Affiliate Professor, Global Health
325 Ninth Avenue
Box 359909Seattle, WA 98104-
Dr. Chung believes that global health research should answer scientific questions that are relevant to populations living in resource-limited settings. He has engaged in studies and clinical trials on global health topics including: adherence to antiretroviral medications, HIV drug resistance, cervical cancer screening and treatment, perinatal transmission of HIV, and HIV implementation science. A few of his key areas of study are described below.
Without proper adherence to antiretroviral medications, drug resistance in HIV-infected individuals may develop and lead to treatment failure. Because of the high prevalence of HIV, antiretroviral resistance in sub-Saharan Africa has profound public health implications. Dr. Chung has led and participated in two randomized controlled trials (RCTs) to examine adherence interventions in Kenya. In one study, he found that intensive early behavioral counseling at ART initiation was highly effective while carrying a pocket alarm device was not. In another, he found that patients who received text messaging support through a cell phone similarly improved their adherence and suppressed their viral loads. A Cochrane review of 182 publications found that these were 2 of only 5 high quality RCT studies that could demonstrate improved adherence and biological outcomes to any medication adherence intervention.
HIV resistance to antiretroviral medications can be transmitted between individuals and may lead to infection with an HIV strain that can render first-line antiretroviral medications obsolete. As the prevalence of pre-treatment drug resistance (PDR) and general antiretroviral resistance increases in resource-limited settings, inexpensive laboratory assays are needed to guide local clinicians. Dr. Chung has recently completed an RCT examining the use of an Oligonucleotide Ligation Assay (OLA) to detect PDR to guide antiretroviral (ART) regimen selection in Nairobi, Kenya. Through this research, his TREE laboratory in Nairobi has established the country’s capacity to conduct OLA resistance testing and will soon examine OLA as a point-of-care (POC) test.
HIV-infected women are at higher risk for cervical cancer, but scientific evidence on the best screening and treatment methods in resource-constrained settings, where most of these women live, is limited. Dr. Chung and his team have screened over 7,000 HIV-infected women for cervical cancer in Kenya and have recently completed an RCT comparing cryotherapy vs. loop electrosurgical excisional procedure (LEEP) to treat pre-cancerous cervical lesions in this population. In this study, 400 HIV-infected women were enrolled, treated, and followed over two years for HIV cervical shedding and recurrence of pre-cancerous lesions. These findings are being analyzed for presentation and publication and includes collaborations with the Centers for Disease Control and Prevention (CDC) and the Harvard School of Public Health to investigate cost-effectiveness, human papillomavirus (HPV), and other cancer biomarkers from this trial.
In addition to these ground-breaking RCTs, Dr. Chung has been engaged in a number of other global health studies. Dr. Chung has been examining the progression of chronic lung disease among HIV-infected individuals in Kenya, and has published over 20 papers in HIV implementation science and prevention of mother-to-child transmission of HIV (PMTCT). Finally, Dr. Chung is collaborating with Sun Yat-sen University and examine utilization of health care services in Kenya by Chinese migrant workers in a project funded by the China Medical Board.
MD Medicine (MD), University of Chicago, 1998
MPH International Health, Harvard University, 1998
BA Biology, English, Oberlin College, 1990
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