Longitudinal Study of HIV and Aging in Brazil

巴西艾滋病毒与老龄化的纵向研究

• 批准号: 10616796
• 负责人: Jessica L Castilho
• 金额: $ 69.47万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10616796
• 关键词: Adult; Affect; Age; Age Years; Aging; Area; Assessment tool; Atherosclerosis; Automobile Driving; Biological; Biology of Aging; Brazil; Canada; Cardiometabolic Disease; Caribbean region; Caring; Central America; Cessation of life; Chagas Disease; Chronic; Cities; Clinical; Clinical Research; Clinical assessments; Collaborations; Country; Cytomegalovirus; Data; Development; Disease; Elderly; Epidemic; Epidemiology; Evaluation; Geriatric Assessment; Geriatrics; Germany; HIV; HIV Infections; Health Policy; Hospitalization; Human Herpesvirus 8; Human T-lymphotropic virus 1; Immunologics; Immunology; Impaired cognition; Income; Individual; Induction of Apoptosis; Infection; Inflammation; Inflammatory; Institution; Knowledge; Laboratories; Latin America; Life Expectancy; Ligands; Link; Long-Term Effects; Longitudinal Studies; Lymphocyte; Macrophage; Measures; Mediating; Medical Economics; Morbidity - disease rate; Neurocognitive Deficit; Observation in research; Older Population; Onset of illness; Outcome; Pathogenesis; Pathway interactions; Persons; Positioning Attribute; Productivity; Protein Isoforms; Quality of life; Recording of previous events; Research; Research Personnel; Resources; Risk Factors; Screening procedure; Socioeconomic Factors; Source; South America; Standardization; Syndrome; TNF gene; Toxoplasmosis; Translational Research; Trypanosoma cruzi; Tuberculosis; United States; United States National Institutes of Health; Validation; Viral; antiretroviral therapy; behavioral economics; chemokine; chronic infection; co-infection; comorbidity; cytokine; disability; early onset; effective therapy; epidemiologic data; epidemiology study; experience; falls; frailty; functional decline; human old age (65+); improved; infection burden; inflammatory marker; insight; low and middle-income countries; mitochondrial dysfunction; modifiable risk; mycobacterial; novel; pathogen; predict clinical outcome; prospective; public health relevance; recruit; risk prediction; risk stratification; senescence; social health determinants; socioeconomics; syndemic; telomere; translational study

Project Summary / Abstract This study will investigate the epidemiology, clinical implications, and immunologic and infectious determinants of aging-related diseases and outcomes in older people with HIV (PWH) in Brazil. In part a result of the long- term effects of HIV infection and ongoing inflammation, older PWH experience high rates of non-communicable diseases (NCDs) and early onset of geriatric syndromes including frailty, disability, and cognitive decline. However, HIV is not alone as a chronic infection that can cause inflammation and other immunological changes associated with these outcomes. Our knowledge of how other chronic infections endemic to low-and middle-income countries affect the pathogenesis and epidemiology of geriatric syndromes in is lacking. A middle-income country with a large population of older PWH, Brazil has a history of comprehensive HIV care as well as endemic chronic infections. This diverse, longitudinal study will recruit PWH on antiretroviral therapy ≥50 years of age in three Brazilian cities (n=360 ages 50-64years and n=340 ages ≥65 years) to evaluate the ways coinfections such as TB, HTLV-1, Chagas disease, toxoplasmosis, and others affect the epidemiology and immunologic pathways of aging-related morbidity. We will examine the association of syndemics of coinfections and social determinants of health with validated NCDs. We will prospectively evaluate how individual and cumulative burden of coinfections predict incident geriatric syndromes. We will evaluate a novel screening tool to assess vulnerability of older PWH for adverse clinical outcomes including death, hospitalization, and new disability. This study will also investigate how coinfections affect biologic pathways of inflammation which contribute to development of NDCs and geriatric syndromes Building upon established and productive collaborations in HIV observational research in Latin America, this study is uniquely positioned to provide urgently needed, high-quality data to understand aging with HIV in a global context. It will offer novel insights into a diversity of infectious contributions to cellular mechanisms of aging experienced by PWH around the globe.

项目概要/摘要 本研究将调查流行病学、临床意义以及免疫学和感染性决定因素 巴西艾滋病毒感染者 (PWH) 与衰老相关的疾病和结果。部分原因是长期 HIV 感染和持续炎症的长期影响，老年感染者非传染性疾病发生率很高 疾病 (NCD) 和早发的老年综合症，包括虚弱、残疾和认知能力下降。 然而，艾滋病毒并不是唯一一种可以引起炎症和其他免疫学问题的慢性感染。 与这些结果相关的变化。我们对其他慢性感染如何流行于低收入和低收入人群的了解 中等收入国家缺乏影响老年综合症的发病机制和流行病学。一个 巴西是拥有大量老年感染者的中等收入国家，拥有全面艾滋病毒护理的历史 以及地方性慢性感染。这项多样化的纵向研究将招募感染者接受抗逆转录病毒治疗 巴西三个城市的 ≥50 岁人士（n=360 名 50-64 岁，n=340 名 ≥65 岁）来评估 结核病、HTLV-1、恰加斯病、弓形体病等合并感染影响流行病学的方式 和衰老相关发病的免疫途径。我们将研究以下综合症的关联性： 经验证的非传染性疾病的合并感染和健康的社会决定因素。我们将前瞻性地评估如何 合并感染的个体和累积负担可预测老年综合征的发生。我们将评估一本小说 用于评估老年感染者对不良临床结果（包括死亡）的脆弱性的筛查工具 住院治疗和新的残疾。这项研究还将调查合并感染如何影响生物途径 炎症有助于 NDC 和老年综合征的发展 拉丁美洲艾滋病毒观察研究方面的富有成效的合作，这项研究具有独特的定位 提供急需的高质量数据，以了解全球范围内艾滋病毒导致的老龄化情况。它将提供新颖的 深入了解感染者对衰老细胞机制的多样性贡献 地球仪。