Vanderbilt University School of Medicine

Hulgan, Todd , M.D., M.P.H.
Associate Professor of Medicine

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S-2115 MCN

A2200 MCN Vanderbilt University 37232-2582

Research Specialty
Clinical outcomes/translational HIV research; antiretroviral toxicity; mitochondrial genomics and oxidant stress

Clinical Research Description
The primary goals of my research are to: 1) expand our understanding of the role of genetic variation in mitochondrial DNA (mtDNA) in outcomes of HIV infection and treatments; and 2) to characterize relevant biomarkers of adverse outcomes in treated HIV-infected persons. This work includes collaborations with the AIDS Clinical Trials Group (ACTG), the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) group, and multi-disciplinary teams of investigators including clinical pharmacologists, biostatisticians, mitochondrial geneticists, and computational biologists/geneticists. My projects bridge epidemiology-outcomes and clinical-translational research domains.

Koethe, JR, Bian, A, Shintani, AK, Wester, CW, Erdem, H, Hulgan, T. An association between adiposity and serum levels of macrophage inflammatory protein-1?? and soluble CD14 in HIV-infected adults: results from a cross-sectional study. Antivir Ther, , , 2013.

Koethe, JR, Dee, K, Bian, A, Shintani, A, Turner, M, Bebawy, S, Sterling, TR, Hulgan, T. Circulating Interleukin-6, Soluble CD14, and Other Inflammation Biomarker Levels Differ Between Obese and Nonobese HIV-Infected Adults on Antiretroviral Therapy. AIDS Res Hum Retroviruses, , , 2013.

Rasbach, DA, Desruisseau, AJ, Kipp, AM, Stinnette, S, Kheshti, A, Shepherd, BE, Sterling, TR, Hulgan, T, McGowan, CC, Qian, HZ. Active cocaine use is associated with lack of HIV-1 virologic suppression independent of nonadherence to antiretroviral therapy: use of a rapid screening tool during routine clinic visits. AIDS Care, 25(1), 109-17, 2013.

Holzinger, ER, Hulgan, T, Ellis, RJ, Samuels, DC, Ritchie, MD, Haas, DW, Kallianpur, AR, Bloss, CS, Clifford, DB, Collier, AC, Gelman, BB, Marra, CM, McArthur, JC, McCutchan, JA, Morgello, S, Simpson, DM, Franklin, DR, Rosario, D, Selph, D, Letendre, S, Grant, I, , . Mitochondrial DNA variation and HIV-associated sensory neuropathy in CHARTER. J Neurovirol, 18(6), 511-20, 2012.

Hulgan, T, Robbins, GK, Kalams, SA, Samuels, DC, Grady, B, Shafer, R, Murdock, DG, Selph, D, Haas, DW, Pollard, RB, , . T cell activation markers and African mitochondrial DNA haplogroups among non-Hispanic black participants in AIDS clinical trials group study 384. PLoS One, 7(8), e43803, 2012.

Koethe, JR, Bian, A, Shintani, AK, Boger, MS, Mitchell, VJ, Erdem, H, Hulgan, T. Serum leptin level mediates the association of body composition and serum C-reactive protein in HIV-infected persons on antiretroviral therapy. AIDS Res Hum Retroviruses, 28(6), 552-7, 2012.

Grady, BJ, Samuels, DC, Robbins, GK, Selph, D, Canter, JA, Pollard, RB, Haas, DW, Shafer, R, Kalams, SA, Murdock, DG, Ritchie, MD, Hulgan, T, , . Mitochondrial genomics and CD4 T-cell count recovery after antiretroviral therapy initiation in AIDS clinical trials group study 384. J Acquir Immune Defic Syndr, 58(4), 363-70, 2011.

Haas, DW, Kuritzkes, DR, Ritchie, MD, Amur, S, Gage, BF, Maartens, G, Masys, D, Fellay, J, Phillips, E, Ribaudo, HJ, Freedberg, KA, Petropoulos, C, Manolio, TA, Gulick, RM, Haubrich, R, Kim, P, Dehlinger, M, Abebe, R, Telenti, A, , . Pharmacogenomics of HIV therapy: summary of a workshop sponsored by the National Institute of Allergy and Infectious Diseases. HIV Clin Trials, 12(5), 277-85, 2011.

