Acute HIV-1 Infections Network Core

预防艾滋病毒-1感染需要比目前更详细的艾滋病毒-1传播知识。通过动物实验和临床转化研究，对HIV-1致病机制的认识已经取得了巨大的进展。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，以及如果可能的话，研究“传播对”才能获得。不幸的是，事实证明，识别和研究这些主题非常困难。首先，在新生的或完全表达的免疫反应形成之前，大多数研究人员无法找到可信数量的受试者。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提前进行研究。 或“最近”感染的患者在血清转换后，经常将这些受试者与急性艾滋病毒-1感染混为一谈进行分析。我们和其他人试图更准确地定义艾滋病毒-1感染的第一阶段，并开发技术，在艾滋病毒-1传播后，在血清转换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：目的1.建立由美国、英国、南非、马拉维、坦桑尼亚、乌干达、冈比亚、博茨瓦纳和赞比亚的站点组成的CHAVI急性HIV-1感染网络；目标2.建立用于识别急性HIV感染患者、传播对和暴露于HIV-1的患者和未感染的患者的标准操作程序；目标3.建立样本采集、样本处理、样本运输和样本存储的标准操作程序；以及目标4.将选择急性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，通过建立CHAVI AHI网络，Core B将向CHAVI调查人员提供患者样本，用于对真正的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.