Multicenter AIDS Cohort Study

描述（由申请人提供）： 本申请是多中心艾滋病队列研究（MACS）合作协议（1 U 01 AI 035041）匹兹堡部分竞争性更新的B部分，是CAMACS提交的A部分复合申请的附件。MACS始于1983年，是对男男性行为者（MSM）艾滋病自然史的纵向研究。这一请求是为匹兹堡MACS中MSM队列的临床随访和实验室检测提供额外五年的支持。匹兹堡MACS的广泛目标是实现A部分主MACS应用程序的特定目标，并在匹兹堡当地进行专门研究，以提高我们在治疗干预以及免疫和预防性疫苗开发方面的流行病学和发病机制知识。我们的具体目标是确定MSM中HIV感染的长期自然史和治疗史，描述对HIV治疗的反应，包括心理和行为预测因素，检查HIV和长期HIV治疗暴露对脂肪代谢障碍，糖尿病，心血管疾病，肝病，恶性肿瘤，神经认知功能，物质使用，肾脏疾病和其他结果的影响，评估衰老对HIV和HIV治疗临床过程的影响，检查宿主遗传学和HIV之间的相互作用，定义HIV发病机制，描述HIV相关癌症的特征，包括识别风险因素，确定影响HIV传播和疾病进展的社会行为因素，描述合并感染及其对艾滋病毒疾病进展的影响，检查药物滥用对抗逆转录病毒治疗有效性的影响，保持纵向收集的流行病学数据和生物标本库，作为促进自然史和发病机制研究的平台，在匹兹堡MACS对MSM进行临床和实验室检测，包括T细胞亚群、抗HIV抗体、HIV病毒载量、B型肝炎病毒和丙型肝炎病毒检测、血脂/胰岛素/葡萄糖水平、肝功能检测、肾功能和心血管研究。这项研究与NIH治疗和预防HIV感染和艾滋病的使命直接相关。相关性：作为MACS研究联盟的一部分，匹兹堡MACS建议继续对艾滋病毒/艾滋病的自然史进行为期25年的科学调查。这项研究提供了深入了解艾滋病毒感染的机制，艾滋病毒治疗的效果，以及艾滋病毒感染的治疗性和预防性疫苗的开发。它与美国国立卫生研究院的艾滋病毒/艾滋病公共卫生项目高度相关。

DESCRIPTION (provided by applicant): This application is Part B of a competing renewal to the Pittsburgh component of the Multicenter AIDS Cohort Study (MACS) Cooperative Agreement (1 U01 AI035041), the companion to the Part A composite application that is being submitted by CAMACS. The MACS began in 1983 as a longitudinal study of the natural history of AIDS in men who have sex with men (MSM). This request is for an additional five years of support for clinical follow-up and laboratory testing of the cohort of MSM in the Pittsburgh MACS. The broad objectives of the Pittsburgh MACS are to fulfill the specific aims of the Part A master MACS application, and do special studies locally in Pittsburgh to enhance our epidemiologic and pathogenesis knowledge in relation to treatment intervention, and development of immunotherapeutic and prophylactic vaccines. Our specific aims are to determine the long-term natural and treated history of HIV infection in MSM, characterize the responses to HIV therapy, including psychological and behavioral predictors, examine the effects of HIV and prolonged HIV therapy exposure on lipodystrophy, diabetes, cardiovascular disease, liver disease, malignancies, neurocognitive function, substance use, kidney disease, and other outcomes, assess the effects of aging on the clinical course of HIV and HIV therapy, examine the interaction between host genetics and HIV, define HIV pathogenesis, characterize HIV-associated cancers including identification of risk factors, determine socio-behavioral factors that affect HIV transmission and disease progression, characterize concomitant infections and their effects on HIV disease progression, examine the effects of substance abuse on antiretroviral treatment effectiveness, maintain longitudinally collected epidemiological data and biological specimen repository as a platform to facilitate natural history and pathogenesis studies, perform clinical and lab testing of MSM in the Pittsburgh MACS, including T-cell subsets, anti-HIV Ab, HIV viral load, hepatitis B virus and hepatitis C virus testing, serum lipid/insulin/glucose levels, liver function tests, renal function and cardiovascular studies. This research has direct relevance to the mission of the NIH to cure and prevent HIV infection and AIDS. RELEVANCE: As part of the MACS research consortium, the Pittsburgh MACS proposes to continue its 25 year scientific investigation into the natural history of HIV/AIDS. This research provides insight into the mechanisms of HIV infection, the effects of HIV therapy, and development of therapeutic and preventative vaccines for HIV infection. It is highly relevant to HIV/AIDS public health programs of the NIH.