The Study of HIV Infection in the Etiology of Lung Disease (SHIELD)

HIV 感染与肺部疾病病因学研究 (SHIELD)

• 批准号: 8102048
• 负责人: Gregory D Kirk
• 金额: $ 87.59万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-28 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8102048
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; African American; Baltimore; Basic Science; Behavioral; Biological; Biometry; Bronchoscopy with Bronchoalveolar Lavage; CD8B1 gene; Cardiac Catheterization Procedures; Cessation of life; Chronic Disease; Chronic Obstructive Airway Disease; Chronic lung disease; Clinic; Clinical; Clinical Data; Cohort Studies; Collaborations; Collection; Communicable Diseases; Data; Development; Disease; Drug usage; Echocardiography; Enrollment; Epidemic; Epidemiology; Etiology; Evaluation; Female; Gender Issues; HIV; HIV Infections; Highly Active Antiretroviral Therapy; Illicit Drugs; Imaging Techniques; Immune; Immunology; Immunosuppression; Incidence; Individual; Infection; Injecting drug user; Intravenous; Investigation; Investments; Link; Lung; Lung diseases; Malignant neoplasm of lung; Maryland; Mediating; Mediator of activation protein; Methods; Microbiology; Monitor; Morbidity - disease rate; Natural History; Opportunistic Infections; Outcome; Parents; Participant; Pathogenesis; Patients; Persons; Population; Prevalence; Pulmonary Emphysema; Pulmonary Hypertension; Pulmonary function tests; Pulmonology; Research; Research Infrastructure; Research Personnel; Resolution; Resources; Respiratory physiology; Risk; Risk Factors; Role; Screening procedure; Site; Smoker; Smoking; Source; Specimen; Spirometry; Sputum; Surgical Oncology; Symptoms; T cell response; Tobacco use; Translational Research; United States National Institutes of Health; Urban Population; X-Ray Computed Tomography; antiretroviral therapy; cancer risk; cohort; experience; follow-up; high risk; high risk men; improved; male; men who have sex with men; mortality; multidisciplinary; neoplasm registry; next generation; novel; programs; prospective; pulmonary arterial hypertension; respiratory; response; success; working group

DESCRIPTION (provided by applicant): Following the introduction of highly active antiretroviral therapy (HAART) and improved survival among HIV-infected persons, non-infectious lung diseases are hypothesized to increase as causes of morbidity and mortality. Limited evidence suggests that HIV-infected persons may be more susceptible to development of emphysema. An increase in lung cancer risk has been observed with HIV infection; we have demonstrated that this risk persists after controlling for heavy tobacco use, among HIV-infected persons. HIV infection is recognized as an independent risk factor for pulmonary hypertension; however accurate characterization of the prevalence and clinical manifestations remains elusive. To address these issues, we propose SHIELD: The Study of HIV Infection in the Etiology of Lung Disease, a collaborative and systematic investigation of lung disease among HIV-infected persons nested within three on-going HIV cohort studies in Baltimore, MD. Our specific aims include: 1) to determine the prevalence, clinical manifestations, and risk factors for chronic obstructive pulmonary disease (COPD) among HIV-infected persons. Prospective evaluation will characterize the effect of HIV infection, immune deficiency, HAART use, pulmonary infections, smoking, and illicit drug use on rates of decline in lung function and on related morbidity and mortality; 2) To determine incidence rates, clinical manifestations, risk factors, and mechanisms for lung cancer among HIV-infected persons, and 3) To determine the prevalence, clinical manifestations, and risk factors for pulmonary arterial hypertension (PAH) among HIV-infected persons. The collective experience of our HIV cohorts spans well over two decades and includes follow-up on more than 11,000 participants; active follow-up of over 4,000 HIV-infected persons are available for inclusion in focused studies of COPD, lung cancer, and PAH. SHIELD represents a consortium of investigators with multidisciplinary expertise in pulmonary medicine, HIV and infectious diseases, surgical oncology, epidemiology and biostatistics, translational imaging techniques, immunology and basic sciences. Given the established collaborative research team, the substantive existing resources and infrastructure, and the strength of our scientific methods, we anticipate a high likelihood of success in characterizing non-infectious lung disease in HIV infection and contributing to an improved understanding of mechanisms involved.

描述（由申请人提供）： 在采用高效抗逆转录病毒疗法（HAART）和提高艾滋病毒感染者的存活率之后，据推测，非传染性肺部疾病作为发病率和死亡率的原因会增加。有限的证据表明，艾滋病毒感染者可能更容易患肺气肿。已观察到艾滋病毒感染者肺癌风险增加;我们已经证明，在艾滋病毒感染者中，在控制大量吸烟后，这种风险仍然存在。艾滋病毒感染被认为是肺动脉高压的一个独立的危险因素;然而，准确的描述患病率和临床表现仍然是难以捉摸的。为了解决这些问题，我们提出了SHIELD：肺部疾病病因学中的HIV感染研究，这是一项在马里兰州巴尔的摩进行的三项正在进行的HIV队列研究中嵌套的HIV感染者肺部疾病的协作和系统调查。我们的具体目标包括：1）确定HIV感染者中慢性阻塞性肺疾病（COPD）的患病率、临床表现和危险因素。前瞻性评价将描述艾滋病毒感染、免疫缺陷、HAART使用、肺部感染、吸烟和非法药物使用对肺功能下降率以及相关发病率和死亡率的影响; 2）确定HIV感染者肺癌的发病率、临床表现、危险因素和机制，3）确定HIV感染者肺癌的患病率、临床表现、和艾滋病毒感染者肺动脉高压（PAH）的危险因素。我们的HIV队列的集体经验跨越了二十多年，包括对11，000多名参与者的随访;对4，000多名HIV感染者的积极随访可纳入COPD，肺癌和PAH的重点研究。SHIELD代表了一个研究者联盟，该联盟具有肺部医学、艾滋病毒和传染病、外科肿瘤学、流行病学和生物统计学、转化成像技术、免疫学和基础科学等多学科的专门知识。鉴于已建立的合作研究团队，大量的现有资源和基础设施，以及我们的科学方法的力量，我们预计成功描述艾滋病毒感染中的非感染性肺部疾病并有助于更好地了解所涉及的机制的可能性很高。