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(IeDEA-SA)合作 与持续的艾滋病毒护理有关的两个关键的、相关的总体研究目的：(1)全球监测 和评价艾滋病毒护理、抗逆转录病毒疗法(抗逆转录病毒疗法)和 艾滋病毒相关共病方案(二)通报最佳治疗和实施准则 在资源有限的情况下，艾滋病毒及其共病。这些区域将在整个生命过程中进行检查 从怀孕到婴儿(感染艾滋病毒和接触艾滋病毒)、儿童、青少年和成人，通过区域和 IeDEA-SA联盟内外的多区域研究。 随着艾滋病的相应下降，艾滋病毒的流行正在通过大规模的抗逆转录病毒治疗扩张而发生变化。 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。在来之不易的基础上继续减少和改善 对于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， 包括在生命过渡期间保留护理，预防和治疗与 感染和非传染性疾病(例如癌症、心血管疾病和精神健康 精神障碍)，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)从诊断到长期结果的连续护理；2)研究 合并感染(结核病；乙肝)、心血管和代谢并存；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#年的长期结果 艾滋病毒携带者母亲及其子女，从怀孕到接触到未感染的婴儿，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)研究实质 在青少年和成人中使用ART，具有交叉目标(7)以开发和应用最先进的技术 统计方法、数据统一标准、数据收集和联系工具。的常规队列数据 近90万艾滋病毒感染者(登记时为13岁)将因与死亡率挂钩而得到加强 和其他疾病数据库(例如癌症和结核病)，以及有针对性的额外数据收集，包括 跟踪研究，以最大限度地减少死亡率和共同发病率，在确定的情况下，以及现场调查。自始至终， 将开发和使用处理常规队列数据中的偏差的统计方法。 南部非洲是艾滋病毒/结核病流行的中心(整个区域艾滋病毒流行率为10%-27%)，以及 IeDEA-SA包括最多的成人和儿童。IeDEA-SA非常适合解决特定的 旨在通过其长期和成功的流行病学和业务合作记录 伯尔尼大学和开普敦大学的领导力，临床、科学和方案专家 南部非洲和其他IeDEA地区，以及世卫组织、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.