should investigate cardiac complications of HIV infection seen in injecting drug users.
* NHLBI should broaden its work on the other pulmonary Ols seen in AIDS.
11/5. National Institute of Child Health
+ Human Development (NICHD)
Created in 1962 by act of Congress (P.L. 87-838), NICHD has five large components - the Center for
Research for Mothers and Children; the Center for Population Research (both extramural programs); the
intramural research program; the Prevention Research Program; and the Scientific Review Program.
NICHD spent $32.6 million on AIDS in FY 1991.
BaIc research. NICHD spent $1.3 million on intramural AIDS research programs, investigating genetic
transcription factors, mammalian retrovirus genetics, protein structure (including trichosanthin and its less
toxic derivative, TAP 29), HIV-1 aspartic protease inhibition, prevention of AIDS-associated neuronal
deficits, studies of T cell activation, interleukin-2 and T cell receptor structure/function studies. Extramural
basic research is eclectic, ranging from in vitro models of transplacental transmission and animal models
of vertical transmission to fetal toxicity of AZT. NICHD also supports a broad range of epidemiological and
behavioral studies in high-risk populations, STD clinic patients, drug users, students and others. NICHD

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