Hulgan, T, Haubrich, R, Riddler, SA, Tebas, P, Ritchie, MD, McComsey, GA, Haas, DW, Canter, JA. European mitochondrial DNA haplogroups and metabolic changes during antiretroviral therapy in AIDS Clinical Trials Group Study A5142. AIDS, 25(1), 37-47, 2011. PMCID:3081810

McGowan, CC, Weinstein, DD, Samenow, CP, Stinnette, SE, Barkanic, G, Rebeiro, PF, Sterling, TR, Moore, RD, Hulgan, T. Drug use and receipt of highly active antiretroviral therapy among HIV-infected persons in two U.S. clinic cohorts. PLoS One, 6(4), e18462, 2011. PMCID:3081810

Qian, HZ, Stinnette, SE, Rebeiro, PF, Kipp, AM, Shepherd, BE, Samenow, CP, Jenkins, CA, No, P, McGowan, CC, Hulgan, T, Sterling, TR. The relationship between injection and noninjection drug use and HIV disease progression. J Subst Abuse Treat, 41(1), 14-20, 2011. PMCID:3081810

Alves, TP, Hulgan, T, Wu, P, Sterling, TR, Stinnette, SE, Rebeiro, PF, Vincz, AJ, Bruce, M, Ikizler, TA. Race, kidney disease progression, and mortality risk in HIV-infected persons. Clin J Am Soc Nephrol, 5(12), 2269-75, 2010. PMCID:3081810

Canter, JA, Robbins, GK, Selph, D, Clifford, DB, Kallianpur, AR, Shafer, R, Levy, S, Murdock, DG, Ritchie, MD, Haas, DW, Hulgan, T. African mitochondrial DNA subhaplogroups and peripheral neuropathy during antiretroviral therapy. J Infect Dis, 201(11), 1703-7, 2010. PMCID:2862090

Melekhin, VV, Shepherd, BE, Jenkins, CA, Stinnette, SE, Rebeiro, PF, Bebawy, SS, Rasbach, DA, Hulgan, T, Sterling, TR. Postpartum discontinuation of antiretroviral therapy and risk of maternal AIDS-defining events, non-AIDS-defining events, and mortality among a cohort of HIV-1-infected women in the United States. AIDS Patient Care STDS, 24(5), 279-86, 2010. PMCID:2875979

Shepherd, BE, Jenkins, CA, Rebeiro, PF, Stinnette, SE, Bebawy, SS, McGowan, CC, Hulgan, T, Sterling, TR. Estimating the optimal CD4 count for HIV-infected persons to start antiretroviral therapy. Epidemiology, 21(5), 698-705, 2010. PMCID:3086582

Boger, MS, Shintani, A, Redhage, LA, Mitchell, V, Haas, DW, Morrow, JD, Hulgan, T. Highly sensitive C-reactive protein, body mass index, and serum lipids in HIV-infected persons receiving antiretroviral therapy: a longitudinal study. J Acquir Immune Defic Syndr, 52(4), 480-7, 2009. PMCID:2794651

Hulgan, T, Donahue, JP, Smeaton, L, Pu, M, Wang, H, Lederman, MM, Smith, K, Valdez, H, Pilcher, C, Haas, DW . Oral cyclosporin A inhibits CD4 T cell P-glycoprotein activity in HIV-infected adults initiating treatment with nucleoside reverse transcriptase inhibitors. Eur J Clin Pharmacol, , , 2009.

Kallianpur, AR, Hulgan, T. Pharmacogenetics of nucleoside reverse-transcriptase inhibitor-associated peripheral neuropathy. Pharmacogenomics, 10(4), 623-37, 2009. PMCID:2706211

Lemly, DC, Shepherd, BE, Hulgan, T, Rebeiro, P, Stinnette, S, Blackwell, RB, Bebawy, S, Kheshti, A, Sterling, TR, Raffanti, SP. Race and sex differences in antiretroviral therapy use and mortality among HIV-infected persons in care. J Infect Dis, 199(7), 991-8, 2009.

