Seek and Treat for Optimal Prevention of HIV & AIDS (STOP HIV/AIDS) in BC

寻求和治疗以最佳预防艾滋病毒

基本信息

项目摘要

DESCRIPTION (provided by applicant): This application requests funding to undertake innovative research on a large-scale population-based Seek, Test, Treat and Retain (STTR) initiative. The Province of British Columbia (Canada) has embarked upon one of the world's largest and most advanced STTR initiatives, which was renewed in November 2012. The universal healthcare system within the province provides all medical care, including highly active antiretroviral therapy (HAART) and substance abuse treatment, free of charge. Extensive confidential record linkages allow the accurate attainment of all key measures, including health service utilization and HIV clinical outcomes. Taking advantage of this initiative and a large linked database, as well as the interdisciplinary research capacity of the British Columbia Centre for Excellence in HIV/AIDS (Vancouver), herein we propose a program of rigorous and innovative study that will marshal epidemiologic, clinical, geographic, and phylogenetic approaches to critically inform efforts to respond to HIV transmission and pathogenesis among HIV-infected individuals, with a particular emphasis on individuals who inject drugs (IDU). Specifically, we seek to augment our ongoing epidemiologic and clinical research activities with molecular genetics and geographic information systems (GIS) based methods to model the effect of this STTR initiative on the generation of antiretroviral drug resistance and HIV incidence. As well, we will use novel phylogenetic methods and next generation sequencing to assess the suitability of new HIV diagnoses as a surrogate for HIV incidence. In order to aid in the optimization of STTR approaches, we will also identify patterns and predictors of engagement in and leakage from the "Cascade of Care' among IDU. Lastly, by integrating GIS with phylogenetic data, we will identify unrecognized foci of HIV transmission throughout the province. This proposal comes at a time of international consensus on the need to respond urgently to elevated levels of HIV-related morbidity and mortality, particularly among IDU. Evidence from mathematical modeling, observational cohorts and clinical trials has revealed the close link between HAART access and the risk of HIV transmission between individuals, resulting in markedly lower rates of infection in populations with higher levels of coverage of HAART. This observation has led to renewed HIV prevention efforts to seek out members of vulnerable populations, test them for HIV infection, and engage them in healthcare, including treatment for HIV infection, in order to reduce HIV-related morbidity and mortality and lower HIV incidence. Given the research infrastructure established to date and our track record in undertaking novel and high impact research on STTR, we are uniquely well placed to prospectively assess key second-generation questions regarding the impact of STTR on engagement in treatment and care, HAART resistance, and HIV incidence. The work proposed herein is strongly aligned with the priorities in the FY 2013 Trans-NIH Plan for HIV-Related Research.
描述(由申请人提供):本申请申请资金用于开展基于大规模人群的寻找、测试、治疗和保留(STTR)计划的创新研究。不列颠哥伦比亚省(加拿大)启动了世界上最大、最先进的STTR计划之一,该计划于2012年11月获得续签。该省的全民医疗保健系统免费提供所有医疗服务,包括高效抗逆转录病毒治疗和药物滥用治疗。广泛的保密记录联系可以准确地实现所有关键措施,包括保健服务的利用和艾滋病毒的临床结果。利用这一倡议和一个大型关联数据库,以及不列颠哥伦比亚省艾滋病毒/艾滋病卓越中心(温哥华)的跨学科研究能力,我们在此提出一项严格和创新的研究方案,该研究将汇集流行病学、临床、地理和系统发育方法,为应对艾滋病毒感染者之间的艾滋病毒传播和发病机制的努力提供重要信息。特别强调注射毒品的个人。具体来说,我们试图通过基于分子遗传学和地理信息系统(GIS)的方法来增强我们正在进行的流行病学和临床研究活动,以模拟这一STTR倡议对抗逆转录病毒药物耐药性和艾滋病毒发病率的影响。此外,我们将使用新的系统发育方法和下一代测序来评估新的HIV诊断作为HIV发病率替代指标的适用性。为了帮助优化STTR方法,我们还将确定IDU中“护理级联”的参与和泄漏的模式和预测因素。最后,通过将GIS与系统发育数据相结合,我们将在全省范围内确定未被识别的艾滋病毒传播焦点。这项建议是在国际上就需要紧急应对与艾滋病毒有关的发病率和死亡率上升,特别是在注射吸毒者中,达成共识的时候提出的。来自数学模型、观察性队列和临床试验的证据表明,获得高效抗逆转录病毒治疗与艾滋病毒在个体之间传播的风险之间存在密切联系,从而导致在高效抗逆转录病毒治疗覆盖率较高的人群中感染率显著降低。这一观察结果导致重新开展艾滋病毒预防工作,寻找弱势群体成员,对他们进行艾滋病毒感染检测,并使他们参与包括艾滋病毒感染治疗在内的保健工作,以减少与艾滋病毒有关的发病率和死亡率,并降低艾滋病毒发病率。鉴于迄今为止建立的研究基础设施以及我们在开展新颖和高影响力的STTR研究方面的记录,我们具有独特的优势,可以前瞻性地评估关于STTR对参与治疗和护理,HAART耐药性和HIV发病率的影响的关键第二代问题。本文提出的工作与2013财年跨nih艾滋病相关研究计划的优先事项密切相关。

