Expanding the pool of Independent Investigators in Implementation Science in Nigeria throug h HIV research training (EXPAND)

通过艾滋病毒研究培训扩大尼日利亚实施科学领域的独立研究者队伍 (EXPAND)

• 批准号: 10872335
• 负责人: Alash'le G. Abimiku
• 金额: $ 10万
• 依托单位: INSTITUTE OF HUMAN VIROLOGY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10872335
• 关键词: Acceleration; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adolescent and Young Adult; Age; Aging; Anthropometry; Area; Biological Aging; Capital; Caring; Centers of Research Excellence; Characteristics; Chronic; Clinical; Cross-Sectional Studies; DNA Damage; Data; Disease; Early Diagnosis; Elderly; Eligibility Determination; Emergency Situation; Epidemiology; Evaluation; Faculty; General Population; Goals; Grant; HIV; HIV Infections; HIV-infected adolescents; HIV/AIDS; Health; Health Services Accessibility; Human; Hypertension; Incidence; Individual; International; Leadership; Life Expectancy; Literature; Longevity; Maryland; Measurement; Mentors; Metabolic Diseases; Monitor; Morbidity - disease rate; Nigeria; Nigerian; Parents; Participant; Perinatal; Persons; Phenotype; Population; Prevalence; Prevention; Public Health; Recommendation; Recording of previous events; Research; Research Design; Research Personnel; Research Project Summaries; Research Proposals; Research Training; Site; Source; Structure; Syndrome; Telomere Shortening; Training; UNICEF; Universities; aged; antiretroviral therapy; career; comorbidity; early onset; early screening; implementation science; improved; medical schools; mid-career faculty; mortality; operation; oxidative damage; patient engagement; prenatal exposure; prevent; programs; recruit; screening; skills training; virology; young adult

PROJECT SUMMARY The research proposal on facility-based screening for Hypertension and Associated Non-communicable Diseases in young adults living with HIV/AIDS (HANDY) speaks to the aims of the parent training grant EXPAND (D43TW012280), whose goal is to establish long-term structured hard and soft skills training and mentoring to guide early-career Nigerian researchers for independent investigator-ship and research leadership at the International Research Center of Excellence at the Institute of Human Virology Nigeria (IRCE-IHVN). Dr. Ahmad Aliyu, a former Fogarty trainee who currently serves as the Senior Technical Advisor (STA) for Monitoring and Evaluation (M&E) at IHVN will lead the execution of this supplement. In addition to support from the MPIs with relevant expertise in studying adolescents with HIV (Dr. Sam Agudu) and HIV exposed uninfected persons (Dr. Abimiku); Dr. Aliyu will be mentored by two additional faculty; Dr. Dakum at IHVN and Dr. Stafford at University of Maryland School of Medicine (UMSOM), both Associate Professors of Epidemiology and Public Health at UMSOM with expertise in HIV and aging. The proposed supplement will address critical gaps in our understanding of the impact of comorbidities such as non-communicable diseases (NCDs) on general health and aging among Adolescents And Young Adults Living with HIV (AYALWH). Access to durable and tolerable antiretroviral therapy (ART) has transformed HIV into a chronic condition and has dramatically increased life expectancy.1 Today a young person with HIV and on ART can expect an overall lifespan similar to the general population; however, they are likely to have a shorter comorbidity-free life expectancy than young people without HIV. Approximately 12% of the 1.9 million people living with HIV in Nigeria are adolescents (UNICEF, 2019) and annual HIV incidence is highest among adolescents and young adults ages 15-34 years.2 There is overwhelming evidence from the literature that demonstrates accelerated biological aging due to HIV infection and associated clinical manifestations among perinatally- infected person with HIV (PHIV) and PLWH in general.3 Indeed, a characteristic phenotype of NCDs is accelerated aging from DNA damage, telomere shortening and irreversible oxidative damage.4 Additional evidence also shows that HIV infection and use of ART potentiate early onset of geriatric syndrome and recommends early screening and further studies on comorbidities with non-communicable diseases (NCD) among PLWH on ART.5,6 Studies on HIV and aging are scanty in Nigeria and even less in adolescents and young adults. Available studies also recommend further studies on NCDs among PLWH on ART. HANDY will be conducted within the context of Presidents’ Emergency Plan for AIDS Relief (PEPFAR) program implementation by IHVN, and would address a priority area in the National Multi-sectoral Action Plan (NMSAP) for the Prevention and Control of NCDs 2019-2025. HANDY will focus on these two specific aims: 1. To determine the prevalence of hypertension and associated metabolic disorders among PHIV compared to HIV-exposed and uninfected (HEU) and HIV-unexposed and uninfected (HUU) young adults. 2. To improve early detection of hypertension and associated metabolic disorders among AYALWH, and linkage to care for appropriate management and care Using a cross-sectional study design, HANDY will recruit 450 participants from three groups: 150 PHIV, 150 HEU and 150 HUU young adults aged 18-24 years. The source population of potential study participants are engaged in care PEPFAR-supported Operation triple zero (OTZ) sites in Federal Capital Territory (FCT) and Nassarawa supported by IHVN, where 7,127 eligible individuals are currently receiving care. (Refer to Table 1). Data will be collected on history of prior HIV exposure in-utero, HIV sero-status, antiretroviral therapy (ART) status, anthropometry, BP measurement, and screening for metabolic disorders. HANDY achieves the following 1) early detection of HTN and associated metabolic disorders 2) referral for specialized care and management to prevent complications to prevent early and late of sequelae 3) reducing morbidity and mortality among those with associated NCDs. The project reduces the burden of NCDs and increases access to care and treatment

