The Asia-Pacific HIV Observational Database (APHOD)

描述(申请人提供)：许多艾滋病毒疾病及其治疗方法来自发达国家，主要是高加索人。然而，在许多重要方面，亚洲的艾滋病毒感染与其他地区不同。艾滋病毒感染的流行病学是不同的，包括大规模注射吸毒流行。丙型肝炎和乙型肝炎的混合感染率很高。艾滋病毒感染的自然历史不同，进展速度更快，机会性感染的范围也不同。有新的证据表明，抗逆转录病毒(ARV)治疗在亚洲人群中的药理学和毒性是不同的。结合种族和经济发展等差异，以及抗逆转录病毒治疗机会的迅速扩大，研究亚洲人群中的艾滋病毒疾病和治疗势在必行。这项研究旨在研究亚洲艾滋病毒疾病的自然病史和治疗方法，并评估与高加索人群的差异。具体研究将着眼于抗逆转录病毒治疗的疗效和毒性。艾滋病毒和结核病(TB)的研究，包括艾滋病毒和结核病治疗的相互作用，以及免疫重建疾病，将是一个重要的焦点。将评估抗逆转录病毒治疗的长期效果，包括死亡原因的趋势，以及与年龄和行为匹配的艾滋病毒阴性组的比较。亚太艾滋病毒观察数据库结合了治疗亚洲艾滋病毒观察数据库和澳大利亚艾滋病毒观察数据库，这两项既定研究覆盖了南亚、东南亚和东亚以及澳大利亚的39个地点，并跟踪了亚洲约1 750人和澳大利亚约2 329人。这两项研究都是观察性的，收集了人口统计学、治疗、疾病结局和毒性数据。一个特别的优势是根据亚洲和澳大利亚相同的方法收集和编码毒性和结果数据，从而能够直接比较亚洲人和高加索人的人口。这两项研究都使用了一种数据收集的电子传输方法，这种方法已证明具有很高的成本效益，同时满足严格的数据准确性水平。相关性：亚洲(不包括中国)拥有世界三分之一以上的人口，2005年约有700万艾滋病毒携带者。众所周知，与其他地区相比，亚洲的艾滋病毒流行病学、自然病史和抗逆转录病毒治疗结果在许多重要方面都有所不同。与此同时，抗逆转录病毒疗法正在迅速扩大。亚太艾滋病毒观察数据库旨在审查亚洲艾滋病毒疾病的自然历史和治疗情况，并与主要在澳大利亚的高加索人口比较结果，以了解该区域艾滋病毒疾病的最佳护理和治疗情况。

DESCRIPTION (provided by applicant): Much that informs HIV disease and its treatment is derived from the developed world, mainly Caucasian populations. However, in many important respects HIV infection in Asia differs from other regions. The epidemiology of HIV infection is different, including large injecting drug use epidemics. Co-infection rates with hepatitis C and B are substantial. The natural history of HIV infection differs with faster progression rates and a different spectrum of opportunistic infections. There is emerging evidence that the pharmacology and toxicity of antiretroviral (ARV) treatments in Asian populations are different. Combined with differences such as ethnicities and economic development, and the coincident rapid expansion of ARV treatment access, the study of HIV disease and treatment in Asian populations is imperative. This study seeks to examine HIV disease natural history and treatment in Asia, and to assess differences with Caucasian populations. Specific studies will look at the efficacy and toxicity of ARV treatments. Studies of HIV and tuberculosis (TB), including HIV and TB treatment interactions, and immune reconstitution disease will be an important focus. The long-term effects of ARV treatments will be assessed, including trends in causes of death and comparisons with an age and behavior-matched HIV-negative group. The Asia-Pacific HIV Observational Database combines the TREAT Asia HIV Observational Database and the Australian HIV Observational Database, two established studies covering 39 sites in South, South East and East Asia and Australia, and following some 1750 individuals in Asia and 2329 in Australia. Both studies are observational, collecting demographic, treatment, disease outcome and toxicity data. A particular strength is having toxicity and outcome data collected and coded according to identical methods in Asia and Australia, allowing straightforward comparison of Asian and Caucasian populations. Both studies use an electronic transfer method of data collection that has demonstrated to be highly cost efficient while meeting stringent levels of data accuracy. Relevance: Asia (excluding China) is home to over one third of the world's population, and in 2005 some 7 million people living with HIV. It is known that in many important respects HIV epidemiology, natural history and ARV treatment outcomes differ in Asia compared with other regions. Simultaneously, ARV treatment is rapidly expanding. The Asia-Pacific HIV Observational Database aims to examine HIV disease natural history and treatment in Asia, and compare outcomes with Caucasian populations, principally in Australia, to inform optimal care and treatment for HIV disease in the region.