AIDS Research at the NIH: A Critical Review

children; and a study of congenital CMV infection and auditory pathology in mice at UCSD. None of these
appears on its face to have any direct AIDS-related application. NIDCD also provides otolaryngic and
audiological consultation and care to people with AIDS participating in research protocols run by other ICDs
(two NIAID adult and two NCI pediatric protocols).
Future plans. For FY 1993, NIDCD asked for new funds to research CMV-related conditions such as
Meniere's disease, perilymphatic fistulae, sudden onset hearing loss, and hearing and balance disorders
emerging in people with AIDS. NIDCD wants $1.865M to support 6 new research grants in this area.
Recommendations
* NIDCD should direct its program towards more specifically AIDS-related projects.
* Recent studies have found auditory or cochleo-vestibular impairment in people with HIV infection
in the absence of opportunistic infection of the CNS or ear. Olfactory impairment has been
reported in HIV infection as well. NIDCD should fund studies to follow up on these findings.
* Finally, in conjunction with the epidemiological and natural history studies funded by NIAID, NIDCD
could investigate the incidence of sensory impairment in HIV infection.
* NIDCD could study ways of improving communication and research participation in populations
whose primary language is not English. This is a major impediment to research diversity, and
sometimes (e.g., with Roche) an explicit exclusion criterion!

58