Robert Gross, MD, MSCE

Office Location804, Blockley Hall
Office Phone215-898-2437
Emailgrossr@mail.med.upenn.edu

Faculty Information

CCEB AppointmentSenior Scholar, Epidemiology
Primary Faculty AppointmentAssociate Professor of Medicine, Infectious Diseases Division, University of Pennsylvania Perelman SOM
DBE AppointmentAssociate Professor of Epidemiology

Research Statement

Robert Gross, M.D., M.S.C.E., is board certified in Infectious Diseases and Epidemiology. Dr. Gross is Associate Professor of Medicine and Epidemiology in the Division of Infectious Diseases and has a position as Senior Scholar (core faculty) within the CCEB. Dr. Grossí research has been on HIV outcomes with a focus on antiretroviral drug adherence. Dr. Grossí projects observational studies have looked at both short- and long-term adherence behavior. His ultimate goal is the development of interventions aimed at improving treatment outcomes. He is currently PI of an NIMH R01-funded adherence intervention based on problem solving theory and using microelectronic monitors (MEMS) and pharmacy refill data to measure adherence. He is also co-chair of A5234, an international study (Brazil, Haiti, Panama, Peru, Uganda, South Africa) testing partner-based directly observed therapy in first treatment failures. His methods work is focused on the use of pharmacy refill measures of antiretroviral adherence and he has refined this approach over the last several years. Most recently, Dr. Gross has expanded his research into Botswana, particularly in the area of pharmacogenomics. He has demonstrated that polymorphisms in HIV drug metabolizing enzymes are common in Botswana. He is now poised to initiate a large cohort study in Botswana to assess the impact of slow drug metabolism on treatment outcomes and the potential interaction between slow metabolism and suboptimal adherence. Ultimately, he aims to determine whether pharmacogenetic information can be used to tailor antiretroviral therapy to the individual for better outcomes.

Selected Publications

Kimmel SE, Chen Z, Price M, Parker CS, Metlay JP, Christie JD, Brensinger CM, Newcomb CW, Samaha FF, Gross R. The influence of patient adherence on anticoagulation control with warfarin: results from the INR anticoagulation and genetics (IN-RANGE) study. Arch Intern Med 2007; 167: 229-235.

Graham J, Bennett I, Holmes WC, Gross R. Medication beliefs as mediators of the health literacy-antiretroviral adherence relationship in HIV infected individuals. AIDS and Behav 2007; 11(3): 385-392.

Holmes WC, Bilker W, Wang H, Chapman J, Gross R. HIV/AIDS-specific quality of life and adherence to antiretroviral therapy over time. JAIDS 2007; 1(46): 323-7.

Gross R, Bilker WB, Wang H, Chapman J. How long is the window of opportunity between adherence failure and virologic failure on efavirenz-based HAART? HIV Clin Trials 2008; 9(3): 202-206.

Umscheid CA, Maguire MG, Pines JM, Everett WW, Baren JM, Townsend RR, Mines DM, Szyld D, Gross R. Untreated hypertension and the Emergency Department: a chance to intervene? Acad Emerg Med 2008; 15: 529-536.

Bisson GP, Robertson A, Weinstein R, Gaolathe T, Frank I, Gross R. Antiretroviral failure despite high levels of adherence: discordant adherence-response relationship in Botswana. JAIDS 2008; 49(1): 107-110.

Lo Re III V, Wertheimer B, Localio AR, Kostman JR, Dockter J, Linnen JM, Giachetti C, Tebas P, Frank I, Strom BL, Gross R. Incidence of transaminitis among HIV-infected patients with occult hepatitis B. J Clin Virol 2008; 43(1): 32-36.

Gross R, Bilker WB, Strom BL, Hennessy, S. Validity and comparison of two measures of days supply in Medicaid claims data. Pharmacoepidemiol and Drug Saf 2008; 17(10): 1029-1032.

Gross R, Aplenc R, TenHave T, Foulkes AS, Thakur R, Mosepele M, Barrett JS, Flexner C, Strom BL, Bisson G. Slow efavirenz metabolism genotype is common in Botswana. JAIDS 2008; 49(3): 336-337.

Acri T, TenHave T, Bogner H, Chapman J, Gross R. Lack of association between retrospectively-collected pharmacy refill data and electronic drug monitoring of antiretroviral adherence. AIDS and Behav Dec 2008 Notes: epub ahead of print.

Bachhuber M, Gross, R. Mortality benefit of isoniazid preventive therapy in HIV-positive persons: a simulation study. International Journal of Tuberculosis and Lung Disease 2009 (in press).

Gross R, Tierney C, Andrade A, Lalama C, Rosenkranz S, Eshleman SH, Flanigan T, Santana J, Salomon N, Reisler R, Wiggins I, Hogg E, Flexner C, Mildvan D for the AIDS Clinical Trials Group A5073 Study Team. Modified directly observed antiretroviral therapy compared with self-administered therapy in treatment-naÔve HIV-1 infected patients: a randomized trial. Archives of Internal Medicine 2009 (in press).

Lo Re V III, Amorosa VK, Localio AR, O'Flynn R, Teal V, Dorey-Stein Z, Kostman JR, Gross R. Adherence to hepatitis C virus therapy and early virologic outcomes. Clinical Infectious Diseases 2009; 48(2): 186-193.


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