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David M. Clifford, MD

David Clifford is the Melba and Forest Seay Professor of Clinical Neuropharmacology in Neurology and Professor of Medicine

He has assumed positions of leadership in the Medical School, including chairing the Executive Committee of the Faculty Council, faculty clinical representative to the Faculty Practice Plan, and serving on numerous committees.

Dr. Clifford has served as President of the medical staff of St. Louis ConnectCare, the corporation providing indigent health care in the St. Louis region and as Medical Director of Neurology for Barnes Jewish Hospital.

On a national basis, Dr. Clifford has chaired the Neurology Section of the AIDS Clinical Trials Group, served on the Scientific Program Committees for the American Academy of Neurology and for the Conference on Retroviruses and Opportunistic Infections, as a Counsellor for the American Neurological Association, Chairs the External Advisory Committee for the National NeuroAIDS Tissue Consortium and is a member of the American Federation for AIDS Research Scientific Advisory Board. He sits on the editorial boards of Journal of NeuroVirology and NeuroAIDS and is a frequent ad hoc reviewer for the major neurologic journals. He is listed in "Best Doctors in the U.S.".

Dr. Clifford is the Principal Investigator of the NINDS supported Neurologic AIDS Research Consortium (NARC), a national group including over 20 medical centers that organizes and supports clinical trials for HIV neurologic complications. In addition, Dr.Clifford has participated in pharmacologic investigations in Parkinson's Disease and multiple sclerosis. He is also the Principal Investigator for the Washington University AIDS Clinical Trials Unit organized to lead translational research relevant to HIV/AIDS.

Dr. Clifford has a broad interest in neuropharmacology. Development of more successful medical management of neurological disease has been his clinical focus, and has included participation in studies of epilepsy, Parkinson's disease, multiple sclerosis, and virtually all neurologic complications of HIV. His present focus is on developing optimal treatments for neurologic complications of HIV including HIV-associated dementia, painful peripheral neuropathies in HIV, progressive multifocal leukoencephalopathy, cryptococcal meningitis, toxoplasma encephalitis, primary CNS lymphoma, cytomegalovirus encephalitis/radiculomyelitis, and HIV myelopathy. Dr. Clifford leads a nationwide clinical research group, the Neurologic AIDS Research Consortium, funded by NINDS of the National Institute of Health, whose specific mission is to pursue better treatments for HIV associated neurologic complications. He is also Principal Investigator for the Washington University AIDS Clinical Trials Unit. He is working in international studies, particularly cooperating with medical schools of Ethiopia to further diagnosis and treatment of HIV in that country.

Medical Training

Originally from Tecumseh, Michigan, Dr. Clifford received his BA (summa cum laude in chemistry and history) from Southwestern University in Georgetown, Texas in1971, and his MD from Washington University School of Medicine in 1975. He completed residency programs in medicine and neurology at Barnes Hospital in St. Louis, Missouri and served as as Postdoctoral Fellow in Neurology before becoming appointed as a Research Instructor in Neurology in 1980.
In 1982, Dr. Clifford was appointed Assistant Professor of Neurology at Washington University School of Medicine, where he has served as full Professor since 1994.

Selected Publications

Clifford DB, Mitke MT, Mekonnen Y, Zhang J, Zenebe G, Melaku Z, Zewede A, Gessesse N, Wolday D, Messele T, Teshome M, and Evans S. Neurological evaluation of untreated human immunodeficiency virus infected adults in Ethiopia. J NeuroVirol 2007; 13:67-72.

Sacktor N, Nakasujja N, Robertson K, Clifford DB. HIV-associated cognitive impairment in sub-Saharan Africa - the potential effect of clade diversity. Nature Clinical Practice Neurology 2007; 3:436-443.

Lima MA, Marzocchetti A, Autissier P, Tompkins T, Chen Y, Gordon J, Clifford DB, Gandhi RT, Venna N, Berger JR, Koralnik IJ. Frequency and phenotype of JC virus-specific CD8+ T lymphocytes in the peripheral blood of patients with progressive multifocal leukoencephalopathy. Journal of Virology 2007; 81:3361-3368.

Schifitto G, Zhang J, Evans SR, Sacktor N, Simpson D, Millar LL, Hung VL, Smith E, Miller EN, Ellis RJ, Valcour V, Singer E, Marra CM, Kolson D, Weihe J, Remmel R, Katzenstein D, Clifford DB, The ACTG A5090 Team. A multicenter trial of selegiline transdermal system for HIV-associated cognitive impairment. Neurology 2007; 69:1314-1321.

Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, Clifford DB, Cinque P, Epstein LG, Goodkin K, Gisslen M, Grant I, Heaton RK, Joseph J, Marder K, Marra CM, McArthur JC, Nunn M, Price RW, Pulliam L, Robertson KR, Sacktor N, Valcour V, Wojna VE. Updated research nosology for HIV-associated neurocognitive disorders. Neurology 2007; 69:1789-1799.

Evans SR, Simpson DM, Kitch DW, King A, Clifford DB, Cohen BA, McArthur JC, for the Neurologic AIDS Research Consortium and the AIDS Clinical Trials Group. A randomized trial evaluating Prosaptide® for HIV-associated sensory neuropathies: use of an electronic diary to record neuropathic pain. Plos One 2007; 7:e551.

Letendre S, Marquie-Beck J, Capparelli E, Best B, Clifford D, Collier AC, Gelman BB, McArthur JC, McCutchan JA, Morgello S, Simpson D, Grant I, Ellis RJ, for the CHARTER Group. Validation of the CNS penetration-effectiveness rank for quantifying antiretroviral penetration into the central nervous system. Arch Neurol 2008; 65:65-70.

