Central Africa International Epidemiologic Database to Evaluate AIDS

项目负责人/主要研究者（Anastasis，Kathryn Nash Denis）： 项目摘要 消除艾滋病毒感染作为人类疾病和死亡的一个原因，实现“艾滋病毒零传播” 已经被艾滋病研究和治疗界认为是可以实现的。艾滋病护理和 治疗方案在整个非洲实施，需要在研究和政策方面取得重大进展， 护理和治疗资源可以得到最佳利用：减少新的艾滋病毒传播， 和艾滋病毒相关的发病率和死亡率。在最大限度地提高公众的最重要的挑战之一， 艾滋病毒护理和治疗方案的健康益处是艾滋病毒感染的诊断较晚， 高比例的晚期抗逆转录病毒治疗开始，这反过来又与高死亡率有关， 临床管理和持续的艾滋病毒传播。此外，还有一些临床问题尚未得到解答， 对于撒哈拉以南非洲（SSA）的艾滋病毒感染者， 在降低艾滋病毒相关的发病率（和死亡率）方面非常有效，但艾滋病毒与 代谢疾病和其他衰老状况（如癌症），以及营养不足或营养过剩的影响， 没有很好的定义。四年前，我们作为CA-IeDEA获得了新的资助，建立了一个新的中非IeDEA（CA- （1），有1）。编译和管理约52，000例患者的二级源患者水平数据， 从现有的电子数据和新的地面系统中提取，以有效地捕获临床 低资源临床环境中的数据; 2.）在科学上具有很高的生产力，发表了20多篇论文， 数据收集正在进行中; 3.）继续培养非洲领导力， 容量我们现在建议适度增加数据库（约80，000例患者），以增加 艾滋病毒在本区域的地理代表性以及在服务提供战略和成功方面， 扩大我们的实施科学方法，以优化短期和长期艾滋病毒护理成果， 中非和全球继续调查具有临床影响的流行病学问题，重点是 关于衰老和女性生殖健康的共病。 OMB编号0925-0001/0002（2012年8月批准至2015年8月31日修订版）页码续页格式页码

Program Director/Principal Investigator (Anastos, Kathryn Nash Denis): Project Summary Elimination of HIV infection as a cause of human illness and death, and achieving "zero HIV transmission" have been embraced by the AIDS research and treatment communities as achievable. As HIV care and treatment programs are implemented throughout Africa, critical advances in research and policy are needed, so that care and treatment resources can be deployed to optimal benefit: decreasing both new HIV transmissions and HIV-related morbidity and mortality. Among the most important challenges to maximizing the public health benefits of HIV care and treatment programs are late diagnosis of HIV-infection, low rates of linkage to care, and high rates of late ART initiation which in turn are associated with high rates of mortality, more costly clinical management and continued HIV transmission. In addition there remain unanswered clinical questions for persons living with HIV (PLWH) even with optimal ART. For PLWH in SubSaharan Africa (SSA), ART has been highly effective in decreasing HIV-related morbidity (and mortality), but the association of HIV with metabolic diseases and other conditions of aging (e.g. cancers), and the impact of under- or over-nutrition are not well defined. Newly funded as CA-IeDEA four years ago, we have built a new Central Africa IeDEA (CA- IeDEA), and have 1.) Compiled and managed secondary source patient-level data on ~52,000 patients through both extraction from existing electronic data and new on-the-ground systems for efficient capture of clinical data in low-resource clinical settings; 2.) Been highly productive scientifically with >20 publications even while data collection was in development, and 3.) have continued to foster African leadership and build local research capacity. We propose now to increase the database modestly (to ~80,000 patients) to increase the representativeness of HIV in the region geographically and in service delivery strategies and success and to expand our implementation science approaches to optimize short- and long-term HIV care outcomes both in Central Africa and globally, continue to investigate epidemiologic questions with clinical impact, with a focus on the comorbidities of aging and women's reproductive health. OMB No. 0925-0001/0002 (Rev. 08/12 Approved Through 8/31/2015) Page Continuation Format Page