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Making a difference in fight against HIV
Fan-Havard established clinic that helped babies be born HIV negative
By KEVIN FRYLING
Reporter Staff Writer
Although high salaries attract most pharmacists to private practice after graduation, a UB specialist in infectious diseases and HIV says she aims to show future pharmacists that academia offers rewards no amount of money can buy.
Patty Fan-Havard hopes to establish a regional HIV in Women Research Network between ECMC, Ohio State and the University of Rochester Medical Center.
PHOTO: NANCY J. PARISI
If just one more infant born free of HIV is priceless, then students of Patty Fan-Havard—who has helped close to 100 babies be born HIV-negative in the past six years alone—will no doubt come to learn that work such as hers is invaluable.
Fan-Havard, an associate professor of pharmacy practice and division head of Pharmacotherapy Research Programs in the School of Pharmacy and Pharmaceutical Sciences, joined the UB faculty last fall.
"During my tenure at Ohio State University (OSU)," she says, "I worked very closely with the Division of Infectious Diseases in the College of Medicine, the Department of Obstetrics and Gynecology, and Columbus Children's Hospital to establish and implement an HIV High-Risk Pregnancy Program. It was a multidisciplinary clinic that provided seamless care for pregnant HIV-infected women and their newborns.
"During the five years I worked at the clinic," she adds, "we delivered well over 85 patients and none were [HIV] positive."
Other statistics from the clinic are more sobering, however: Eighty-eight percent of patients were single mothers and more than 90 percent were unemployed and on Medicaid or some other form of government assistance. Up to 60 percent did not know about their HIV status until their pregnancy, she says.
Fan-Havard also pointed out that 75 percent of patients were African-American, of which 22 percent were continental Africans from such countries as Somalia and Ethiopia. "There's such a disparity in that HIV/AIDS affects more African-American women," she says. "The profile is very similar for the patient population at Erie County Medical Center (ECMC)."
Establishing a regional HIV in Women Research Network between ECMC, OSU—where she remains on the faculty as a clinical associate professor in the Department of Obstetrics and Gynecology—and the University at Rochester Medical Center, a member of the NIH-funded AIDS Clinical Trials Group, is one of her professional goals at UB.
"What is impressive about the HIV program at ECMC is that pharmacists also participate in interpreting the HIV-susceptibility testing and formulating treatment options to the physician for their final treatment recommendation," she says. "[HIV pharmacotherapy] really is a specialty that requires a close working relationship with infectious-disease specialists, nurses, microbiologists and other health care providers." Pharmacists also are taking on greater roles with HIV patients since the most effective treatment for HIV—the well-known "AIDS cocktail," or HAART (Highly Active Anti-retroviral Therapy)—can involve a daily drug regimen of up to a dozen pills, she says.
"Pharmacists not only educate patients about their medications and disease, we also think of ways to improve adherence," she says, noting that adherence is one of the biggest barriers to treatment because patients require more than 95 percent of their regular doses. "We assess for potential drug-drug interactions and drug-food interactions as well," she adds.
As the recipient of a doctoral degree in pharmacy from the University of the Pacific School of Pharmacy in 1985, Fan-Havard says she first started encountering HIV patients in the late-1980s as an assistant professor of pharmacy practice at Rutgers University and clinical specialist at the Veteran's Affairs Medical Center in East Orange, N.J.
"Patients were coming down with opportunist infections and [the cancer] Kaposi's Sarcoma in the early '80s," she recalls. "It used to be thought of as a gay men's disease, but then it was realized it was caused by an infectious organism and HIV was identified as the virus attacking the immune system." Improved drugs started to hit the market around the time she moved to Ohio in the 1990s, she adds, but notes it took time for health professionals to learn how to prescribe these medications to manage the disease.
At UB, Fan-Havard will pursue research into the effect of HIV protease inhibitors on placental vascular architecture using tissue samples from her clinic at OSU, contributing knowledge to dosing guidelines for HIV-pregnant women. She also is the principle investigator on a $100,000 grant from the National Institute of AIDS Research and Southwest National Primate Research Center that is examining the effects of a well-known HIV drug on the liver toxicity in pregnant baboons.
"Nevirapine is one of the more effective agents in reducing [mother-child] HIV transmission in developing countries," she explains. "However, nevirapine resistance can develop with a single dose and so international efforts are under way to optimize therapy during pregnancy."
Additional goals at UB include developing a database on HIV-pregnant women for ECMC and pursuing overseas collaborations to encourage international education on HIV.
Fan-Havard teaches two classes this semester—a clinical research course and "Pharmacotherapeutics"—to students pursuing doctorates in pharmacy. "I've been absolutely impressed with our students who are interested in going into research," she says. "We're really making efforts to recruit the top applicants into our program. We are getting students not only locally, but nationally who want to be a part of this program."
Born in Taiwan and raised in northern California, Fan-Havard resides in Clarence Center where she and her husband, Donald, a fiscal officer at OSU, are the parents of two children: Andrew, 13, and Nick, 11.
She, her husband and children took their first trip ever to Niagara Falls after their move to the Buffalo area last fall, says Fan-Havard, adding they're looking forward to more trips this summer to sites throughout the region, such as the Finger Lakes and Toronto.
"Buffalo is very much like Columbus," she says, "I feel very much at home."