项目摘要 高血压及相关疾病设施筛查研究建议 青年艾滋病毒/艾滋病感染者的非传染性疾病（HANDY）向 父母培训补助金EXPAND（D43 TW 012280）的目标是建立长期的 结构化的硬技能和软技能培训和指导，以指导尼日利亚研究人员的早期职业生涯 国际研究中心的独立研究员和研究领导 尼日利亚人类病毒学研究所（IRCE-IHVN）。Ahmad Aliyu博士，前 Fogarty实习生，目前担任监测和 IHVN的评估（M&E）将领导本补充文件的执行。除了支持， 在研究青少年艾滋病毒感染者（Sam Agudu博士）和艾滋病毒感染者方面具有相关专业知识的MPI 未受感染的接触者（Abimiku博士）; Aliyu博士将由另外两名教员指导; 博士IHVN的Dakum和马里兰州大学医学院（UMSOM）的斯塔福德博士， UMSOM流行病学和公共卫生副教授，具有艾滋病毒和 衰老拟议的补编将解决我们在理解《公约》的影响方面存在的重大差距， 非传染性疾病（NCDs）等并发症对一般健康和老龄化的影响 艾滋病毒感染者青少年和年轻人协会。 获得持久和可耐受的抗逆转录病毒疗法已将艾滋病毒转化为一种 慢性疾病，并大大增加了预期寿命。1今天，一个年轻人与 艾滋病毒感染者和接受抗逆转录病毒治疗者的总体寿命与一般人群相似;然而， 与未感染艾滋病毒的年轻人相比， 尼日利亚190万艾滋病毒感染者中约有12%是青少年（联合国儿童基金会， 2019年），15-34岁的青少年和年轻人的艾滋病毒年发病率最高 2文献中有压倒性的证据表明， 由于艾滋病毒感染和围产期相关临床表现的生物老化， 感染艾滋病毒（PHIV）和PLWH的人。3事实上， 非传染性疾病是由于DNA损伤、端粒缩短和不可逆的氧化作用而加速衰老。 4其他证据也表明，艾滋病毒感染和使用抗逆转录病毒疗法可促进早期发病， 并建议早期筛查和进一步研究老年综合征的合并症， 艾滋病毒/艾滋病感染者中的非传染性疾病（NCD）。 在尼日利亚很少，在青少年和年轻人中更少。现有研究还 建议进一步研究艾滋病毒/艾滋病感染者接受抗逆转录病毒治疗的非传染性疾病。 美国总统艾滋病紧急救援计划（PEPFAR） IHVN，并将处理国家多部门行动计划中的一个优先领域， 《2019-2025年非传染性疾病预防和控制》。HANDY将专注于这两个具体目标： 1.确定高血压和相关代谢紊乱的患病率 与艾滋病毒暴露和未感染者（HEU）和艾滋病毒未暴露者相比， 未感染（HUU）的年轻人。 2.提高高血压和相关代谢紊乱的早期发现， AYALWH，以及与适当管理和护理的护理联系 采用横断面研究设计，HANDY将从三组中招募450名参与者： 艾滋病毒感染者、150名高浓缩铀和150名高浓缩铀使用者，年龄在18-24岁之间。潜在的人口来源 研究参与者参与了PEPFAR支持的“三零行动”（OTZ）现场的护理工作， 联邦首都直辖区（FCT）和Nassarawa由IHVN支持，其中7，127人符合条件 目前正在接受护理。（参见表1）。将收集以下历史数据： 既往宫内HIV暴露、HIV血清状态、抗逆转录病毒治疗（ART）状态、人体测量学， 血压测量和代谢紊乱筛查。HANDY实现了以下目标：1）早期 检测HTN和相关代谢紊乱2）转诊接受专门护理， 预防并发症的管理，以防止早期和晚期后遗症3）降低发病率 和死亡率之间的关系。 该项目减轻了非传染性疾病的负担，增加了获得护理和治疗的机会