Washington Women's Interagency HIV/AIDS Study

描述（由申请人提供）：自1993年以来，华盛顿大都会WIHS（WMW）联盟招募并保留了一个HIV感染和未感染妇女的代表性社区队列，目的是支持NIAID了解当前HIV流行病学、风险行为、疾病进展、治疗吸收和结局以及相关合并症。感染妇女的早期队列正在老化，年龄和绝经状态对疾病结局和合并症的影响尚待阐明。WMW已经与全国各地的中心和华盛顿大都市的网站合作，以解决这些问题。这一点特别重要，因为华盛顿特区的艾滋病毒流行率是美国所有城市中心中最高的，而且妇女工作组已经招募并保留了一个在种族和心理社会方面代表妇女的队列。WMW成功地参与了WIHS协议的所有内容，并积极支持国家WIHS的基础设施。WMW研究人员参与了所有主要的WIHS科学倡议。此外，凭借其丰富的数据库以及地方和国家标本库，WMW支持了旨在了解合并症基础病理生理学的地方和国家举措。WMW建议继续开展这项工作，并通过继续与国家WIHS在方案制定、实施、子研究参与和新举措确定方面的密切合作关系来扩大其研究组合。此外，对于下一轮的复宁，我们提出了新的举措，包括基于电话的抑郁症干预，这将对依从性和健康行为产生积极影响，目标是减少社区病毒载量。这种干预可以很容易地在更大的DC社区中实施。我们正在扩大我们的艾滋病毒和丙型肝炎病毒相关的肝脏疾病的本地倡议，通过聘请一组研究人员在探索宿主反应，表观遗传因素，以及蛋白质糖基化在肝脏疾病和癌症。我们还将继续并扩大我们对与老龄化人群长期生存相关的器官特异性发病率的研究，目的是减少或预防血管健康，神经认知能力下降和阴道免疫反应等领域的发病率。我们将通过与在这些领域具有成熟专业知识的国家和地方研究人员合作，进一步利用NIH对这一重要女性群体的投资来实现这一目标。这将使我们能够更好地确定感染艾滋病毒的妇女的地位，并实现无艾滋病一代和为已感染者提供有效和可持续治疗的目标。

DESCRIPTION (provided by applicant): Since 1993, the Washington Metropolitan WIHS (WMW) Consortium has enrolled and retained a representative community cohort of HIV-infected and uninfected women with the purpose of supporting NIAID in understanding the current epidemiology of HIV, risk behaviors, disease progression, treatment uptake and outcomes, and related co-morbidities. The early cohort of infected women is aging, and the effects of age and menopausal status on disease outcomes and co-morbidities is yet to be elucidated. The WMW has joined with centers around the country and with sites across metropolitan Washington, DC to address these issues. This is particularly pertinent as Washington, DC has the highest prevalence of HIV of any urban center in the U.S. and the WMW has enrolled and retained a cohort that represents women both ethnically and psychosocially. The WMW has successfully participated in all elements of the WIHS protocol and has actively supported the infrastructure of the national WIHS. WMW investigators have participated in all of the major WIHS scientific initiatives. Additionally, with its rich data baseand local and national specimen repository, the WMW has supported local and national initiatives designed to understand the pathophysiology underlying co-morbidities. The WMW proposes to continue this work and to expand its research portfolio by continuing its strong collaborative relationship with the national WIHS in the area of protocol development, implementation, sub study participation, and identification of new initiatives. Additionally, for the next cycle of funing we have proposed new initiatives that include a telephone-based intervention for depression that will positively impact adherence and health behaviors with the goal of reducing community viral load. This intervention can easily be implemented in the larger DC community. We are expanding our local initiatives on HIV and HCV associated liver disease by engaging a team of researchers in exploring the host response, epigenetic factors, and protein glycosylation in liver disease and cancer. We will also continue and expand our investigations in organ specific morbidities associated with long-term survival in an aging population with the goal of reducing or preventing morbidity in the areas of vascular health, neurocognitive decline, and the vaginal immunologic response in aging. We will accomplish this by engaging with national and local investigators with proven expertise in these areas to further leverage the NIH investment in this important cohort of women. This will allow us to better define the status of women with HIV and bring to fruition the goals of an AIDS free generation and effective and sustainable treatment for those already infected.