ANTIRETROVIRAL THERAPY AND LONG-TERM CLINICAL OUTCOMES

描述(改编自申请S摘要)：最新进展 抗逆转录病毒治疗极大地改变了治疗和临床 艾滋病毒感染者的结局。治疗的目标已经从 延缓HIV疾病进展和死亡以抑制病毒复制 尽可能长时间低于定量水平以允许免疫学 改善和临床稳定。然而，现在有一个不断增长的 经常无法维持病毒抑制的患者比例，尽管 改变和更复杂的治疗方案。候选人假设S 在临床环境中，与临床试验环境相比， 稳步上升的患者比例不会有持续的抑制 从长远来看，病毒复制的可能性。更好地定义仿制药 纵向泌尿外科与免疫学指标的关系及意义 大量抗逆转录病毒药物的长期临床结果 可用的组合，对临床医生来说将变得越来越重要。在……里面 此外，有必要评估早期和早期的潜在生存益处。 长期有效的抗逆转录病毒治疗与长期疗效的关系 与治疗相关的事件，如神经病和代谢并发症 (如高脂血症、高血糖)、与健康相关的生活质量和 质量调整后的生存。补充和扩展来自以下位置的信息 临床疗效试验，研究人员提出了一种流行病学 艾滋病无病生存预测因素及质量调整的研究 接受有效联合治疗的艾滋病毒感染者的存活率 抗逆转录病毒疗法。为此，她开发了一种计算机化的 华盛顿大学的医疗信息系统捕捉到 中国HIV诊所人群的实时临床实践信息 西北方向。收集有关艾滋病毒的全面纵向信息 在这个诊所的感染患者，可能会使候选人发展 对强效病毒的病毒学、免疫学和临床反应的一系列测量 最能预测长期临床结果的抗逆转录病毒治疗。这个 被指导者以病人为中心提供的指导和额外培训 研究奖将为候选人提供一个致力于 利用临床信息研究问题的重大努力 系统，并发展必要的技能，以追求研究生涯 将流行病学方法和卫生服务研究结合起来。

DESCRIPTION (adapted from the application s abstract): Recent advances in antiretroviral therapy have dramatically changed the treatment and clinical outcomes for persons with HIV infection. The goal of therapy has expanded from delaying HIV disease progression and death to suppressing viral replication below the level of quantitation for as long as possible to permit immunologic improvement and clinical stabilization. However, now there is a growing proportion of patients who cannot maintain viral suppression often despite changing and more complex therapeutic regimens. The candidate hypothesis s that in the clinic setting, in contrast to the clinical trials setting, a steadily increasing proportion of patients will not have sustained suppression of viral replication over the long-term. Better definition of the generic relationship between longitudinal urologic and immunologic measures and long-term clinical outcomes across the enormous number of antiretroviral combinations available, will become increasingly essential to clinicians. In addition, there is a need to assess potential survival benefits of early and prolonged potent antiretroviral treatment in relation to the long-term effects of treatment-related events, such as neuropathy and metabolic complications (e.g. hyperlipidemia, hyperglycemia), on health-related quality-of-life and quality-adjusted survival. To complement and extend information available from clinical efficacy trials, the investigator proposes an epidemiological investigation of predictors of AIDS-free survival and quality-adjusted survival among HIV infected individuals receiving potent combination antiretroviral therapies. For this purpose, she has developed a computerized medical information system at the University of Washington that captures real-time clinical practice information for an HIV clinic population in the Northwest. Collection of comprehensive longitudinal information about HIV infected patients in this clinic setting, may enable the candidate to develop sets of measures of virologic, immunologic, and clinical responses to potent antiretroviral treatment that best predict long-term clinical outcomes. The mentoring and additional training provided by the Mentored Patient-Oriented Research Award will provide the candidate with an opportunity to devote significant efforts to research questions using the clinical information system and to develop the skills necessary to pursue a research career that blends epidemiological approaches and health services research.