PEDIATRIC AIDS CLINICAL TRIALS UNIT

北卡罗来纳州目前有两家儿科艾滋病诊所 审判单位。一个完整的儿科ACTU自1月以来一直在杜克大学 1987年，作为成人/儿童混合艾滋病的一部分提供资金 治疗评价股，直到1989年。北卡罗来纳大学 在教堂山的儿科部门看到了孩子们 自1990年起成年ACTU。隶属于北卡罗来纳大学亚单位的是一小部分 北卡罗来纳州夏洛特市卡罗莱纳州医疗中心的围产期计划。我们 提议将这三个地点和布伦纳的另外两个单位合并 温斯顿-塞勒姆和东卡罗来纳大学的儿童医院 格林维尔的医学院，合并为单一的统一计划，北方 卡罗莱纳儿童艾滋病网络(NC-CAN)。所有五个地点都将是 能够让儿童参加ACTG儿科方案，其中4个 这5个国家将让儿童参加围产期研究(ECU不会)。这个 统一这些方案将有几个目的：1)获得 ACTG协议将得到改进。北卡罗来纳州是全球第十大 该州人口众多，但其公民和感染艾滋病毒的儿童 在城市和农村环境中平均分配。这5个地点是 地理分布，并接近最高的艾滋病毒血清阳性率 该州的地区。2)该州所有的医学院都将 统一协作，减少竞争和 从而允许更有效地利用资源。此外, 来自全州的医学生和居民将接触到 日益严重的儿科艾滋病毒问题，并接受了提供护理的培训 这些难缠的病人。3)5所院校的研究技能 可以汇集并应用于临界数量的患者 注册NC-CAN系统。4)NC-CAN将为 在农村地区提供以研究为基础的护理。东南部有 世界上通过异性传播的艾滋病病例最多 美国和北卡罗来纳州妇女中艾滋病毒血清阳性率 正在迅速升级。NC-CAN将演示执行以下操作的方法 对这类人群的临床研究，届时将 适用于疫情蔓延到城市以外的其他地区 国家。作为当前方案成功的一个例子，尽管 患者单程旅行的中位数超过90分钟 去杜克大学和北卡罗来纳大学的诊所诊疗率为88% 病人。这主要归因于社会工作者和 关注交通问题的志愿者，对给予的尊重 患者和家属，以及家属的参与 临床护理和研究计划。

The state of North Carolina currently has two pediatric AIDS Clinical Trials Units. A complete pediatric ACTU has been at Duke since January 1987, with funding provided as part of a mixed adult/pediatric AIDS Treatment Evaluation Unit until 1989. The University of North Carolina at Chapel Hill has been seeing children at a pediatric component of an Adult ACTU since 1990. Affiliated with the UNC subunit is a small perinatal program at the Carolinas Medical Center in Charlotte, NC. We propose to merge these three sites and two other units, at Brenner Children's Hospital in Winston-Salem and East Carolina University Medical School in Greenville, into a single unified program, the North Carolina Children's AIDS Network (NC-CAN). All five sites will be capable of enrolling children into ACTG pediatric protocols, and 4 of the 5 will enroll children onto perinatal studies (ECU will not). The unification of these programs will serve several purposes: 1) Access to ACTG protocols will be improved. North Carolina is the tenth largest state in population, but its citizens and its HIV infected children are evenly divided between urban and rural settings. The 5 sites are geographically distributed and are near the highest HIV seroprevalence regions of the state. 2) All of the state's medical schools will be working together in a unified manner, decreasing competition and allowing for more efficient utilization of resources. In addition, medical students and residents from across the state will be exposed to the growing problem of pediatric HIV and trained to provide care for these difficult patients. 3) The research skills of the 5 institutions can be pooled and applied to the critical mass of patients who will enroll in the NC-CAN system. 4) The NC-CAN will provide a model for the provision of research based care in a rural setting. The Southeast has the largest number of heterosexually transmitted AIDS cases in the United States, and in North Carolina the HIV seroprevalence among women is rapidly escalating. The NC-CAN will demonstrate methods to perform clinical research in this type of population which will then be applicable as the epidemic spreads to other non-urban sectors of the country. As an example of the current success of the programs, despite the fact that patients travel a median of more than 90 minutes each way to get to Duke and UNC, the clinic show rate is 88% for protocol patients. This is primarily attributable to social workers and volunteers focusing on the issue of transportation, to the respect given the patients and families, and to the families' involvement in the clinical care and research program.