Mentoring in Global Patient-Oriented HIV Research in the Era of COVID-19 and Universal ART

COVID-19 和通用 ART 时代全球以患者为导向的艾滋病毒研究的指导

• 批准号: 10483694
• 负责人: SHAHIN LOCKMAN
• 金额: $ 19.4万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-03-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10483694
• 关键词: 2019-nCoV; AIDS/HIV problem; Address; Adult; Africa; African; African ancestry; Age; Antimicrobial Resistance; Area; Behavior; Birth; Body Weight Changes; Body mass index; Botswana; COVID-19; COVID-19 pandemic; COVID-19 vaccination; COVID-19 vaccine; Child; Child Development; Child Health; Clinical; Clinical Research; Communicable Diseases; Communities; Country; Data; Databases; Development; Diabetes Mellitus; Enrollment; Environment; Epidemic; Evolution; Exposure to; Faculty; Fumarates; Funding; Future; Genomics; Glycosylated hemoglobin A; Goals; Grant; Growth; Guidelines; HIV; HIV Infections; HIV antiretroviral; HIV risk; HIV-1; Health; Human immunodeficiency virus test; Incidence; Income; Individual; International Maternal Pediatric Adolescent AIDS Clinical Trials; Laboratory Research; Lead; Long COVID; Malaria; Maternal and Child Health; Mentors; Mentorship; Metabolic syndrome; Mutation; Outcome; Pattern; Persons; Population; Positioning Attribute; Postpartum Women; Pregnancy; Pregnancy Outcome; Pregnant Women; Prevalence; Prevention trial; Protocols documentation; Randomized; Recurrence; Regimen; Research; Research Personnel; Research Project Grants; Resource-limited setting; Resources; Risk Factors; Role; SARS coronavirus; SARS-CoV-2 infection; Sampling; Secure; Southern Africa; Students; Tenofovir; Testing; Time; Toxic effect; Training; Treatment Protocols; Tuberculosis; Vaccinated; Variant; Viral; Weight Gain; Woman; adverse pregnancy outcome; antenatal; antiretroviral therapy; behavioral outcome; cardiometabolic risk; cardiometabolism; career; co-infection; cohort; coronavirus disease; data resource; design; excessive weight gain; experience; follow-up; infection rate; maternal weight; metabolic rate; neurodevelopment; neuropsychiatric symptom; next generation; pandemic disease; pathogen; patient oriented; patient oriented research; perinatal HIV; postpartum weight; pregnant; prenatal exposure; randomized trial; severe COVID-19; skills; treatment arm; treatment program

Project Summary / Abstract The primary purpose of this K24 renewal proposal is to support mentorship by Dr. Lockman of early career investigators from the US and Africa in conducting global patient-oriented research. This next generation of investigators will need to tackle ongoing global infectious disease epidemics (such HIV, COVID-19, tuberculosis, malaria, and antimicrobial resistance) and to respond rapidly to future emerging pandemics and pathogens. Effective mentorship of early career investigators to conduct clinical research in resource- constrained settings requires substantial time and effort by experienced mentors, and the need for such mentors exceeds their availability. The initial K24 project period permitted Dr. Lockman to successfully mentor more than 20 early career investigators (half of them from Africa) to lead clinical research projects, many of whom were able to quickly respond to the severe COVID-19 epidemic in Botswana because of prior training. This K24 grant also allowed Dr. Lockman to gain additional skills in designing and conducting patient-oriented research in resource-constrained settings with a focus on HIV (particularly in pregnancy) and COVID-19. Currently, nearly one in five adults in many sub-Saharan African countries is living with HIV; the impact of HIV co-infection on COVID-19 clinical outcomes and on SARS-CoV-2 viral evolution in settings with both very high HIV prevalence and high COVID incidence are unknown. In addition, the impact of widely used HIV antiretroviral treatment (ART) regimens during pregnancy on birth outcomes and on long-term maternal and child health and development are not well understood. The research aims of this project, which Dr. Lockman will mentor early career investigators from Africa and the US to lead, include studies of the role of HIV co- infection in several aspects of SARS-CoV-2 infection in Botswana -- specifically, the impact of HIV infection on long COVID and on the emergence of SARS-CoV-2 mutations/variants, by SARS-CoV-2 vaccination status. Additional mentored aims will evaluate the impact of different ART regimens during pregnancy on cardiometabolic factors in women (specifically, pregnancy and postpartum weight gain, and markers of diabetes and metabolic syndrome in pregnancy), and the association between these cardiometabolic factors and pregnancy outcomes and child health/growth. Dr. Lockman’s mentees will use existing data and samples for these aims, including from studies that she leads (multi-country IMPAACT 2010/VESTED randomized trial of 3 ART regimens in pregnancy and a new R01-funded study of child developmental/behavioral outcomes after in utero exposure to different maternal ART regimens in Botswana) and from stored clinical SARS-CoV-2 samples and related electronic routine health databases in Botswana. Dr. Lockman will also help her mentees access a wealth of other existing data, resources, and co-mentors. The overarching goal of this K24 renewal proposal is to help expand sustained capacity to conduct high-impact patient-oriented research in Africa by supporting the mentorship and training of early career investigators.

