Thor A Wagner, MD

Professional History

Board Certified:

Pediatrics

Medical/Professional School:

Temple University School of Medicine, Philadelphia

Residency:

Children's Hospital of New York, CHN-517, New York, Pediatrics

Fellowship:

Children's Hospital and Regional Medical Center, Seattle, Infectious Disease

Clinical Interests:

General pediatric infectious diseases, pediatric HIV

Mechanism of persistent HIV infection despite effective treatment, improving HIV diagnostics for the low resource settings

Description of Research:

My research is focused on pediatric HIV infection, which accounts for 15 percent of all HIV deaths.

I have two specific research questions:

1. Despite excellent drugs, why can't we cure HIV?

HIV-infected children currently face a lifetime of complicated daily therapy. I hypothesize that there is persistent low-level replication of HIV, especially at peripheral sites where the immune system is most active, such as mucosal surfaces. Specifically, I am looking at HIV in the sputum of children who are receiving state-of-the-art HIV treatment in order to see if there is evidence of ongoing viral replication. I am also exploring whether HIV is propagated within lymphocytes as the cells replicate. Determining how HIV persists despite therapy is a critical first step in developing new strategies to eradicate the virus.

2. In low-resource settings, why aren't more children being treated?

Effective HIV drugs are increasingly available worldwide, but children are often not started on therapy. A major reason is that there are no simple tests available to diagnose infants with HIV. Existing tests are extremely expensive and can only be done in sophisticated laboratories. As a result, 50 percent of all HIV-infected children die before they are diagnosed. I am collaborating with a biotechnology company to develop promising new technology that would enable inexpensive "point-of-care" infant HIV testing.

Key Publications:

Landweber, L., Simon, P.J., and Wagner, T. Ribozyme Engineering and Early Evolution. BioSciences 1998;48:94-103.

Wagner, T., Soong, G., Sokol, S., Saiman, L., and Prince, A. Effects of Azithromycin on Clinical Isolates of P. aeruginosa from Cystic Fibrosis patients. Chest. 2005; 128: 912-919.

Lin, C-H., Sloan, D., Dang, C., Wagner, T., Tobin, N., Frenkel, L., and Jerome, K. Assessment of mitochondrial toxicity by analysis of mitochondrial protein expression in mononuclear cells, Cytometry: Part B - Clinical Cytometry (published on-line 29 Aug 2008, in advance of print).

Wagner, T. and Frenkel, L. Potential Limitation of CCR5 Inhibitors: CXCR4 HIV-1 Variants in Treatment-Experienced Individuals twice as likely to be Drug Resistant, AIDS. 2008: 22:2393-2395. PMCID: PMC2585823.

Wagner, T., Tobin, N., McKernan, J., Xu, M., Melvin, A., Mohan, K., Learn, G., Mullins, J., and Frenkel, L. Increased Mutations in HIV-1 Env and Pol Suggest Greater Viral Replication in Sputum Compared to Blood (minor revision in submission).

Honors & Awards:

2006: Young Scientist Scholarship, XV HIV International Drug Resistance Workshop

2007: Young Investigator Award, 14th Conf. on Retroviruses and Opportunistic Infections

2008: Young Investigator Award, 15th Conf. on Retroviruses and Opportunistic Infections

American Society of Tropical Medicine and Hygiene / Postdoctoral Fellowship in Tropical Infectious Disease