Longitudinal Study of HIV and Aging in Brazil

项目总结/摘要 本研究将调查流行病学，临床意义，免疫和感染决定因素 巴西老年艾滋病毒感染者（PWH）的衰老相关疾病和结果。部分原因是长期以来- 由于HIV感染和持续炎症的长期影响，老年PWH的非传染性疾病发生率很高， 疾病（NCD）和老年综合征的早期发作，包括虚弱、残疾和认知下降。 然而，艾滋病毒并不是唯一的慢性感染，它可以引起炎症和其他免疫性疾病。 与这些结果相关的变化。我们对其他慢性传染病如何流行于低- 中等收入国家缺乏对老年综合征发病机制和流行病学的影响。一 巴西是一个中等收入国家，有大量老年艾滋病毒感染者，有全面艾滋病毒护理的历史 以及地方性慢性感染。这项多元化的纵向研究将招募接受抗逆转录病毒治疗的威尔斯亲王 巴西三个城市≥50岁的受试者（n=360例50- 64岁和n=340例≥65岁），以评价 结核病、HTLV-1、恰加斯病、弓形虫病等合并感染影响流行病学的方式 以及衰老相关疾病的免疫学途径。我们将研究 共同感染和健康的社会决定因素与经验证的非传染性疾病。我们将前瞻性地评估 合并感染个体和累积负担可预测老年综合征的发生。我们要评估一部小说 筛选工具，以评估老年威尔斯亲王医院对不良临床结局（包括死亡）的脆弱性， 住院和新残疾。本研究还将研究合并感染如何影响 炎症导致NDC和老年综合征的发展 在拉丁美洲的艾滋病毒观察研究的富有成效的合作，这项研究是独特的定位， 提供迫切需要的高质量数据，以了解全球范围内艾滋病毒感染者的老龄化。它将提供新颖的 深入了解感染对PWH周围经历的衰老细胞机制的多种贡献 地球仪。

Project Summary / Abstract This study will investigate the epidemiology, clinical implications, and immunologic and infectious determinants of aging-related diseases and outcomes in older people with HIV (PWH) in Brazil. In part a result of the long- term effects of HIV infection and ongoing inflammation, older PWH experience high rates of non-communicable diseases (NCDs) and early onset of geriatric syndromes including frailty, disability, and cognitive decline. However, HIV is not alone as a chronic infection that can cause inflammation and other immunological changes associated with these outcomes. Our knowledge of how other chronic infections endemic to low-and middle-income countries affect the pathogenesis and epidemiology of geriatric syndromes in is lacking. A middle-income country with a large population of older PWH, Brazil has a history of comprehensive HIV care as well as endemic chronic infections. This diverse, longitudinal study will recruit PWH on antiretroviral therapy ≥50 years of age in three Brazilian cities (n=360 ages 50-64years and n=340 ages ≥65 years) to evaluate the ways coinfections such as TB, HTLV-1, Chagas disease, toxoplasmosis, and others affect the epidemiology and immunologic pathways of aging-related morbidity. We will examine the association of syndemics of coinfections and social determinants of health with validated NCDs. We will prospectively evaluate how individual and cumulative burden of coinfections predict incident geriatric syndromes. We will evaluate a novel screening tool to assess vulnerability of older PWH for adverse clinical outcomes including death, hospitalization, and new disability. This study will also investigate how coinfections affect biologic pathways of inflammation which contribute to development of NDCs and geriatric syndromes Building upon established and productive collaborations in HIV observational research in Latin America, this study is uniquely positioned to provide urgently needed, high-quality data to understand aging with HIV in a global context. It will offer novel insights into a diversity of infectious contributions to cellular mechanisms of aging experienced by PWH around the globe.