Redhage, LA, Shintani, A, Haas, DW, Emeagwali, N, Markovic, M, Oboho, I, Mwenya, C, Erdem, H, Acosta, EP, Morrow, JD, Hulgan, T. Clinical factors associated with plasma F2-Isoprostane Levels in HIV-Infected Adults. HIV Clin Trials, 10(3), 181-92, 2009.

Shepherd, BE, Sterling, TR, Moore, RD, Raffanti, SP, Hulgan, T. Cross-cohort heterogeneity encountered while validating a model for HIV disease progression among antiretroviral initiators. J Clin Epidemiol, 62(7), 729-37, 2009. PMCID:2747519

Asad, S, Hulgan, T, Raffanti, SP, Daugherty, J, Ray, W, Sterling, TR. Sociodemographic factors predict early discontinuation of HIV non-nucleoside reverse transcriptase inhibitors and protease inhibitors. J Natl Med Assoc, 100(12), 1417-24, 2008.

El-Bejjani, D, Hazen, SL, Mackay, W, Glass, NE, Hulgan, T, Tungsiripat, M, McComsey, GA. Higher plasma myeloperoxidase levels are not associated with an increased risk for cardiovascular events in HIV-infected adults. HIV Clin Trials, 9(3), 207-11, 2008.

Hulgan, T. High-concentration capsaicin reduced pain in patients with HIV-associated polyneuropathy. Evid Based Med, 13(6), 183, 2008.

Hulgan, T, Klausner, JD. Phosphodiesterase type-5 inhibitors and the reemerging HIV epidemic. JAMA, 299(12), 1426, 2008.

Hulgan, T, Tebas, P, Canter, JA, Mulligan, K, Haas, DW, Dub??, M, Grinspoon, S, Robbins, GK, Motsinger, AA, Kallianpur, AR . Hemochromatosis gene polymorphisms, mitochondrial haplogroups, and peripheral lipoatrophy during antiretroviral therapy. J Infect Dis, 197(6), 858-66, 2008.

Bress, JN, Hulgan, T, Lyon, JA, Johnston, CP, Lehmann, H, Sterling, TR. Agreement of decision analyses and subsequent clinical studies in infectious diseases. Am J Med, 120(5), 461.e1-9, 2007. PMCID:1909755

Canter, JA, Haas, DW, Kallianpur, AR, Ritchie, MD, Robbins, GK, Shafer, RW, Clifford, DB, Murdock, DG, Hulgan, T. The mitochondrial pharmacogenomics of haplogroup T: MTND2(*)LHON4917G and antiretroviral therapy-associated peripheral neuropathy. Pharmacogenomics J, , , 2007.

Hulgan, T, Shepherd, BE, Raffanti, SP, Fusco, JS, Beckerman, R, Barkanic, G, Sterling, TR. Absolute Count and Percentage of CD4+ Lymphocytes Are Independent Predictors of Disease Progression in HIV-Infected Persons Initiating Highly Active Antiretroviral Therapy. J Infect Dis, 195(3), 425-31, 2007.

Motsinger, AA, Haas, DW, Hulgan, T, Ritchie, MD. Human genomic association studies: a primer for the infectious diseases specialist. J Infect Dis, 195(12), 1737-44, 2007.

Oswald-Richter, K, Grill, SM, Leelawong, M, Tseng, M, Kalams, SA, Hulgan, T, Haas, DW, Unutmaz, D. Identification of a CCR5-expressing T cell subset that is resistant to R5-tropic HIV infection. PLoS Pathog, 3(4), e58, 2007. PMCID:1857714

Hulgan, T, Haas, DW. Toward a pharmacogenetic understanding of nucleotide and nucleoside analogue toxicity. J Infect Dis, 194(11), 1471-4, 2006.

Hulgan, T, Hughes, M, Sun, X, Smeaton, LM, Terry, E, Robbins, GK, Shafer, RW, Clifford, DB, McComsey, GA, Canter, JA, Morrow, JD, Haas, DW. Oxidant stress and peripheral neuropathy during antiretroviral therapy: an AIDS clinical trials group study. J Acquir Immune Defic Syndr, 42(4), 450-4, 2006.

