New U.S. Site Won’t be a Silent Partner

As leader of the only new U.S. site to join the AIDS Clinical Trials Group (ACTG) during the Network’s most recent re-competition for federal funding, Richard Elion, MD, is excited for Whitman-Walker Health (WWH) to contribute to HIV and Hepatitis C clinical research.

“We are not going to be a silent partner,” says Elion. “We will be a voice for our constituency.”

This constituency includes 3,000 people living with HIV in the greater Washington, D.C. area. At its two sites in the city, Elion says he and his staff primarily treat intravenous (IV) drug users and African American men who have sex with men (MSM). WWH has had great clinical success with 85-90 percent of patients on HIV treatment. However, only 35 percent of people living with HIV in the DC area have their viral loads fully suppressed. Elion says this means there is more work to be done.

“What I see when I am treating patients informs my research,” Elion says. “For example, at our Anacostia clinic we have a lot of IV drug users who have HIV and Hepatitis C. Therefore, this co-infection is an area we would like to research further.”

Elion and his staff are not strangers to conducting clinical trials. Whitman-Walker Health enrolled 100 patients in four months for the National Institutes of Health (NIH) funded PrEP study. In this trial, people who were HIV negative, but at risk for contracting HIV were asked to take a pill, or pre-exposure prophylaxis (PrEP), to prevent the infection.

Whitman-Walker also enrolled 200 men in the Multicenter AIDS Cohort Study (MACS). This trial has spanned more than 29 years and included HIV positive and HIV negative gay and bisexual men. MACS shed light on how the virus was spreading, how long it took people to get AIDS and how the immune system failed to protect the body from HIV. It also helped researchers determine how big the epidemic was, particularly in the gay community. MACS data led to the development of the protease inhibitor class of anti-HIV drugs that has been successful in keeping people alive.

Elion says it was this work on MACS in partnership with Johns Hopkins University in Baltimore that helped Whitman-Walker become an ACTG site within the Johns Hopkins Baltimore-Washington-India Clinical Trials Unit (BWI-CTU).

“We needed the backing of a major institution so we approached Johns Hopkins as a partner for us becoming an ACTG site as we already had clinical, regulatory and laboratory ties with them through MACS,” Elion says. “Drs. Charles Flexner and Amita Gupta are the BWI-CTU leaders. They understood what we had to offer and supplemented what we didn’t have. This pre-existing relationship and their support helped our application become successful.”

Whitman-Walker received its notice of award on Dec. 1, 2013.

"We are thrilled to have Rick join the ACTG as the Site Leader for the only new domestic site,” says Flexner. “Rick has a long history of contributions to groundbreaking HIV clinical research, and to have him leading the only ACTG site in one of the epicenters of the U.S. epidemic is so great for the Network."

While his site was gearing up to come online within the ACTG’s research network, Elion thought about what type of studies would have the greatest impact on his patients.

“We have a commitment to our community,” he says. “It’s time for a community health center like us to service our own.”

In addition to Hepatitis C, Elion says his patients have concerns about inflammation and aging. Whitman-Walker Health’s Chief Medical Officer Ray Martins, MD, says Elion has diversified the health center's research department to expand within its core mission of improving HIV care while broadening it to other chronic health conditions and health disparities. This has resulted in a doubling of WWH's research department revenue from 2007 until today and, more importantly, has improved the health of WWH’s patients.

“Dr. Rick Elion is a true renaissance man,” says Martins. “He is an innovative researcher who also provides the highest quality HIV primary care and creatively educates medical students and residents. To emphasize his great diversity, Dr. Elion also has mastered playing the guitar and drums, and one of his musical highlights was playing the drums with Wyclef Jean at a presidential inaugural ball in 2009.”

As Elion marks 25 years caring for people living with HIV, he says his passion for the work remains strong.

“I look at our work and I am still inspired,” he says. “I was an English and biology major in college and I love that I have been able to combine the two. To see science bring evidence that changes lives and communicate those results never loses its fire for me.”