CVD and inflammation across the lifespan in HIV infected adults and children

HIV 感染成人和儿童一生中的 CVD 和炎症

• 批准号: 8705011
• 负责人: Joseph Austin Delaney
• 金额: $ 15.75万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-22 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8705011
• 关键词: Accounting; Adolescence; Adolescent; Adult; Affect; Age; Aging; Ambulatory Care Facilities; Anti-Retroviral Agents; Atherosclerosis; Biological Markers; Blood; Blood Pressure; Blood Vessels; C-reactive protein; CD4 Positive T Lymphocytes; Calcium; Cardiovascular Diseases; Cardiovascular system; Carotid Arteries; Cell Count; Cessation of life; Child; Cholesterol; Clinical; Coagulation Process; Cohort Studies; Coronary Arteriosclerosis; Coronary artery; Data; Data Coordinating Center; Diabetes Mellitus; Diastolic blood pressure; Disease; Disease Association; Disease Outcome; Drops; Dyslipidemias; Elderly; Enrollment; Epidemiology; Event; Fibrin fragment D; General Population; Goals; Grant; Grouping; HIV; HIV Infections; Hemostatic Agents; Hemostatic function; Image; Immune; Individual; Infection; Inflammation; Interleukin-6; Intervention; Investigation; Laboratories; Lead; Light; Lipids; Literature; Longevity; Malnutrition; Measurement; Measures; Mediating; Meta-Analysis; Methodology; National Heart, Lung, and Blood Institute; Nature; Participant; Pathogenesis; Patients; Persons; Pharmaceutical Preparations; Population; Publishing; RNA; Reading; Research; Research Methodology; Risk; Risk Factors; Sample Size; Serum; Smoking; Staging; Stratification; Subgroup; Thick; Time; Triad Acrylic Resin; Ultrasonography; Vascular Diseases; age effect; age related; antiretroviral therapy; base; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular risk factor; cohort; demographics; evidence base; experience; hemodynamics; inclusion criteria; innovation; intima media; middle age; novel; patient population; public health relevance; screening

DESCRIPTION: We have little understanding of how the epidemiology of cardiovascular disease (CVD) and the value of CVD risk factors may evolve with aging in the HIV-infected population. Now that HIV has become a lifelong condition with the advent of effective antiretroviral therapy, this is of great concern. If risk factors for CVD are to be applied for cliical risk stratification in a evidence- based fashion, better data are needed across the age spectrum. The overarching goal of this proposal is to study how determinants of CVD change with aging among HIV-infected persons. Prior cohort studies, by applying similar research approaches to many cohorts across the age spectrum, have revealed much about the influence of age on the epidemiology of CVD. As has long been recognized, not only does CVD risk increase with aging, but the risk factors for CVD differ across early and later life. For example, while elevated cholesterol is unquestionably a causal CVD risk factor, in older adult's serum cholesterol levels have a weak, inconsistent relationship with incident and prevalent CVD. Elevated blood pressure (BP) and C-reactive protein, also known CVD risk factors, likewise are profoundly age-dependent. These phenomena have not been studied in the HIV-infected patient population. We plan an R21 proposal that will significantly extend and build upon the NHLBI HIV-CVD Consortium, which includes 9 R01 investigations on atherosclerotic CVD in adults and children with HIV. Coordination is provided by a Data Coordinating Center (DCC), Central Laboratory, and 3 specialized Reading Centers that have measured CVD risk factors, blood biomarkers, and noninvasive vascular images in identical fashion in the Consortium's nearly 5,000 enrolled subjects. Scientific aims will involve the identification of risk factors, including standard clinial CVD risk factors such as lipids, blood pressure and diabetes, as well as novel biomarkers of inflammation and hemostasis that are associated with the presence of subclinical atherosclerosis in patient groups across the lifespan from adolescence, through young-to- middle adulthood and later decades of adulthood.

描述：在HIV感染人群中，心血管疾病(CVD)的流行病学和心血管疾病危险因素的价值如何随着年龄的增长而演变，我们知之甚少。现在，随着有效的抗逆转录病毒疗法的出现，艾滋病毒已经成为一种终生疾病，这一点非常令人担忧。如果心血管疾病的风险因素要以循证的方式应用于临床风险分层，则需要更好的跨年龄段的数据。这项建议的首要目标是研究艾滋病毒感染者心血管疾病的决定因素如何随着年龄的增长而变化。先前的队列研究，通过对不同年龄段的许多队列应用类似的研究方法，揭示了许多关于年龄对心血管疾病流行病学的影响。正如早就认识到的那样，不仅心血管疾病的风险随着年龄的增长而增加，而且心血管疾病的危险因素在生命的早期和后期是不同的。例如，虽然提升了 毫无疑问，胆固醇是导致心血管疾病的危险因素，在老年人中，血清胆固醇水平与心血管疾病的发病和流行有微弱的、不一致的关系。血压升高和C反应蛋白，也是已知的心血管疾病危险因素，同样与年龄密切相关。这些现象还没有在艾滋病毒感染患者群体中进行研究。我们计划一项R21提案，该提案将显著扩展和建立NHLBI艾滋病毒-心血管疾病联盟，该联盟包括9项关于成人和儿童艾滋病毒携带者动脉粥样硬化性心血管疾病的R01研究。协调由一个数据协调中心(DCC)、中央实验室和三个专业阅读中心提供，这三个中心以相同的方式在该联盟的近5,000名登记受试者中测量了心血管疾病风险因素、血液生物标志物和无创血管图像。科学目标将涉及识别风险因素，包括标准的临床心血管疾病风险因素，如血脂、血压和糖尿病，以及新的炎症和止血生物标记物，这些因素与从青春期到中青年和成年后数十年的患者组中亚临床动脉粥样硬化的存在有关。