Dr. Jacobson's research interests include epidemiologic methods in cohort studies, HIV, effects of therapy on HIV, and infectious causes of cancer, particularly the human herpesvirus-8 (HHV-8) and Kaposi's sarcoma, and the effects of HIV, therapy and age. As the Principal Investigator of the Data and Analytical Coordinating Center for the Multicenter AIDS Cohort Study (MACS), Dr. Jacobson provides epidemiologic expertise in the conduct of the study, with particular attention to the standardization of study protocols and the design of nested studies. Dr. Jacobson chairs the MACS Data Working Group and represents CAMACS in the Malignancy Group of the Clinical Working Group and participates in the MACS Executive Committee. In addition, she provides epidemiologic, methodological and analytic support to the investigators of the Women's Interagency HIV Study (WIHS), and to those involved in the mulicenter cohort study of kidney disease in children (CKID). Dr. Jacobson analyzed the timing of infections with HIV-1 and HHV-8 for progression to Kaposi's sarcoma [J Infect Dis 2000;181:1940-1949]. As an extension of her interest in malignacies and research design, Dr. Jacobson collaborates with investigators from the Department of Environmental Health Sciences in investigations of molecular biomarkers for environmental carcinogens.

Dr. Jacobson is also investigating the use and impact of highly active antiretroviral therapies (HAART), in the context of cohort studies. In one paper, Dr. Jacobson demonstrated the dramatic decline of Kaposi's sarcoma in the HAART era; a similar immediate effect on the incidence of non-Hodgkin's lymphoma was not observed [JAIDS 1999;21:S34-S41]. In another paper, Dr. Jacobson demonstrated that the heterogeneity of using antiretroviral therapies differs according to disease stage [J Clin Epidemiol 2001;54:149-156]. Dr. Jacobson also showed that those starting HAART with <200 cells/µ have the equivalent progression to AIDS as those with approximately 300 more cells in the nautral history era [Am J Epidemiol 2002;155:760-770]. This compliated historical and prospective data provided methods for using biomarker data to established treatment effectiveness. She provides epidemiologic expertise to the analyses of HIV effectiveness, long-term use and outcomes, including behavior related to HAART. Taking advantage of her expertise in epidemiologic methods, Dr. Jacobson instructs doctoral students in the application of these methods in the formation and review of research proposals.

Epidemiology,epidemiologic methods; cohort studies; HIV; cancer; OpenCourseWare

Jacobson LP, Li R, Phair J, Margolick JB, Rinaldo CR, Detels R, Muñoz A. Evaluation of the effectiveness of highly active antiretroviral therapy in persons with human immunodeficiency virus using biomarker-based equivalence of disease progression. Am J Epidemiol 2002;155:760-770.

Egner PA, Wang JB, Zhu YR, Zhang BC, Wu Y, Zhang QN, Qian GS, Kuang SY, Gange SJ, Jacobson LP, Helzlsouer KJ, Bailey GS, Groopman JD, Kensler TW. Chlorophyllin intervention reduces aflatoxin-DNA adducts in individuals at high risk for liver cancer. PNAS 2001;98:14601-6.

Skolasky RL, Phair J, Detels R, Riddler S, Margolick J, Jacobson LP. Thrush and fever as markers of immune competence in the era of highly active antiretroviral therapy (HAART). AIDS Res Hum Retroviruses 2001;17:1311-1316.

Wang Q, Jenkins FJ, Jacobson LP, Kingsley LA, Day RB, Zhang ZW, Meng YX, Pellett PE, Kousoulas KG, Baghian A, Rinaldo CR Jr. Primary human herpesvirus 8 infection generates a broadly specific CD8+ T cell response to viral lytic proteins that is not associated with a specific illness or immunosuppression. Blood 2001;97:2366-2373.

Yamashita TE, Phair JP, Muñoz A, Margolick JB, Detels R, O'Brien SJ, Mellors JW, Wolinsky SM, Jacobson LP. Immunologic and virologic response to highly active antiretroviral therapy in the Multicenter AIDS Cohort Study. AIDS 2001;15:735-746.

Greenblatt RM, Jacobson LP, Levine A, Melnick S, Anastos K, DeHovitz J, Young M, Cohen M, Burns D, Miotti P. Human herpesvirus 8 infection and Kaposi's sarcoma among human immunodeficiency virus-infected and -uninfected women. J Infect Dis 2001;183:1130-1134.

