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Urvi Parikh, PhD

Assistant Professor of Medicine, Division of Infectious Diseases, University of Pittsburgh

A risk of using the same drugs for HIV prevention and HIV treatment is drug resistance. It's a major concern. My research team's diligent monitoring and rigorous characterization of HIV drug resistance in PrEP trials and programs contributes to preserving options for both treatment and prevention of HIV in vulnerable populations.
Urvi Parikh, PhD

Research in Brief

Dr. Parikh’s translational research laboratory uses novel technical approaches to solve public health problems in the research areas of HIV prevention and drug resistance. Her laboratory serves as the Virology and Pharmacodynamics Core for the MTN, with the aim of confirming virologic endpoints for all MTN studies, conducting pharmacodynamic assessments in genital tract specimens to support product development, assessing population and low-frequency resistance in seroconverters from HIV prevention trials, developing new assays and addressing research questions relevant to the field of HIV prevention, and providing virology support to MTN protocols, international clinical research sites, and community working groups. In addition to these major projects, Dr. Parikh’s lab is investigating the detection of Y chromosome DNA in genital tract specimens using quantitative real-time PCR as a biomarker for unprotected sex and evaluating new HIV diagnostic algorithms using antigen-based rapid tests for identifying seroconverters. Dr. Parikh also leads the USAID/PEPFAR-funded Global Evaluation of Microbicide Sensitivity (GEMS) Project whose goals are to characterize resistance risk from pre-exposure prophylaxis (PrEP) trials and demonstration projects, identify the most effective and efficient HIV testing and resistance monitoring strategies, generate evidence-based policy recommendations for HIV diagnostic testing frequency and ARV resistance monitoring, and monitor seroconverters from PrEP roll-out programs for ARV resistance in selected clinics in South Africa, Zimbabwe, and Kenya. The GEMS project brings together a diverse team of laboratory scientists, mathematical modelers, policy experts, health economists, in-country stakeholders, demonstration project teams and others towards the common public health goal of minimizing resistance risk during PrEP roll-out.

Laboratory Center: Microbicide Trials Network

Role: Co-Investigator

Grant Number: UM1 AI106707 (Mellors/Rohan)

Source: Magee-Womens Research Institute and Foundation (NIH/NIAID)

Aims: Dr. Parikh works collaboratively with MTN Central Laboratory investigators as one of 5 core laboratories supporting the Microbicide Trials Network's clinical evaluation of microbicide products.

Comprehensive Assessment of Resistance Risk and Development of Policy Recom-mendations for Microbicide/PrEP Roll-Out

Role: Senior Technical Advisor

Grant Number: AID-OAA-A-15-00031 (Mellors)

Source: USAID

Aims: This project will help fill this critical knowledge gap by providing new information about the risk of resistance and its impact on future treatment from the use of ARVs for prevention.

Hormones, Immunity and HIV Risk

Role: Co-Investigator

Grant Number: 5R01HD092016-02 (Rohan)

Source: Magee-Womens Research Institute and Foundation (NIH/NIAID)

Aims: The overarching goal of this study is to determine if exogenous progestins used in long acting reversible contraceptives (LARCs) will enhance adolescent risk for mucosal HIV acquisition.

