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Veterans Health
Research at NCIRE

NCIRE-The Veterans Health Research Institute is the leading private nonprofit institute devoted to Veterans health research in the United States. Our mission is to advance Veterans health through research.

We support the work of some of the nation's foremost physicians and scientists at the San Francisco Veterans Affairs Medical Center, the premier biomedical research facility in the VA system. All have faculty appointments at the University of California, San Francisco, which has its own proud traditions of research and patient care. We also partner with the U.S. Department of Defense to support health research on behalf of our men and women in the Armed Forces.

Those who have served in uniform have given their best for their country. In return, we believe that they deserve nothing less than the best health care research we can provide.

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Carl Grunfeld, MD, PhD

Associate Chief of Staff for Research and Development, SFVAHCS
Staff Physician, Chief of Metabolism and Endocrine Sections, SFVAHCS
Professor of Medicine, UCSF
Email: carl.grunfeld@ucsf.edu

Infection, Inflammation, and Atherosclerosis & HIV Complications

Dr. Grunfeld is the lead investigator in delineating how infection and inflammation can promote atherosclerosis, a major cause of admission to VA hospitals. He has shown that the body reacts to infection by changing how cholesterol and triglycerides travel in the blood - changes that fight infection but also promote atherosclerosis. He also showed that when macrophages are activated by infection or inflammatory signals, they turn into foam cells, the first step in atherosclerosis. Dr. Grunfeld was also the first researcher to show that HIV wasting is primarily due to opportunistic infections and not, as was thought, overwhelming replication of the virus. His group then demonstrated that growth hormone could restore muscle mass and improve function in patients with HIV infection. Dr. Grunfeld defined the metabolic and body fat changes that occur in HIV infection and showed that they would promote atherosclerosis. In addition, he was the first to propose that complications from protease inhibitors - insulin resistance, increased triglycerides and increased cholesterol - were not common to all protease inhibitors. Since the VA population of HIV-infected patients is aging, which predisposes to high triglycerides and diabetes, and many were exposed to Agent Orange, which predisposes to diabetes, the knowledge gained from these studies can help physicians tailor their therapies to optimize outcomes.

To see Dr. Grunfeld on Pub Med, click here.