Core G: Clinical and Comorbidity Research

项目总结/文摘

Project Summary/Abstract Antiretroviral therapy (ART) has dramatically altered HIV disease progression, but emerging complications of HIV from chronic immune activation and metabolic changes when the virus is largely suppressed are driving morbidity and mortality in the contemporary ART era. PWH develop cardiovascular disease (CVD), diabetes, cancer, cognitive and functional decline at ages 10-15 years younger than uninfected controls. Geriatric syndromes such as frailty and multimorbidity are becoming increasingly prevalent in PWH, leading to more hospitalizations and deaths. Thus, there is an urgent need for research on aging in PWH. The 2023-28 CCR Core will leverage an unparalleled combination of resources developed over 25 years to support interdisciplinary clinical, epidemiologic, socio-behavioral, translational, and basic research at the interface of HIV and aging through the following specific aims. AIM 1. Target expansion of the UW HIV Information System, UW HIV Cohort and novel IT to support emerging HIV research priorities: develop, test, and scale innovative technologies to ascertain new data and adjudicate key comorbid outcomes and extend these platforms to multi-center HIV research consortia such as the CFAR Network of Integrated Clinical Systems (CNICS). AIM 2. Improve clinical outcomes through comorbidity research at the intersection of HIV and aging: foster an inclusive, collaborative research environment engaging local experts and ESI in HIV- associated Comorbidity Research Collaborations (CRCs) conducting high-impact research focused on prevention and treatment of CVD, metabolic, neurologic, pulmonary, liver disease, cancer, aging and emerging priorities such as COVID-19 in PWH. CCR Core leadership of large multi-center HIV networks, such as CNICS and the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), facilitates access to data and specimens for PWH across North America, increasing the scope and generalizability of research. AIM 3. Support clinical, translational and basic HIV research and enhance community engagement: provide high-quality clinical data, consultation on feasibility and study design, analytic datasets with adjudicated outcomes (e.g., strokes) and patient-reported outcomes (PROs) such as current substance use, specimens, and eligible study participants from a single entity. The Core will connect study teams to clinical teams and the community to inform research priorities, facilitate study implementation and better engage with underrepresented groups to advance equity and inclusion. AIM 4: Mentor the next generation of HIV investigators: CCR Core multidisciplinary mentorship team with expertise in epidemiology, data science, health informatics, biostatistics, clinical medicine, basic and translational research will train ESI in study design, methods (qualitative, quantitative), statistical analysis, manuscript and grant writing, and facilitate participation in CRCs and multi-center HIV networks (e.g., CNICS, NA-ACCORD, International epidemiologic Databases to Evaluate AIDS (IeDEA) consortium) to support development of the next generation of HIV researchers.