International Epidemiologic Databases to Evaluate AIDS - Southern Africa (IeDEA-SA)

评估南部非洲艾滋病的国际流行病学数据库合作组织（IeDEA-SA） 与艾滋病毒连续护理有关的两个关键、相关的总体研究目的：㈠全球监测 艾滋病毒护理、抗逆转录病毒疗法和 （二）为艾滋病毒相关的并发症提供最佳治疗和实施指南， 资源有限环境中的艾滋病毒及其合并症。这些领域将在整个生命过程中进行检查 从怀孕到婴儿（感染和接触艾滋病毒）、儿童、青少年和成人，通过区域和 在IEDEA-SA联盟内外开展多区域研究。 抗逆转录病毒疗法的大规模推广正在改变艾滋病毒的流行，艾滋病的发病率也相应下降， 相关死亡和母婴传播，以及通过获得更好的 药物、实验室测试和卫生系统创新。维持和改善来之不易的削减， 艾滋病毒相关的发病率和死亡率，我们需要了解和优化艾滋病毒的长期结果， 包括在整个生命过渡期保持护理，预防和治疗与 感染和非传染性疾病（如癌症、心血管疾病和精神健康） 疾病），并解决药物滥用的影响。因此，IEDEA-SA的具体目标是：1）研究 艾滋病毒和结核病（TB）护理从诊断到长期结果的连续性; 2）研究 合并感染（结核病、B型肝炎）、心血管和代谢合并症; 3）研究 艾滋病毒阳性儿童和成人的癌症; 4）研究艾滋病毒/抗逆转录病毒疗法的连续性，特别是长期结果， 艾滋病毒阳性母亲及其子女，从怀孕到接触未感染的婴儿，再到感染的婴儿， 儿童和青少年; 5）研究精神卫生和精神卫生保健的提供; 6）研究物质 （7）开发和应用最新技术， 统计方法、数据统一标准、数据收集和联系工具。常规队列数据 近900，000名艾滋病毒阳性者（60，000名注册时<13岁）将因与死亡率的联系而得到加强 和其他疾病数据库（如癌症和结核病）以及有针对性的额外数据收集，包括 跟踪研究，以尽量减少死亡率和并发症的不确定性，和现场调查。自始至终， 将制定和使用处理常规队列数据中偏倚的统计方法。 南部非洲是艾滋病毒/结核病流行的中心（整个地区的艾滋病毒流行率为10-27%）， IEDEA-SA包括最多的成人和儿童。IEDEA-SA能够很好地解决 其目标是通过其长期和成功的跟踪记录之间的合作，流行病学和业务 伯尔尼大学和开普敦大学的领导层， 南部非洲和其他非洲数据交换所区域，以及卫生组织、艾滋病规划署和其他信息消费者。

The International epidemiologic Databases to Evaluate AIDS in Southern Africa (IeDEA-SA) Collaboration has two key, related overarching research purposes related to the continuum of HIV care: (i) Global surveillance and evaluation of access to, effectiveness and outcomes of HIV care, antiretroviral therapy (ART) and HIV-related comorbidity programs (ii) Informing optimal treatment and implementation guidelines for HIV and its comorbidities in resource-limited settings. These areas will be examined across the life course from pregnancy to infants (HIV-infected and exposed), children, adolescents and adults, through regional and multiregional studies, within and beyond the IeDEA-SA consortium. The HIV epidemic is being transformed by massive ART expansion with corresponding declines in AIDS- related deaths and mother-to-child transmission, as well as ART improvements through access to better drugs, laboratory tests and health system innovations. To sustain and improve on hard-won reductions in HIV-related morbidity and mortality, we need to understand and optimize long-term HIV outcomes, including retention in care across life transitions, prevention and treatment of co-morbidity with infections and non-communicable diseases (e.g. cancer, cardiovascular disease and mental health disorders) and address the impact of substance abuse. Hence, IeDEA-SA specific aims are: 1)To study the continuum of HIV and tuberculosis (TB) care from diagnosis through to long-term outcomes; 2)To study co-infections (TB; hepatitis B), cardiovascular and metabolic co-morbidities; 3)To study the burden and care of cancers in HIV+ children and adults; 4) To study the HIV/ART continuum especially long-term outcomes in HIV+ mothers and their children, from pregnancy to exposed uninfected infants through to infected infants, children and adolescents; 5) To study mental health and mental health care provision; 6) To study substance use in adolescents and adults on ART, with a cross-cutting aim (7) To develop and apply state-of-the-art statistical methods, data harmonization standards, data collection and linkage tools. Routine cohort data of nearly 900,000 HIV+ individuals (60,000 <13 years old at enrolment) will be enhanced by linkage to mortality and other disease databases (e.g. cancer and TB) together with targeted additional data collection including tracing studies to minimize mortality and co-morbidity under-ascertainment, and site surveys. Throughout, statistical methods addressing biases in routine cohort data will be developed and used. Southern Africa is the epicenter of the HIV/TB epidemic (HIV prevalence of 10-27% across the region), and IeDEA-SA includes the largest number of adults and children. IeDEA-SA is well-placed to address the specific aims through its long and successful track-record of collaboration between the epidemiologic and operational leadership at the Universities of Bern and Cape Town, clinical, scientific and programmatic experts across Southern African and other IeDEA regions, as well as with WHO, UNAIDS and other information consumers.