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Laurence Huang, MD

Professor of Medicine, University of California,
San Francisco; Attending Physician, San Francisco General Hospital,
Division of Pulmonary and Critical Care Medicine and HIV/AIDS Division;
Investigator, MU-UCSF Research Collaboration.

Affiliation:
Makerere University-University of California San Francisco,
HIV-Pneumonia.

E-mail Address:  lhuang@php.ucsf.edu

 
Professional Interests:
HIV-associated pulmonary disease, Pneumocystis pneumonia (PCP), tuberculosis (TB), bacterial pneumonia, chronic obstructive pulmonary disease (COPD), and pulmonary arterial hypertension (PAH). We conduct clinical and translational studies that examine the epidemiology, diagnosis, and treatment of HIV-associated pneumonias and the immunology and pathogenesis of these pneumonias, COPD, and PAH.

Current Main Activities:
International HIV-associated Opportunistic Pneumonias (IHOP) Study. This is an NIH-funded prospective study of HIV-associated pneumonia conducted in 3 cites representing the current HIV/AIDS epidemic in Africa (Kampala, Uganda), Europe (London, United Kingdom), and USA (San Francisco, CA) and involving 6 independent laboratories at the NIH, the University of California San Francisco, the University of Cincinnati, and the University of North Carolina. The goals of this study are:

  • To determine the frequency and mortality of HIV-associated opportunistic pneumonias in an international, multi-center, longitudinal cohort and to test the hypothesis that PCP is associated with increased mortality.

  • To estimate the sensitivity and specificity of molecular tools for PCP and TB diagnosis and to test the hypotheses that 60-second oropharyngeal washing (OPW, gargle) specimens combined with polymerase chain reaction (PCR) assays are sensitive tests to diagnose PCP and TB.

  • To test the hypothesis that P. jirovecii dihydropteroate synthase (DHPS) gene mutations are associated with an increased morbidity and mortality and to explore potential mechanisms, and

  • To characterize the predominant P. jirovecii Msg-C variant recognized by antibodies at the 3 study sites, to examine systemic (serum) and local (BAL) antibody responses, and to test the hypotheses that the level of antibodies to the predominant variant is correlated with PCP status.
The IHOP Study serves as the foundation for complementary research studies, led by MU-UCSF Investigators William Worodria, MBChB, MMed, J. Lucian (Luke) Davis, MD, and Adithya Cattamanchi, MD.

Education and Training:
BA, Johns Hopkins University, 1985
MD, Columbia University College of Physicians and Surgeons, 1989
Internal Medicine residency, Columbia Presbyterian Medical Center, 1989-1992
Pulmonary and Critical Care Medicine fellowship, University of California, San Francisco, 1992-1995

Selected Publications

  • Huang, L, Hecht, FM, Stansell, JD, Montanti, R, Hadley, WK, and Hopewell, PC. Suspected Pneumocystis carinii pneumonia with a negative induced sputum examination. Is early bronchoscopy useful? Am J Respir Crit Care Med 1995;151(6):1866-1871.

  • Gruden, JF, Huang, L, Webb, WR, Gamsu, G, Hopewell, PC, and Sides, DM. AIDS-related Kaposi sarcoma of the lung: radiographic findings and staging system with bronchoscopic correlation. Radiology 1995;195(2):545-552.

  • Huang, L, Schnapp, LM, Gruden, JF, Hopewell, PC, and Stansell, JD. Presentation of AIDS-related pulmonary Kaposi's sarcoma diagnosed by bronchoscopy. Am J Respir Crit Care Med 1996;153(4 Pt 1):1385-1390.

  • Gruden, JF, Huang, L, Turner, J, Webb, WR, Merrifield, C, Stansell, JD, Gamsu, G, and Hopewell, PC. High-resolution CT in the evaluation of clinically suspected Pneumocystis carinii pneumonia in AIDS patients with normal, equivocal, or nonspecific radiographic findings. AJR Am J Roentgenol 1997;169(4):967-975.

  • Huang, L, Stansell, J, Osmond, D, Turner, J, Shafer, KP, Fulkerson, W, Kvale, P, Wallace, J, Rosen, M, Glassroth, J, Reichman, L, and Hopewell, P. Performance of an algorithm to detect Pneumocystis carinii pneumonia in symptomatic HIV-infected persons. Pulmonary Complications of HIV Infection Study Group. Chest 1999;115(4):1025-1032.

