Dr. David Boulware Works to Find Answers for Neglected, New Diseases

David Boulware, MD, MPH

Visiting Minnesota during the often-frigid month of November may not make the best first impression for new visitors. Yet, when David Boulware, MD, MPH, thinks about when he first traveled to the state to interview for a residency at the University of Minnesota Medical School in November 1999, he recalls very little about the weather and more about the sense of energy and hope he had to join the community.

“The immigrant and refugee community was really diverse and interesting from a medical perspective,” Dr. Boulware said. “One of my interests, and why I went into infectious diseases, was really an interest in travel medicine and immigrant medicine to look at a variety of medical problems that occur in the immigrant population in Minnesota and how best to address those.”

This passion has kept him at the Medical School for 20 years, where today, he is a professor in the Department of Medicine’s Division of Infectious Diseases and International Medicine.

Discovering New Treatments for HIV-related Meningitis

Dr. Boulware and his team study neglected diseases that affect vulnerable populations around the world. One disease, cryptococcal meningitis, causes roughly 15% of all HIV-related deaths in Sub-Saharan Africa.

“Our research team has partnered with great collaborators in Africa and in Minnesota that, over the last 15 years, have become world leaders in how to treat this disease both in the U.S. and in Africa,” Dr. Boulware said.

His team, including a number of trainees and medical students, frequently travel to Uganda to study the disease because of its higher prevalence. Yet, their research has implications for both those at risk of the disease in Africa and in Minnesota—patients with suppressed immune systems due to HIV as well as organ transplantation, chemotherapy, liver disease and other medical issues.

Discovering New Treatments for COVID-19

Dr. Boulware’s team prepared to travel to an HIV conference, but two days beforehand, the spread of COVID-19 canceled the event. With four days of “free time” blocked on their calendars, Dr. Boulware brought the team in for a meeting.

“We started thinking about a clinical trial for COVID-19. Most of the trials at that time were focused on patients who were hospitalized, but we knew if you want to change the epidemic, you really want to prevent new infections or treat people so that they don’t have to be hospitalized,” Dr. Boulware said. “We kind of looked around and said, ‘Someone should be doing this,’ and then we realized that, well, maybe it should be us.”

Within eight days, the team began enrolling patients exposed to COVID-19 into some of the nation’s first clinical trials focused on prevention and early treatment. Today, they lead three clinical trials studying the use of hydroxychloroquine, an FDA-approved drug often prescribed to treat malaria.

“Does it work for prevention or early treatment? We don’t know the answer yet, but I do know it’s important to find out and to find out quickly,” Dr. Boulware said. “Our University has been very proactive to a point where we could actually respond and make a difference, and I think as a land-grant university, that’s really important. We’re not just some ivory tower that writes papers—we really impact the daily lives of Minnesotans for the better.”

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