  • Chirenje ZM, Marrazzo J, Parikh UM. Antiretroviral-based HIV prevention strategies for women. Expert Rev Anti Infect Ther. 2010 Oct;8(10):1177-86. PMCID: PMC4381115.
  • Dezzutti CS, Hendrix CW, Marrazo JM, Pan Z, Wang L, Louissaint N, Kalyoussef S, Torres NM, Hladik F, Parikh U, Mellors J, Hillier SL, Herold BC. Performance of swags, lavage, and diluents to quantify biomarkers of female genital tract soluble mucosal mediators. PLoS One. 2011;6(8):e23136. PMCID: PMC3155537.
  • Parikh UM, Mellors JW. HIV-1 drug resistance resulting from antiretroviral therapy far exceeds that from pre-exposure prophylaxis. Clin Infect Dis. 2013 Jul;55(2):303-4. PMCID: PMC3491772.
  • Parikh UM, Kiepiela P, Ganesh S, Gomez K, Horn S, Eskay K, Kelly C, Mensch B, Gorbach P, Soto-Torres L, Ramjee G, Mellors JW; MTN-009 Protocol Team. Prevalence of HIV-1 drug resistance among women screening for HIV prevention trials in KwaZulu-Natal, South Africa (MTN-009). PLoS One. 2013 Apr 9;8(4):e59787. PMCID: PMC3621859.
  • Herold BC, Keller MJ, Shi Q, Hoover DR, Carpenter CA, Huber A, Parikh UM, Agnew KJU, Minkoff H, Colie C, Nowicki MJ, D’Souza G, Watts DH, Anastos K. Plasma and mucosal HIV viral loads are associated with genital tract inflammation in HIV-infected women. J Acquir Immune Defic Syndr. 2013 Aug 1;63(4):485-93. PMCID: PMC3706034.
  • Penrose KJ, Richardson BA, Besson G, Dezzutti CS, Herold BC, Abdool Karim SS, Mellors JW, Parikh UM, MTN Biomedical Sciences Working Group and the HPTN 035 Protocol Team. Y chromosome and HIV DNA detection in vaginal swabs as biomarkers of semen and HIV exposure in women. Sex Transm Dis. 2014 Nov;41(11):674-9. PMCID: PMC4346249.
  • Marrazzo JM, Ramjee G, Richardson BA, Gomez K, Mgodi N, Nair G, Palanee T, Nakabiito C, van der Straten A, Noguchi L, Hendrix CW, Dai JY, Ganesh S, Mkhize B, Taljaard M, Parikh UM, Piper J, Masse B, Grossman C, Rooney J, Schwartz JL, Watts H, Marzinke MA, Hillier SL, McGowan IM, Chirenje ZM; VOICE Study Team. Tenofovir-based preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2015 Feb 5;375(6):509-18. PMCID: PMC4341965.
  • Mensch BS, Gorbach PM, Kelly C, Kiepiela P, Gomez K, Ramjee G, Ganesh S, Morar N, Soto-Torres L, Parikh UM. Characteristics associated with HIV drug resistance among women screening for an HIV prevention trial in KwaZula-Natal, South Africa. AIDS Behav. 2015 Nov;19(11):2076-86. PMCID: PMC4600421.
  • Noguchi LM, Richardson BA, Baeten JM, Hillier SL, Balkus JE, Chirenje ZM, Bunge K, Ramjee G, Nair G, Palanee-Phillips T, Selepe P, van der Straten A, Parikh UM, Gomze K, Piper JM, Watts DH, Marrazzo JM, VOICE Study Team. Risk of HIV-1 acquisition among women who use different types of injectable progestin contraception in South Africa: a prospective cohort study. Lancet HIV. 2015 Jul;2(7):e279-87. PMCID: PMC4491329.
  • Nakra NA, Madan RP, Buckley N, Huber AM, Freiermuth JL, Espinoza L, Walsh J, Parikh UM, Penrose KJ, Keller MJ, Herold BC. Loss of innate host defense following unprotected vaginal sex. J Infect Dis. 2016 Mar 1;213(5):840-7. PMCID: PMC4747617.
  • Parikh UM, Mellors JW. Should we fear resistance from tenofovir/emtricitabine preexposure prophylaxis? Curr Opin HIV AIDS. 2016 Jan;11(1):49-55. PMCID: PMC4970748.