项目概要/摘要 此 K24 更新提案的主要目的是支持洛克曼博士对早期职业生涯的指导 来自美国和非洲的研究人员进行全球以患者为导向的研究。这下一代 研究人员需要应对持续的全球传染病流行（例如 HIV、COVID-19、 结核病、疟疾和抗菌素耐药性）并快速应对未来新出现的流行病和 病原体。对早期职业研究人员进行有效指导，以开展资源方面的临床研究 有限的环境需要经验丰富的导师投入大量的时间和精力，并且需要这样的 导师超出了他们的可用性。最初的 K24 项目期间，Lockman 博士成功指导了 超过 20 名早期职业研究人员（其中一半来自非洲）领导临床研究项目，其中许多 由于之前的培训，他们能够快速应对博茨瓦纳严重的 COVID-19 疫情。 这笔 K24 拨款还让洛克曼博士获得了设计和实施以患者为中心的额外技能。 在资源有限的环境中进行研究，重点是艾滋病毒（特别是怀孕期间）和 COVID-19。 目前，在许多撒哈拉以南非洲国家，近五分之一的成年人感染了艾滋病毒；艾滋病毒的影响 在两者都非常高的环境中，混合感染对 COVID-19 临床结果和 SARS-CoV-2 病毒进化的影响 HIV 患病率和新冠肺炎高发病率尚不清楚。此外，广泛使用的艾滋病毒的影响 妊娠期间抗逆转录病毒治疗 (ART) 方案对出生结局以及长期孕产妇和 儿童健康和发育尚不十分了解。 Lockman博士该项目的研究目的 将指导来自非洲和美国的早期职业研究人员领导，包括对艾滋病毒共同作用的研究 博茨瓦纳 SARS-CoV-2 感染的几个方面——特别是 HIV 感染对 根据 SARS-CoV-2 疫苗接种状况，了解长期新冠病毒 (COVID-19) 以及 SARS-CoV-2 突变/变体的出现。 其他指导目标将评估怀孕期间不同 ART 方案对患者的影响 女性的心脏代谢因素（特别是怀孕和产后体重增加，以及 糖尿病和妊娠期代谢综合征），以及这些心脏代谢因素之间的关联 以及妊娠结局和儿童健康/生长。洛克曼博士的学员将使用现有的数据和样本 为了这些目标，包括她领导的研究（多国 IMPAACT 2010/VESTED 随机试验 怀孕期间的 3 种 ART 治疗方案以及一项由 R01 资助的新的儿童发育/行为结果研究 在博茨瓦纳子宫内接受不同孕产妇 ART 治疗方案后）和储存的临床 SARS-CoV-2 博茨瓦纳的样本和相关电子常规健康数据库。洛克曼博士也将帮助她的学员 访问大量其他现有数据、资源和共同导师。 K24 更新的总体目标 该提案旨在帮助扩大在非洲开展高影响力的以患者为导向的研究的持续能力 支持早期职业调查员的指导和培训。