Clifford D. HIV-associated neurocognitive disease continues in the antiretroviral era. Topics in HIV Medicine 2008; 16:94-98.

Ellis RJ, Marquie-Beck J, Delaney P, Alexander T, Clifford DB, McArthur JC, Simpson DM, Ake C, Collier AC, Gelman BB, McCutchan JA, Morgello S, Grant I, the CHARTER Group. Human immunodeficiency virus protease inhibitors and risk for peripheral neuropathy. Annals of Neurology 2008; 64:566-572.

Best BM, Letendre SL, Brigid E, Clifford DB, Collier AC, Gelman BB, McArthur JC, McCutchan JA, Simpson DM, Ellis R, Capparelli EV, Grant I for the CHARTER Group. Low atazanavir concentrations in cerebrospinal fluid. AIDS 2009; 23:83-7.

Clifford DB. Natalizumab and PML: a risky business? Gut 2008; 57:1347-1349.

Best BM, Letendre SL, Brigid E, Clifford DB, Collier AC, Gelman BB, McArthur JC, McCutchan JA, Simpson DM, Ellis R, Capparelli EV, Grant I for the CHARTER Group. Low atazanavir concentrations in cerebrospinal fluid. AIDS 2009; 23:83-7.

Sacktor N, Nakasujja N, Skolasky RL, Robertson K, Musisi S, Ronald A, Katabira E, Clifford DB. Benefits and risks of stavudine therapy for HIV-associated neurologic complications in Uganda. Neurology 2009; 72:165-170.

Wenning W, Haghikia A, Laubenberger J, Clifford DB, Behrens PF, Chan A, Gold R. Treatment of progressive multifocal leukoencephalopathy associated with natalizumab. NEJM 2009; 361:1075-1080.

Marra CM, Zhao Y, Clifford DB, Letendre S, Evans S, Henry K, Ellis RJ, Rodriguez B, Coombs RW, Schifitto G, McArthur JC, Robertson K. Impact of combination antiretroviral therapy on cerebrospinal fluid HIV RNA and neurocognitive performance. AIDS 2009; 2009; 23:1359-66.

Sacktor N, Nakasujja N, Skolasky RL, Rezapour M, Robertson K, Musisi S, Katabira E, Ronald A, Clifford DB, Laevendecker O, and Quinn T. HIV subtype D is associated with dementia compared to subtype A, in immunosuppressed individuals at risk for cognitive impairment in Kampala, Uganda. Clin Inf Dis, 2009; 49:780-786.

Valcour V, Yeh TM, Bartt R, Clifford D, Gerschenson M, Evans SR, Cohen BA, Ebenezer GJ, Hauer P, Millar L, Gould M, Tran P, Shikuma C, Souza S, McArthur JC, AIDS Clinical Trials Group (ACTG) 5157 Protocol Team. Acetyl-L-carnitine and nucleoside reverse transcriptase inhibitor-associated neuropathy in HIV infection. HIV Medicine 2009; 10:103-110.

Clifford DB, Smurzynski M, Park LS, Yeh TM, Zhao Y, Blair L, Arens M, Evans SR. Effects of active HCV replication on neurologic status in HIV RNA virally suppressed patients. Neurology 2009; 73:309-314.

Boero J, Duntley J, Clifford D, Ding J, Shannon W. Actigraphy and functional data analysis for objective measurement of fatigue: a case study in HIV/AIDS. JSM Proceedings 2009; in press.

Marzocchetti A, Tompkins T, Clifford DB, Gandhi RT, Kesari S, Berger JR, Simpson DM, Prosperi M, De Luca A, Koralnik IJ. Determinants of survival in progressive multifocal leukoencephalopathy. Neurology 2009; 73:1551-1558.

Joseph J, Clifford D, Douglas SD, Fox H, Gendelman HE, Gonzalez-Scarano F, Grant I, Major E, McArthur J, NeuroAIDS Research Participants. Planning future strategies for domestic and international NeuroAIDS Research, July 24-25, 2008. J Neuroimmune Pharmacol 2009; 4:283-297. (PMCID: 27197353)

Tornatore C, Clifford DB. Clinical vigilance for progressive multifocal leukoencephalopathy in the context of natalizumab use. Multiple Sclerosis 2009; 15:S16-S25.

Clifford DB, Fagan AM, Holtzman DM, Morris JC, Teshome M, Shah AR, Kauwe JSK. CSF biomarkers of Alzheimer disease in HIV-associated neurologic disease. Neurology 2009; 73:1982-1987.

Clifford DB, DeLuca A, Simpson DM, Arendt G, Giovannoni G, Nath A. Natalizumab associated progressive multifocal leukoencephalopathy: Lessons from early cases. Lancet Neurology 2009; submitted.

Ances BM, Christensen JJ, Teshome M, Taylor J, Xiong C, Aldea P, Fagan AM, Holtzman DM, Morris JC, Mintun MA, Clifford DB. Unimpaired HIV+ Participants Do Not Have Increased 11C-PIB: A Case Control Study. Neurology 2009; submitted.

Ances BM, Vaida F, Rosario D, Marquie-Beck J, Ellis RJ, Simpson DM, Clifford DB, McArthur JC, Grant I, McCutchan JA, CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Metabolic Study Group. Role of metabolic syndrome components in HIV-associated sensory neuropathy. AIDS 2009; 23:2317-22. (PMID: 19823068)

Margulies S, Hicks R. Combination therapies for traumatic brain injury; prospective considerations. J Neurotrauma 2009; 26:925-39.