  • Riddler SA, Husnik M, Gorbach PM, Levy L, Parikh U, Livant E, Pather A, Makanani B, Muhlanga F, Kasaro M, Martinson F, Elharrar V, Balkus JE; MTN-015 Protocol Team for the Microbicide Trials Network. Long-term follow-up of HIV seroconverters in microbicide trials - rationale, study design, and challenges in MTN-015. HIV Clin Trials. 2016 Sep;17(5):204-11. PMID: 27465646
  • Baeten JM, Palanee-Phillips T, Brown ER, Schwartz K, Soto-Torres LE, Govender V, Mgodi NM, Matovu Kiweewa F, Nair G, Mhlanga F, Siva S, Bekker LG, Jeenarain N, Gaffoor Z, Martinson F, Makanani B, Pather A, Naidoo L, Husnik M, Richardson BA, Parikh UM, Mellors JW, Marzinke MA, Hendrix CW, van der Straten A, Ramjee G, Chirenje ZM, Nakabiito C, Taha TE, Jones J, Mayo A, Scheckter R, Berthiaume J, Livant E, Jacobson C, Ndase P, White R, Patterson K, Germuga D, Galaska B, Bunge K, Singh D, Szydlo DW, Montgomery ET, Mensch BS, Torjesen K, Grossman CI, Chakhtoura N, Nel A, Rosenberg Z, McGowan I, Hillier S; MTN-020–ASPIRE Study Team. Use of a Vaginal Ring Containing Dapivirine for HIV-1 Prevention in Women. N Engl J Med. 2016 Dec 1;375(22):2121-2132. Epub 2016 Feb 22. PMID: 26900902
  • Cranston RD, Lama JR, Richardson BA, Carballo-Diéguez A, Kunjara Na Ayudhya RP, Liu K, Patterson KB, Leu CS, Galaska B, Jacobson CE, Parikh UM, Marzinke MA, Hendrix CW, Johnson S, Piper JM, Grossman C, Ho KS, Lucas J, Pickett J, Bekker LG, Chariyalertsak S, Chitwarakorn A, Gonzales P, Holtz TH, Liu AY, Mayer KH, Zorrilla C, Schwartz JL, Rooney J, McGowan I; MTN-017 Protocol Team. MTN-017: A Rectal Phase 2 Extended Safety and Acceptability Study of Tenofovir Reduced-Glycerin 1% Gel. Clin Infect Dis. 2017 Mar 1;64(5):614-620. PMID: 27986684
  • Heffron R, Parikh UM, Penrose KJ, Mugo N, Donnell D, Celum C, Mellors JW, Baeten JM; Partners PrEP Study Team. Objective Measurement of Inaccurate Condom Use Reporting Among Women Using Depot Medroxyprogesterone Acetate for Contraception. AIDS Behav. 2017 Jul;21(7):2173-2179. PMID: 27699594
  • Penrose KJ, Wallis CL, Brumme CJ, Hamanishi KA, Gordon KC, Viana RV, Harrigan PR, Mellors JW, Parikh UM. Frequent Cross-Resistance to Dapivirine in HIV-1 Subtype C-Infected Individuals after First-Line Antiretroviral Therapy Failure in South Africa. Antimicrob Agents Chemother. 2017 Jan 24;61(2). PMID: 27895013
  • Livant E, Heaps A, Kelly C, Maharaj R, Samsunder N, Nhlangulela L, Karugaba P, Panchia R, Marrazzo J, Chirenje JM, Parikh UM, on behalf of the VOICE Study Team; The Fourth Generation Alere™ HIV Combo Rapid Test Improves Detection of Acute Infection in MTN-003 (VOICE) Samples. J Clin Virol. 2017 Sep;94:15-21. PMID: 28710996.
  • Riddler SA, Balkus JE, Parikh UM, Mellors JW, Akello C, Dadabhai S, Mhlanga F, Ramjee G, Mayo AJ, Livant E, Heaps AL, O'Rourke C, Baeten JM; MTN-015; MTN-020/ASPIRE Study Teams. Clinical and Virologic Outcomes Following Initiation of Antiretroviral Therapy Among Seroconverters in the MTN-020/ASPIRE Phase III Trial of the Dapivirine Vaginal Ring. Clin Infect Dis. 2018 Oct 22. doi: 10.1093/cid/ciy909. [Epub ahead of print] PubMed PMID: 30346511.
  • Cranston RD, Dezzutti CS, Siegel A, Engstrom J, Shetler C, Richardson-Harman N, Abebe KZ, Back D, Else L, Egan D, Khoo S, Egan JE, Stall R, Williams P, Brand RM, Parikh UM, McGowan IM. A Multiple Dose Phase 1 Assessment of Rilpivirine Long-Acting in a Model of Pre-Exposure Prophylaxis against HIV. AIDS Res Hum Retroviruses. 2019 May 31.[Epub ahead of print] PMID: 31146534

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