Kleeberger CA, Phair JP, Strathdee SA, Detels R, Kingsley L, Jacobson LP. Determinants of heterogeneous adherence to HIV-antiretroviral therapies in the Multicenter AIDS Cohort Study. JAIDS 2001;26:82-92.

Jacobson LP, Gore ME, Strathdee SA Phair JP, Riddler S, Detels R, for the Multicenter AIDS Cohort Study. Therapy naivete in the era of potent antiretroviral therapy. J Clin Epidemiol 2001;54:149-156.

Wang QJ, Jenkins FJ, Jacobson LP, Meng Y-X, Pellett PE, Kingsley LA, Kousoulas KG, Baghian A, Rinaldo CR Jr. CD8+ cytotoxic T lymphocyte responses to lytic proteins of human herpes virus 8 in human immunodeficiency virus type 1-infected and -uninfected individuals. J Infect Dis 2000;182:928-932.

Jacobson LP, Jenkins FJ, Springer G, Muñoz A, Shah K, Phair J, Zhang Z-F, Armenian H. Interaction of HIV-1 and HHV-8 infections on the incidence of Kaposi's sarcoma. J Infect Dis 2000;181:1940-1949.

Muñoz A, Gange SJ, Jacobson LP. Distinguishing efficacy, individual effectiveness and population effectiveness of HIV therapies. AIDS 2000;14:754-756.

Dean M, Jacobson LP, McFarlane G, Margolick JB, Jenkins FJ, Howard OMZ, Dong HF, Oppenheim JJ, O'Brien SJ, Carrington M. Reduced risk of AIDS lymphoma in individuals heterozygous for the CCR5- 32 mutation. Cancer Res 1999;59(15):3561-4.

Jacobson LP, Yamashita TE, Detels R, Margolick JB, Chmiel JS, Kingsley LA, Melnick S and Muñoz A for the Multicenter AIDS Cohort Study. Impact of potent antiretroviral therapy on the incidence of Kaposi's sarcoma and non-Hodgkin's lymphomas among HIV-1-infected individuals. JAIDS 1999;21:S34-41.

Jacobson LP, Zhang B-C, Zhu Y-R, Wang J-B, Wu Y, Zhang Q-N, Yu L-Y, Qian G-S, Kuang S-Y, Li Y-F, Fang X, Zarba A, Chen B, Enger C, Davidson NE, Gorman MB, Gordon GB, Prochaska HJ, Egner PA, Groopman JD, Muñoz A, Helzlsouer KJ, Kensler TW. Oltipraz chemoprevention trial in Qidong, People's Republic of China: Study design and clinical outcomes. Cancer Epidemiol Biomarkers Prev 1997;6:257-265.

Jacobson LP, Armenian HK. An integrated approach to the epidemiology of Kaposi's sarcoma. Curr Opin Oncol 1995;7:450-455.

Park LP, Graham NMH, Jacobson LP, Murphy R, Besley D, Zucconi S, Muñoz A. Factors associated with changes in the use of antiretroviral therapy by a cohort of HIV-1 infected homosexual men. Clinical Infectious Diseases, October 1995; 21:930-937.

Graham NMH, Jacobson LP, Kuo V, Chmiel JS, Morgenstern H, Zucconi SL. Access to therapy in The Multicenter AIDS Cohort Study, 1989-1992. J Clin Epidemiol 1994;47:1003-12.

Jacobson LP, Kirby AJ, Polk S, et al. Changes in survival after AIDS: 1984-1991. Am J Epidemiol 1993;138:952-64

Hoover DR, Black C, Jacobson LP, et al. An epidemiological analysis of Kaposi's sarcoma as an early and late AIDS outcome in homosexual men. Am J Epidemiol 1993;138:266-78.

Jacobson LP, Muoz A, Fox R, Phair JP, Dudley J, Obrams GI, Kingsley LA, Polk BF and the Multicenter AIDS Cohort Study Group. Incidence of Kaposi's sarcoma in a cohort of homosexual men infected with the human immunodeficiency virus-1. J Acquir Immune Defic Syndr 1990; 3:S24-S31.