Core G: Clinical Cohort and Comorbidity Research

摘要 抗逆转录病毒疗法（ART）的广泛使用显著改变了艾滋病毒疾病的进程， 提高预期寿命。然而，有证据表明，与年龄相关的合并症的发生率高于 包括心血管疾病和癌症在内的疾病， HIV感染者的多重死亡负担和早期死亡，即使使用病毒抑制性ART。 临床队列和科摩罗研究核心在过去20年中开发的资源 我们独特地支持多学科研究，旨在提高我们对不断发展的 当代ART时代HIV感染的治疗、进展、合并症和结局。我们进入 下一个5年周期，具有完善的临床队列、研究平台、研究招募和样本 收集服务，将得到加强，以服务于越来越多的地方，国家和国际 研究人员和不断扩大的艾滋病毒临床，流行病学，行为，基础和转化科学 施政纲要的演讲我们提出的目标是利用我们的独特性，我们全面积累的病人， 数据具有广泛的临床范围和与生物标本相关的广泛纵向随访， 访问研究参与者，使项目从概念提案到出版物的快速发展。目标1： 我们将扩大UW HIV信息系统，UW HIV临床队列和新的基于网络的平台 捕获和验证必要的新数据，以构建、设计和成功回答 当代艾滋病毒医学和解决未来五年新兴的研究重点。目标2：我们 促进高影响力的临床研究，以促进艾滋病毒相关疾病的预防和治疗。 心血管、代谢、神经、肺、肝脏疾病和癌症，以改善 艾滋病毒携带者。我们将促进与当地专家的艾滋病研究合作， 由早期职业研究者领导，以确定未来的科学方向和目标结果裁定 需要确定HIV相关合并症的临床病程和后果以及 生存的多重威胁。目标3：我们将支持尖端的基础和转化艾滋病毒研究 研究共病的生物学机制，HIV发病机制，进展和方法， 通过招募研究参与者，提供库存标本，并采购方案驱动和 研究人员需要的标本的扩展类型。核心小组提供的服务将 加强和扩大当地研究人员之间的合作，促进与其他核心和科学研究人员的协同作用， 工作组，将早期研究人员与跨学科的知名艾滋病毒科学家联系起来， 与其他CFAR和艾滋病毒研究中心的科学家建立联系，包括通过我们对CFAR的领导 综合临床系统网络，这是抗击全球艾滋病毒流行所必需的。 3

ABSTRACT The widespread use of antiretroviral therapy (ART) has markedly changed the course of HIV disease and increased life-expectancy. However, evidence suggests that higher incidence of age-related comorbidities than would otherwise be expected, including cardiovascular disease and cancer, are contributing to a growing burden of multimorbidity among HIV-infected individuals and early death even with virally-suppressive ART. Resources developed by the Clinical Cohort and Comorbidity Research Core over the past 20 years position us uniquely to support multidisciplinary research designed to improve our understanding of the evolving treatment, progression, comorbidities, and outcomes of HIV infection in the contemporary ART era. We enter this next 5-year cycle with a well-established clinical cohort, research platform, study recruitment and specimen collection service that will be enhanced to serve a growing number of local, national and international investigators and an expanding HIV clinical, epidemiological, behavioral, basic and translational scientific agenda. We are proposing aims that capitalize on our uniqueness, our comprehensive accumulation of patient data with broad clinical scope and extensive longitudinal follow-up linked to biologic specimens, and ready access to study participants that enable projects to move rapidly from concept proposal to publication. Aim 1: We will expand the UW HIV Information System, UW HIV Clinical Cohort, and novel web-based platforms to capture and validate new data necessary to frame, design, and successfully answer central questions in contemporary HIV medicine and address emerging research priorities over the next five years. Aim 2: We will facilitate high-impact clinical research that will advance prevention and treatment of HIV-associated cardiovascular, metabolic, neurologic, pulmonary, liver disease and cancer to improve outcomes among persons aging with HIV. We will promote HIV Comorbidity Research Collaborations with local experts and leadership by early-career investigators to identify future scientific directions and target outcome adjudication required to define the clinical course and consequences of HIV-associated comorbidity and the impact of multimorbidity on survival. Aim 3: We will support cutting-edge basic and translational HIV research investigating biologic mechanisms of comorbid disease, HIV pathogenesis, progression, and approaches to HIV cure by recruiting study participants, providing banked specimens, and procuring protocol-driven and expanded types of specimens that investigators need for their research. Services provided by the Core will strengthen and expand collaboration among local investigators, foster synergy with other Cores and Scientific Working Groups, link early-stage investigators with established HIV scientists across disciplines, and create ties with scientists at other CFARs and HIV research centers, including through our leadership of the CFAR Network of Integrated Clinical Systems, necessary to combat the global HIV epidemic. 3