Studies of Ocular Complications of AIDS - Chairman's Office

艾滋病眼部并发症的研究 - 主席办公室

• 批准号: 7891072
• 负责人: Douglas A Jabs
• 金额: $ 43.34万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7891072
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adverse effects; Area; Blindness; Cataract; Chairperson; Clinical; Clinical Treatment; Clinical Trials; Cohort Studies; Complication; Contrast Sensitivity; Cytomegalovirus Retinitis; Data; Diabetes Mellitus; Diagnosis; Disease; Enrollment; Epidemic; Epidemiologic Studies; Genetic; Guidelines; HIV; HIV Infections; Highly Active Antiretroviral Therapy; Hyperlipidemia; Immune; Immunologics; Incidence; Insulin Resistance; Longitudinal Studies; Metabolic; National Eye Institute; Newly Diagnosed; Opportunistic Infections; Outcome; Pathogenesis; Patient Recruitments; Patients; Prevalence; Progress Reports; Randomized Clinical Trials; Reading; Recovery; Recruitment Activity; Request for Applications; Research; Research Design; Resources; Risk; Risk Factors; Scientific Advances and Accomplishments; Speed; Vision; Visual Fields; Visual impairment; Visual system structure; cohort; experience; follow-up; genetic risk factor; human subject; improved; prospective; response; trend

DESCRIPTION (provided by applicant): The Studies of the Ocular Complications of AIDS Research Group is dedicated to understanding and improving the outcomes of the ocular complications of AIDS. The Longitudinal Study of the Ocular Complications of AIDS (LSOCA) is a prospective cohort study of these complications and their outcomes in the era of highly active antiretroviral therapy (HAART), and is currently in its ninth year of follow-up. Unlike most cohort studies of HIV-infected patients, which enroll from selected risk groups, LSOCA enrolls patients with AIDS from all risk groups. As of 31 December 2006 the LSOCA cohort has recruited 2024 patients, of whom 448 have cytomegalovirus retinitis and 18 have other ocular opportunistic infections (Ols). Although HAART has decreased the incidence of ocular Ols among patients with AIDS, new cases continue to occur, and there is an increasingly large number of patients with AIDS and ocular Ols who have experienced immune recovery. Although short-term outcomes have been described, no long-term data are available, and the durability of the response to HAART among these patients is unknown. Long-term data are critical for assessing resource needs and determining management guidelines. There also are abnormalities of the visual system among patients with AIDS without ocular Ols, manifested as decreased contrast sensitivity, often of sufficient magnitude to impair reading speed, and as visual field loss. Little is known about the pathogenesis of, the risk factors for, and the course of this neuroretinal disorder, particularly its long-term consequences. In addition, there appears to be an increased prevalence of cataract among patients with AIDS without ocular Ols, which may be aggravated by the metabolic side effects of HAART, such as diabetes and hyperlipidemia. Host genetic factors have a substantial effect on the course of HIV infection, but their effect on the incidence and course of ocular complications is unknown. The immunologic mechanisms underlying ocular complications also need to be elucidated better. The LSOCA cohort will address the ongoing need for long-term data in these areas. The specific aims of this proposal are to evaluate the following among patients with AIDS: 1) the long-term outcomes of ocular Ols; 2) visual impairment among patients without ocular Ols; and 3) host genetic risk factors for and immunologic mechanisms of ocular complications and their outcomes.

描述(申请人提供)：艾滋病眼部并发症研究研究组致力于了解和改善艾滋病眼部并发症的结局。艾滋病眼部并发症纵向研究(LSOCA)是在高效抗逆转录病毒治疗(HAART)时代对这些并发症及其结果进行的前瞻性队列研究，目前已进入第九个随访年头。与大多数艾滋病毒感染患者的队列研究从选定的风险组登记不同，LSOCA从所有危险组登记艾滋病患者。截至2006年12月31日，LSOCA队列已经招募了2024名患者，其中448人患有巨细胞病毒性视网膜炎，18人患有其他眼部机会性感染(OLS)。尽管HAART降低了艾滋病患者眼部OLS的发生率，但新病例不断出现，越来越多的艾滋病患者和眼部OLS经历了免疫恢复。虽然已经描述了短期结果，但没有长期数据可用，这些患者对HAART的反应的持久性尚不清楚。长期数据对于评估资源需求和确定管理方针至关重要。在没有眼部OLS的艾滋病患者中，也有视觉系统的异常，表现为对比敏感度降低，通常程度足以影响阅读速度，以及视野丧失。关于这种神经视网膜疾病的发病机制、危险因素和病程，特别是其长期后果，人们知之甚少。此外，在没有眼部OLL的艾滋病患者中，白内障的发病率似乎有所增加，这可能会因HAART的代谢副作用而加剧，如糖尿病和高脂血症。宿主遗传因素对HIV感染过程有实质性影响，但其对眼部并发症的发生率和病程的影响尚不清楚。眼部并发症的免疫学机制也需要更好地阐明。LSOCA队列将解决这些领域对长期数据的持续需求。这项建议的具体目的是评估艾滋病患者中的以下方面：1)眼部OLL的长期结果；2)非眼部OLS患者的视力损害；以及3)眼部并发症及其后果的宿主遗传危险因素和免疫学机制。