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

项目概要 高血压及相关疾病基于设施的筛查研究提案 感染艾滋病毒/艾滋病的年轻人的非传染性疾病 (HANDY) 向 家长培训补助金 EXPAND (D43TW012280) 的目标是建立长期 结构化的硬技能和软技能培训和指导，以指导早期职业尼日利亚研究人员 国际研究中心的独立调查员和研究领导力 尼日利亚人类病毒学研究所 (IRCE-IHVN) 的卓越奖。艾哈迈德·阿里尤博士，前 Fogarty 实习生，目前担任监测和监测高级技术顾问 (STA) IHVN 的评估 (M&E) 将主导本补充文件的执行。除了来自的支持 具有研究青少年艾滋病毒（Sam Agudu 博士）和艾滋病毒相关专业知识的 MPI 暴露的未感染者（Abimiku 博士）； Aliyu 博士将接受另外两名教师的指导； IHVN 的 Dakum 博士和马里兰大学医学院 (UMSOM) 的 Stafford 博士，均为 UMSOM 流行病学和公共卫生副教授，拥有艾滋病毒和艾滋病毒方面的专业知识 老化。拟议的补充将解决我们对影响的理解中的关键差距 非传染性疾病 (NCD) 等合并症对总体健康和老龄化的影响 感染艾滋病毒的青少年和年轻人 (AYALWH)。 获得持久且可耐受的抗逆转录病毒治疗 (ART) 已将 HIV 转变为一种 慢性病并显着延长了预期寿命。1 如今，一名年轻人患有 艾滋病毒感染者和接受抗逆转录病毒治疗的患者的总体寿命预计与普通人群相似；然而，他们 与没有感染艾滋病毒的年轻人相比，他们的无合并症预期寿命可能更短。 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），15-34 岁的青少年和年轻人的艾滋病毒年发病率最高 年。2 文献中有大量证据表明加速 HIV 感染引起的生物衰老以及围产期相关的临床表现 HIV 感染者 (PHIV) 和一般 PLWH。3 事实上， 非传染性疾病会因 DNA 损伤、端粒缩短和不可逆氧化而加速衰老 4 其他证据还表明，HIV 感染和 ART 的使用会加剧早发 老年综合征，并建议早期筛查和进一步研究老年综合征的合并症 ART.5,6 艾滋病毒感染者和老龄化问题的研究 在尼日利亚很少，在青少年和年轻人中则更少。现有研究还 建议进一步研究接受抗逆转录病毒治疗的感染者中的非传染性疾病。 HANDY 将在 总统艾滋病紧急救援计划 (PEPFAR) 计划实施的背景 IHVN，并将解决国家多部门行动计划 (NMSAP) 中的优先领域： 2019-2025 年非传染性疾病预防和控制。 HANDY 将重点关注这两个具体目标： 1. 确定高血压和相关代谢紊乱的患病率 与 HIV 暴露者和未感染者 (HEU) 以及 HIV 暴露者和未感染者相比 未感染（HUU）的年轻人。 2. 提高高血压及相关代谢紊乱的早期发现率 AYALWH，以及与护理的联系以进行适当的管理和护理 采用横断面研究设计，HANDY 将从三组中招募 450 名参与者： 150 PHIV、150 HEU 和 150 HUU 18-24 岁年轻人。潜力来源人群 研究参与者参与了 PEPFAR 支持的三零行动 (OTZ) 地点的护理工作 联邦首都特区 (FCT) 和纳萨拉瓦获得 IHVN 支持，其中 7,127 人符合资格 个人目前正在接受护理。 （参见表1）。将收集有关历史的数据 既往子宫内 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 检测高血压和相关代谢紊乱 2) 转诊接受专门护理和 预防并发症的管理，预防早期和晚期后遗症 3) 降低发病率 以及患有相关非传染性疾病的患者的死亡率。 该项目减轻了非传染性疾病的负担并增加了获得护理和治疗的机会