NATURAL HISTORY OF HIV INFECTIONS IN SENEGAL

我们关于HIV-2生物学的初步数据表明，这种病毒可能 与HIV-1有着截然不同的生物学特性。 因此，有必要评估 这些差异在两种病毒感染率都很高的人群中 HIV-2和HIV-1。 塞内加尔就是这样一个西非国家， 已经与那里的调查人员建立的合作提供了一个 为今后的研究打下坚实的基础。 HIV潜伏期延长 总体而言，可以从评估中学到很多东西， 感染者随着时间的推移。 这将包括：（1）动态和 传播的风险因素，2）评估的免疫反应参数 以及它们与病毒负荷的相关性， 3）HIV发病机制的演变。 因此，自然 对HIV病毒的历史研究将提供最丰富的信息来源， 传播风险、感染过程和演变的信息 疾病。 目前，HIV-2在儿科的传播和自然史 人口是需要进一步研究的领域。 项目1将寻求 提供关于风险因素和围产期死亡率的重要信息， 与HIV-1相比，HIV-2的传播率更低。 我们将探讨 各种抗体和DNA感染标志物，用于早期诊断和 预后标志物，并将其与临床病程和预后相关， 围产期感染的婴儿 项目3将通过以下方式提供更多关于儿科群体艾滋病毒的信息： 评估高风险儿童的患病率和疾病相关性 暴露于病毒。 在这个哨兵小组调查中，我们希望了解更多 关于儿童感染艾滋病毒的危险因素。 该项目将 还提供了关于HIV-2感染自然史的宝贵信息 在年龄较大的孩子。 由于艾滋病毒疾病的发展预计将更快， 儿科人群，项目1和3也将有助于我们的 了解HIV-2和HIV-1的致病潜力。 这将在项目2的拟议研究中同时处理。 这项研究将通过首先调查所有 艾滋病样疾病的表现和评估的强度 与HIV-1和HIV-2有关。 通过跟踪感染者 我们希望研究HIV-2和HIV-1疾病的临床过程， 初步介绍和评估免疫学和血清学参数， 可能具有预后价值。 HIV-2感染的全部特征 在这些人群中，应提供评估治疗的基础， 以及未来的预防策略。

Our preliminary data on the biology of HIV-2 suggest that this virus may have a distinct biology from HIV-1. It is relevant, therefore, to assess these differences in populations infected with significant rates of both HIV-2 and HIV-1. Senegal is such a West African country and the collaboration already established with investigators there provides a strong base for future research. The prolonged incubation period for HIVs in general suggests that much can be learned from the evaluation of infected individuals over time. This would include: 1) the dynamics and risk factors for transmission, 2) the immune response parameters evaluated over the course of infection and their correlation with viral burden and clinical course and 3) the evolution of HIV pathogenesis. Thus, natural history studies of HIV viruses in general will provide the richest source of information on risks for transmission, course of infection and evolution of disease. At present, the transmission and natural history of HIV-2 in pediatric populations are areas in need of further study. Project 1 will seek to provide important information on risk factors and the rate of perinatal transmission of HIV-2 in direct comparison to HIV-1. We will explore various antibody and DNA markers of infection for both early diagnosis and prognostic markers and correlate these with clinical course and outcome in perinatally infected infant. Project 3 will provide more information on HIV in pediatric groups by evaluating prevalence and disease association in children at high risk for exposure to the virus. In this sentinel group survey we hope to learn more about the risk factors for HIV infection in children. This project will also provide valuable information on the natural history of HIV-2 infection in older children. Since HIV disease evolution would be expected to progress more rapidly in pediatric populations, Projects 1 and 3 will also contribute to our understanding of the comparative pathogenic potentials of HIV-2 and HIV-1. This will be concurrently addressed in the proposed studies of Project 2. This will study disease evolution with HIV in adults by first surveying all AIDS-like disease presentations and evaluating for the strength of association with HIV-1 and HIV-2. By following infected individuals over time we hope to study the clinical course of HIV-2 and HIV-1 disease from initial presentation and evaluate immunologic and serologic parameters that may be of prognostic value. The full characterization of HIV-2 infection in these populations should provide the basis for evaluating therapeutic and preventative strategies in the future.