Acute HIV-1 Infections Network Core

预防 HIV-1 感染需要比目前更详细的 HIV-1 传播知识。通过动物实验和临床转化研究，在了解 HIV-1 发病机制方面取得了巨大进展。但最关键的信息只能通过对新感染（急性）HIV-1 的受试者进行深入研究来获得，如果可能的话，还需要研究“传播对”。不幸的是，事实证明识别和研究这些主题非常困难。首先，大多数研究人员在出现新生或完全表达的免疫反应之前无法找到可靠数量的受试者。因此，许多希望记录与 HIV-1 传播相关的病毒学和免疫学事件的研究人员被迫“尽早”研究 或血清转化后“最近”感染的患者，并且在分析中经常将这些受试者与急性 HIV-1 感染混为一谈。我们和其他人试图对 HIV-1 感染第一阶段的定义更加精确，并开发技术来在 HIV-1 传播后、血清转化之前尽快研究受试者及其性伴侣。因此，本研究提出了四个具体目标： 目标 1. 建立由美国、英国、南非、马拉维、坦桑尼亚、乌干达、冈比亚、博茨瓦纳和赞比亚站点组成的 CHAVI 急性 HIV-1 感染 (AMI) 网络，目标 2. 建立标准操作程序，以识别急性 HIV 感染患者、传播对以及暴露于 HIV-1 且未感染的患者，目标 3. 为样本采集、样本处理、样本运输和样本存储，以及目标 4. 将选定的急性 HIV-1 感染 (AHI) 网络站点从 AHI 站点过渡到疫苗试验站点 在 7 年的 CHAVI 资助期内。因此，通过CHAVI AHI网络的建立，Core B将向CHAVI研究人员提供患者样本，以对真正的HIV-1急性感染患者进行一系列关键研究。

Prevention of HIV-1 infection requires a more detailed knowledge of HIV-1 transmission than is currently available. Tremendous progress on understanding the pathogenesis of HIV-1 has been made through animal experiments and by clinical translational research. But the most critical information can only be obtained through intensive study of subjects with newly acquired (acute) HIV-1, and if at all possible, the study of "transmission pairs". Unfortunately, it has proven remarkably difficult to identify and study such subjects. First, most investigators have been unable to find a credible number of subjects before a nascent or fully expressed immune response has developed. As a consequence, many investigators wishing to document virologic and immunologic events associated with HIV-1 transmission are forced to study "early" or "recently" infected patients after seroconversion, and often lump these subjects together with acute HIV-1 infections in their analyses. We and others have tried to introduce more precision to the definitions of the first stages of HIV-1 infection, and to develop techniques to study subjects and their sexual partners as soon as possible after HIV-1 transmission before seroconversion. Thus, four specific aims are proposed in this study: Aim 1. To establish the CHAVI Acute HIV-1 Infection (AMI) Network comprised of sites in the US, England, South Africa, Malawi, Tanzania, Uganda, Gambia, Botswana, and Zambia, Aim 2. To establish standard operating procedures for identifying patients with acute HIV infection, transmission pairs, and patients that are HIV-1 exposed and uninfected, Aim 3. To establish standard operating procedures for sample acquisition, sample processing, sample transportation, and sample storage, and Aim 4. To transition select Acute HIV-1 Infection (AHI) Network sites from AHI sites to vaccine trial sites over the 7 year CHAVI funding period. Thus, through the establishment of the CHAVI AHI network, Core B will provide the patient samples to CHAVI investigators for a series of critical studies on truly HIV-1 acutely infected patients.