Kallianpur, AR, Hulgan, T, Canter, JA, Ritchie, MD, Haines, JL, Robbins, GK, Shafer, RW, Clifford, DB, Haas, DW. Hemochromatosis (HFE) gene mutations and peripheral neuropathy during antiretroviral therapy. AIDS, 20(11), 1503-13, 2006.

Hulgan, T, Haas, DW, Haines, JL, Ritchie, MD, Robbins, GK, Shafer, RW, Clifford, DB, Kallianpur, AR, Summar, M, Canter, JA. Mitochondrial haplogroups and peripheral neuropathy during antiretroviral therapy: an adult AIDS clinical trials group study. AIDS, 19(13), 1341-9, 2005.

Hulgan, T, Raffanti, S, Kheshti, A, Blackwell, RB, Rebeiro, PF, Barkanic, G, Ritz, B, Sterling, TR. CD4 lymphocyte percentage predicts disease progression in HIV-infected patients initiating highly active antiretroviral therapy with CD4 lymphocyte counts >350 lymphocytes/mm3. J Infect Dis, 192(6), 950-7, 2005.

Hulgan, T, Sterling, TR, Daugherty, J, Arbogast, PG, Raffanti, S, Ray, W. Prescribing of contraindicated protease inhibitor and statin combinations among HIV-infected persons. J Acquir Immune Defic Syndr, 38(3), 277-82, 2005.

Chan, SY, Hulgan, T, D''Aquila, RT. The Role of Baseline HIV-1 Resistance Testing in Patients with Established Infection. Curr Infect Dis Rep, 6(3), 243-249, 2004.

Haas, DW, Ribaudo, HJ, Kim, RB, Tierney, C, Wilkinson, GR, Gulick, RM, Clifford, DB, Hulgan, T, Marzolini, C, Acosta, EP. Pharmacogenetics of efavirenz and central nervous system side effects: an Adult AIDS Clinical Trials Group study. AIDS, 18(18), 2391-400, 2004.

Hulgan, T, Rosenbloom, ST, Hargrove, F, Talbert, DA, Arbogast, PG, Bansal, P, Miller, RA, Kernodle, DS. Oral quinolones in hospitalized patients: an evaluation of a computerized decision support intervention. J Intern Med, 256(4), 349-57, 2004.

Donahue, JP, Dowdy, D, Ratnam, KK, Hulgan, T, Price, J, Unutmaz, D, Nicotera, J, Raffanti, S, Becker, M, Haas, DW. Effects of nelfinavir and its M8 metabolite on lymphocyte P-glycoprotein activity during antiretroviral therapy. Clin Pharmacol Ther, 73(1), 78-86, 2003.

Haas, DW, Johnson, BW, Spearman, P, Raffanti, S, Nicotera, J, Schmidt, D, Hulgan, T, Shepard, R, Fiscus, SA. Two phases of HIV RNA decay in CSF during initial days of multidrug therapy. Neurology, 61(10), 1391-6, 2003.

Hulgan, T, Donahue, JP, Hawkins, C, Unutmaz, D, D''Aquila, RT, Raffanti, S, Nicotera, F, Rebeiro, P, Erdem, H, Rueff, M, Haas, DW. Implications of T-cell P-glycoprotein activity during HIV-1 infection and its therapy. J Acquir Immune Defic Syndr, 34(2), 119-26, 2003.

Hulgan, T, Morrow, J, D''Aquila, RT, Raffanti, S, Morgan, M, Rebeiro, P, Haas, DW. Oxidant stress is increased during treatment of human immunodeficiency virus infection. Clin Infect Dis, 37(12), 1711-7, 2003.

Sherertz, RJ, Ely, EW, Westbrook, DM, Gledhill, KS, Streed, SA, Kiger, B, Flynn, L, Hayes, S, Strong, S, Cruz, J, Bowton, DL, Hulgan, T, Haponik, EF. Education of physicians-in-training can decrease the risk for vascular catheter infection. Ann Intern Med, 132(8), 641-8, 2000.

Moore, RB, Hulgan, TM, Green, JW, Jenkins, LD. Increased susceptibility of the sickle cell membrane Ca2+ + Mg(2+)-ATPase to t-butylhydroperoxide: protective effects of ascorbate and desferal. Blood, 79(5), 1334-41, 1992.

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