David R. Boulware, M.D., MPH, CTropMed
 Lois & Richard King Distinguished Assistant Professor
Associate Director of Global Health Programs in Internal Medicine, Division of Infectious Diseases & International Medicine, Department of Medicine
Dr. Boulware serves as the Associate Director of Global Health Programs in Internal Medicine, and his research interest is in understanding the pathogenesis of HIV immune reconstitution inflammatory syndrome (IRIS), an important complication of HIV therapy that has recently emerged with the roll out of antiretroviral therapy in Africa. In particular, Dr. Boulware is most interested in translational research through translating the understanding of disease pathogenesis into practical clinical interventions to improve outcomes. In collaboration with investigators at the Infectious Diseases Institute of Makerere University and Mbarara University in Uganda, and investigators at the University of Cape Town, South Africa, we are prospectively working to improve the survival of persons with cryptococcal meningitis by testing when is the optimal time to start HIV therapy after meningitis (NCT01075152). Through this trial, Dr. Boulware’s collaborative research involves characterizing the differences in gene expression and inflammatory responses that occur over time among people who develop IRIS. The objective is to identify the pathophysiology of IRIS, identify biomarkers for the prediction and diagnosis of IRIS, and develop better treatments for and to prevent IRIS. Dr. Boulware graduated from Indiana University and then completed an internal medicine-pediatrics residency and an infectious disease fellowship at the University of Minnesota. He joined the UMN faculty in 2007. He previously has served on the 2007 DHHS/IDSA HIV Opportunistic Infections Guidelines Panel, 2011 WHO Cryptococcal Guideline Review Panel, and serves on the ASTMH CTropMed® examination committee. Selected recent publications- Rajasingham R, Meya DB, Boulware DR. Integrating cryptococcal antigen screening and pre-emptive treatment into routine HIV care. J Acquir Immune Defic Syndr. 2012;59:e85-91. PMC3311156
- Rhein J, Boulware DR. The prognosis and management of cryptococcal meningitis in HIV infected patients. Neurobehavioral HIV Med 2012; 4: 45-61.
- Kambugu A, Meya DB, Rhein J, O’Brien M, Janoff EN, Ronald AR, Kamya MR, Mayanja-Kizza H, Sande MA, Bohjanen PR, Boulware DR. Outcomes of cryptococcal meningitis in Uganda before and after the availability of HAART. Clin Infect Dis. 2008; 46: 1694-1701. PMC2593910.
- Stauffer WM, Cartwright CP, Olson DA, Juni BA, Taylor CM, Bowers SH, Hanson KL, Rosenblatt JE, Boulware DR. Superior diagnostic performance of malaria rapid diagnostic tests as compared to blood smears in U.S. clinical practice. Clin Inf Dis. 2009; 49: 908-13. PMC 2912215
- ** Meya DB, Manabe YC, Castelnuovo C, Cook BA, Elbireer AM, Kambugu A, Kamya MR, Bohjanen PR, Boulware DR. Cost-effectiveness of serum cryptococcal antigen screening to prevent deaths among HIV-infected persons with a CD4+ <100 cells/mL who start HIV therapy in resource-limited settings. Clin Infect Dis. 2010; 51:448-55. PMC2946373
- ** Boulware DR, Bonham SC, Meya DB, Wiesner DL, Park GS, Kambugu A, Janoff EN, Bohjanen PR. Paucity of initial cerebrospinal fluid inflammation in cryptococcal meningitis is associated with subsequent immune reconstitution inflammatory syndrome. J Infect Dis. 2010; 202: 962-970. PMC2924457
- Boulware DR, Meya DB, Bergemann TL, Williams D, Vlasova IA, Rhein J, Staddon J, Janoff EN, Kambugu A, Bohjanen PR. Antiretroviral therapy down-regulates innate antiviral response genes in AIDS patients in Sub-Saharan Africa. JAIDS 2010; 55:428-38. PMC3159954
- Haddow LJ, Colebunders R, Meintjes G, Lawn SD, Elliott JH, Manabe YC, Bohjanen PR, Sungkanuparph S, Easterbrook PJ, French MA, Boulware DR. Cryptococcal immune reconstitution inflammatory syndrome: literature review and proposed clinical case definitions. Lancet Infect Dis. 2010; 10: 791 – 802. PMC3026057
- ** Boulware DR, Meya DB, Bergemann TL, Wiesner DL, Rhein J, Musubire A, Lee S, Kambugu A, Janoff EN, Bohjanen PR. Clinical features and serum biomarkers in HIV immune reconstitution inflammatory syndrome after cryptococcal meningitis: a prospective cohort study. PLoS Med. 2010; 7: e1000384. doi:10.1371/journal.pmed.1000384
- Boulware DR, Hullsiek KH, Puronen CE, Rupert A, Baker JV, French MA, Bohjanen PR, Novak RM, Neaton JD, Sereti I, for the INSIGHT Study Group. Higher levels of CRP, d-dimer, IL-6 and hyaluronic acid before initiation of antiretroviral therapy (ART) are associated with increased risk of AIDS or death. J Infect Dis. 2011; 203:1637-46. PMID:21592994
- Bakeera-Kitaka S, Conesa-Botella A, Dhabangi A, Maganda A, Kekitiinwa A, Colebunders R, Boulware DR. Tuberculosis in human immunodeficiency virus infected Ugandan children starting on antiretroviral therapy. Int J Tuberc Lung Dis. 2011;15:1082-6. PMID:21740672
- * Wiesner DL, Boulware DR. Cryptococcus-related immune reconstitution inflammatory syndrome: pathogenesis and its clinical implications. (PDF) Curr
Fungal Infect Rep. 2011; 5(4): In Press. NIHMSID:252-261. The final
publication is available at www.springerlink.com
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