North American AIDS Cohorts on Collaboration and Design (NAACCORD)

北美艾滋病队列研究和设计合作(NA-ACCORD)已经 自2006年以来代表了leDEA倡议的区域1。23个单点和多点临床和 NA-ACCORD的经典流行病学HIV队列涵盖了 美国和加拿大。100多个网站贡献了从19万多名艾滋病毒携带者那里收集的数据 (威尔斯亲王医院)。我们已经建立了强大的协作基础设施，充分利用了人才 和多学科研究小组的专业知识，涵盖基础科学、临床 研究、流行病学、数据信息学和生物统计学。我们在以下方面取得了很高的生产力 解决我们在当代护理和公共卫生方面的先前目标和关键问题 致成年威尔斯亲王医院。我们的优势与美国国土安全部结束艾滋病毒的目标特别相关 流行病(EHE)倡议，独特地提供了广泛的地理和人口范围， 建立科学平台，大样本量，广泛纵向跟踪&GT；130万 人-年和临床数据的深度，为EHE的目标提供丰富的数据 在传播停止后继续携带艾滋病毒生存。随着新冠肺炎倡议的启动 关于新冠肺炎对艾滋病毒结果和艾滋病毒趋势的影响的问题 指标，以及新冠肺炎在威尔斯亲王医院中的长期成果，可以在 一言为定。在这一背景下，我们为下一次筹资提出了三个广泛定义的目标 周期：目标1：描述#年艾滋病毒治疗、进展和结果的纵向过程 在北美的EHE倡议的背景下，这将增加数量和异质性 由于艾滋病毒治疗和艾滋病毒携带者生活的长期挑战继续存在 进化。目的2：评估和描述北美HIV感染的临床过程， 重点关注主要的非艾滋病合并症和合并感染、多发病和共病-- 自由预期寿命。目标3：扩大和扩展我们最先进的流行病学、生物统计学、 以及数据科学的方法论方法。NA-ACCORD是一个世界级的合作 已建立的艾滋病毒队列处于有利地位，以a)提供对纵向 当为EHE作出非常努力时，艾滋病毒的进程；b)与其他人合作 IeDEA区域，为低收入和中等收入区域未来的艾滋病毒流行提供信息；和c) 了解艾滋病毒治疗、结果和预后因素的差异，这将为未来提供信息 全球范围内的研究和艾滋病毒护理。

The North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) has represented Region 1 of the leDEA initiative since 2006. The 23 single and multi-site clinical and classical epidemiologic HIV cohorts of the NA-ACCORD encompass most HIV cohorts within the US and Canada. Over 100 sites contribute data collected from over 190,000 people with HIV (PWH). We have established a strong collaborative infrastructure that capitalizes on the talents and expertise of a multi-disciplinary group of investigators that span basic science, clinical research, epidemiology, data informatics and biostatistics. We have been highly productive in addressing our previous Aims and key questions in contemporary care and public health relevant to adult PWH. Our strengths are especially relevant to the goals of the US DHHS Ending the HIV Epidemic (EHE) initiative, uniquely providing the broad geographic and demographic scope, established scientific platform, large sample size, extensive longitudinal follow-up of >1.3 million person-years, and depth of clinical data to inform the goals of EHE with rich data on those who will continue to survive with HIV after transmission is halted. With the onset of the COVID-19 pandemic, questions regarding the impact of COVID-19 on HIV outcomes and trends in HIV indicators, as well as longer-term outcomes of COVID-19 among PWH, can be answered in the NA-ACCORD. Within this context, we present three broadly-defined aims for the next funding cycle: Aim 1: Characterize the longitudinal course of HIV treatment, progression and outcomes in North America in the setting of the EHE initiative, which will increase the number and heterogeneity of those in HIV care as HIV treatment and the long-term challenges of living with HIV continue to evolve. Aim 2: To assess and characterize the clinical course of HIV infection in North America, with a focus on major non-AIDS comorbidities and co-infections, multimorbidity and comorbidity- free life expectancy. Aim 3: To expand and extend our state-of-the art epidemiologic, biostatistical, and data science methodologic approaches. The NA-ACCORD is a world-class collaboration of established HIV cohorts well-positioned to a) provide in-depth understanding of the longitudinal course of HIV when extraordinary efforts are being made to EHE; b) collaborate with the other IeDEA regions to inform the future HIV epidemics in low- and middle-income regions; and c) understand differences in HIV treatment, outcomes and prognostic factors that will inform future research and HIV care globally.