项目成果

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Julio Sergio Gonzalez Montaner其他文献

Julio Sergio Gonzalez Montaner的其他文献

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{{ truncateString('Julio Sergio Gonzalez Montaner', 18)}}的其他基金

Seek and Treat for Optimal Prevention of HIV & AIDS (STOP HIV/AIDS) in BC
寻求和治疗以最佳预防艾滋病毒
  • 批准号:
    8841486
  • 财政年份:
    2013
  • 资助金额:
    $ 63.14万
  • 项目类别:
Seek and Treat for Optimal Prevention of HIV & AIDS (STOP HIV/AIDS) in BC
寻求和治疗以最佳预防艾滋病毒
  • 批准号:
    8598694
  • 财政年份:
    2013
  • 资助金额:
    $ 63.14万
  • 项目类别:
Seek and Treat for Optimal Prevention of HIV & AIDS (STOP HIV/AIDS) in BC
寻求和治疗以最佳预防艾滋病毒
  • 批准号:
    8805837
  • 财政年份:
    2013
  • 资助金额:
    $ 63.14万
  • 项目类别:
Seek and Treat for Optimal Prevention of HIV & AIDS (STOP HIV/AIDS) in BC
寻求和治疗以最佳预防艾滋病毒
  • 批准号:
    9228352
  • 财政年份:
    2013
  • 资助金额:
    $ 63.14万
  • 项目类别:
Seek and Treat for Optimal Prevention of HIV & AIDS (STOP HIV/AIDS) in BC
寻求和治疗以最佳预防艾滋病毒
  • 批准号:
    8661741
  • 财政年份:
    2013
  • 资助金额:
    $ 63.14万
  • 项目类别:
Seek and Treat for Optimal Prevention of HIV & AIDS (STOP HIV/AIDS) in BC
寻求和治疗以最佳预防艾滋病毒
  • 批准号:
    9126802
  • 财政年份:
    2013
  • 资助金额:
    $ 63.14万
  • 项目类别:
An empirical investigation into recovery from illicit drug abuse using recurrent
使用经常性方法对非法药物滥用的康复进行实证研究
  • 批准号:
    8372718
  • 财政年份:
    2012
  • 资助金额:
    $ 63.14万
  • 项目类别:
An empirical investigation into recovery from illicit drug abuse using recurrent
使用经常性方法对非法药物滥用的康复进行实证研究
  • 批准号:
    8508164
  • 财政年份:
    2012
  • 资助金额:
    $ 63.14万
  • 项目类别:
An empirical investigation into recovery from illicit drug abuse using recurrent
使用经常性方法对非法药物滥用的康复进行实证研究
  • 批准号:
    8690000
  • 财政年份:
    2012
  • 资助金额:
    $ 63.14万
  • 项目类别:
Seek and Treat for Optimal Outcomes and Prevention in HIV & AIDS in IDU
寻求和治疗艾滋病毒的最佳结果和预防
  • 批准号:
    8334069
  • 财政年份:
    2008
  • 资助金额:
    $ 63.14万
  • 项目类别:
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