  • Edinburgh, KJ, Jasmer, RM, Huang, L, Reddy, GP, Chung, MH, Thompson, A, Halvorsen, RA, Jr., and Webb, RA. Multiple pulmonary nodules in AIDS: usefulness of CT in distinguishing among potential causes. Radiology 2000;214(2):427-432.

  • Jasmer, RM, Edinburgh, KJ, Thompson, A, Gotway, MB, Creasman, JM, Webb, WR, and Huang, L. Clinical and radiographic predictors of the etiology of pulmonary nodules in HIV-infected patients. Chest 2000;117(4):1023-1030.

  • Beard, CB, Carter, JL, Keely, SP, Huang, L, Pieniazek, NJ, Moura, IN, Roberts, JM, Hightower, AW, Bens, MS, Freeman, AR, Lee, S, Stringer, JR, Duchin, JS, del Rio, C, Rimland, D, Baughman, RP, Levy, DA, Dietz, VJ, Simon, P, and Navin, TR. Genetic variation in Pneumocystis carinii isolates from different geographic regions: implications for transmission. Emerg Infect Dis 2000;6(3):265-272.

  • Morris, AM, Huang, L, Bacchetti, P, Turner, J, Hopewell, PC, Wallace, JM, Kvale, PA, Rosen, MJ, Glassroth, J, Reichman, LB, and Stansell, JD. Permanent declines in pulmonary function following pneumonia in human immunodeficiency virus-infected persons. The Pulmonary Complications of HIV Infection Study Group. Am J Respir Crit Care Med 2000;162(2 Pt 1):612-616.

  • Huang, L, Beard, CB, Creasman, J, Levy, D, Duchin, JS, Lee, S, Pieniazek, N, Carter, JL, del Rio, C, Rimland, D, and Navin, TR. Sulfa or sulfone prophylaxis and geographic region predict mutations in the Pneumocystis carinii dihydropteroate synthase gene. J Infect Dis 2000;182(4):1192-1198.

  • Morris, AM, Swanson, M, Ha, H, and Huang, L. Geographic distribution of human immunodeficiency virus-associated Pneumocystis carinii pneumonia in San Francisco. Am J Respir Crit Care Med 2000;162(5):1622-1626.

  • Kazanjian, P, Armstrong, W, Hossler, PA, Lee, CH, Huang, L, Beard, CB, Carter, J, Crane, L, Duchin, J, Burman, W, Richardson, J, and Meshnick, SR. Pneumocystis carinii cytochrome b mutations are associated with atovaquone exposure in patients with AIDS. J Infect Dis 2001;183(5):819-822.

  • Soumelis, V, Scott, I, Gheyas, F, Bouhour, D, Cozon, G, Cotte, L, Huang, L, Levy, JA, and Liu, YJ. Depletion of circulating natural type 1 interferon-producing cells in HIV-infected AIDS patients. Blood 2001;98(4):906-912.

  • Navin, TR, Beard, CB, Huang, L, del Rio, C, Lee, S, Pieniazek, NJ, Carter, JL, Le, T, Hightower, A, and Rimland, D. Effect of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of P. carinii pneumonia in patients with HIV-1: a prospective study. Lancet 2001;358(9281):545-549.

  • Nimri, LF, Moura, IN, Huang, L, del Rio, C, Rimland, D, Duchin, JS, Dotson, EM, and Beard, CB. Genetic diversity of Pneumocystis carinii f. sp. hominis based on variations in nucleotide sequences of internal transcribed spacers of rRNA genes. J Clin Microbiol 2002;40(4):1146-1151.

  • Morris, A, Creasman, J, Turner, J, Luce, JM, Wachter, RM, and Huang, L. Intensive care of human immunodeficiency virus-infected patients during the era of highly active antiretroviral therapy. Am J Respir Crit Care Med 2002;166(3):262-267.

  • Jasmer, RM, Gotway, MB, Creasman, JM, Webb, WR, Edinburgh, KJ, and Huang, L. Clinical and radiographic predictors of the etiology of computed tomography-diagnosed intrathoracic lymphadenopathy in HIV-infected patients. J Acquir Immune Defic Syndr 2002;31(3):291-298.

  • Ma, L, Kutty, G, Jia, Q, Imamichi, H, Huang, L, Atzori, C, Beckers, P, Groner, G, Beard, CB, and Kovacs, JA. Analysis of variation in tandem repeats in the intron of the major surface glycoprotein expression site of the human form of Pneumocystis carinii. J Infect Dis 2002;186(11):1647-1654.

  • Morris, A, Wachter, RM, Luce, J, Turner, J, and Huang, L. Improved survival with highly active antiretroviral therapy in HIV-infected patients with severe Pneumocystis carinii pneumonia. AIDS 2003;17(1):73-80.

  • Lin, X, Irwin, D, Kanazawa, S, Huang, L, Romeo, J, Yen, TS, and Peterlin, BM. Transcriptional profiles of latent human immunodeficiency virus in infected individuals: effects of Tat on the host and reservoir. J Virol 2003;77(15):8227-8236.

  • Morris, DG, Jasmer, RM, Huang, L, Gotway, MB, Nishimura, S, and King, TE, Jr. Sarcoidosis following HIV infection: evidence for CD4+ lymphocyte dependence. Chest 2003;124(3):929-935.

  • Larsen, HH, Huang, L, Kovacs, JA, Crothers, K, Silcott, VA, Morris, A, Turner, JR, Beard, CB, Masur, H, and Fischer, SH. A prospective, blinded study of quantitative touch-down polymerase chain reaction using oral-wash samples for diagnosis of Pneumocystis pneumonia in HIV-infected patients. J Infect Dis 2004;189(9):1679-1683.

  • Morris, A, Sciurba, FC, Lebedeva, IP, Githaiga, A, Elliott, WM, Hogg, JC, Huang, L, and Norris, KA. Association of chronic obstructive pulmonary disease severity and Pneumocystis colonization. Am J Respir Crit Care Med 2004;170(4):408-413.

  • Morris, A, Lundgren, JD, Masur, H, Walzer, PD, Hanson, DL, Frederick, T, Huang, L, Beard, CB, and Kaplan, JE. Current epidemiology of Pneumocystis pneumonia. Emerg Infect Dis 2004;10(10):1713-1720.

  • Huang, L, Crothers, K, Atzori, C, Benfield, T, Miller, R, Rabodonirina, M, and Helweg-Larsen, J. Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance. Emerg Infect Dis 2004;10(10):1721-1728.

  • Crothers, K, Beard, CB, Turner, J, Groner, G, Fox, M, Morris, A, Eiser, S, and Huang, L. Severity and outcome of HIV-associated Pneumocystis pneumonia containing Pneumocystis jirovecii dihydropteroate synthase gene mutations. AIDS 2005;19(8):801-805.

  • Beard, CB, Fox, MR, Lawrence, GG, Guarner, J, Hanzlick, RL, Huang, L, Rio, CD, Rimland, D, Duchin, JS, and Colley, DG. Genetic differences in Pneumocystis isolates recovered from immunocompetent infants and from adults with AIDS: epidemiological implications. J Infect Dis 2005;192(10):1815-1818.

  • Morris, A, Masur, H, and Huang, L. Current issues in critical care of the human immunodeficiency virus-infected patient. Crit Care Med 2006;34(1):42-49.

  • Huang, L, Quartin, A, Jones, D, and Havlir, DV. Intensive care of patients with HIV infection. N Engl J Med 2006;355(2):173-181.

  • *Huang, L, *Daly, KR, *Morris, A, Koch, J, Crothers, K, Levin, L, Eiser, S, Satwah, S, Zucchi, P, and Walzer, PD. Antibody response to Pneumocystis jirovecii major surface glycoprotein. Emerg Infect Dis 2006;12(8):1231-1237 *co-first authors.

  • Huang, L, Morris, A, Limper, AH, and Beck, JM. An Official ATS Workshop Summary: Recent Advances and Future Directions in Pneumocystis Pneumonia (PCP). Proc Am Thorac Soc 2006;3(8):655-664.

  • de Oliveira, A, Unnasch, TR, Crothers, K, Eiser, S, Zucchi, P, Moir, J, Beard, CB, Lawrence, GG, and Huang, L. Performance of a molecular viability assay for the diagnosis of Pneumocystis pneumonia in HIV-infected patients. Diagn Microbiol Infect Dis 2007;57:169-176.

  • Morris, A, Wei, K, Afshar, K, and Huang, L. Epidemiology and clinical significance of Pneumocystis colonization. J Infect Dis 2008. In Press.

  • Davis, JL, Welsh, DA, Beard, CB, Jones, JL, Lawrence, GG, Fox, M, Carbonnet, D, Swartzman, A, Morris, A, Crothers, K, and Huang, L. Pneumocystis colonisation is common among hospitalized HIV-infected patients with non-Pneumocystis pneumonia. Thorax 2008. In Press.

Relevant Links: 
http://pulmonary.ucsf.edu/faculty/huang.html
http://php.ucsf.edu/about/huang.shtml
 
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2007 MU-UCSF Research Collaboration.