Optimal Strategies for Management of HIV Disease

描述(申请人提供)：在美国和欧洲，艾滋病毒治疗的改进大大降低了与艾滋病相关的发病率和死亡率。最近，较低的药品价格和对全球艾滋病毒流行的日益关注，为在非洲、亚洲和加勒比欠发达国家发展艾滋病毒治疗方案创造了巨大的势头。弗里德伯格博士在以患者为导向的艾滋病毒结果研究方面有着卓越的记录，他建议以10多年来检验替代艾滋病毒护理策略的临床影响、成本和成本效益的经验为基础，并扩大初级研究人员在这些领域发展技能的机会。研究将集中在三个主要领域：美国艾滋病毒的最佳管理战略，艾滋病毒检测不同战略的成本效益，以及在欠发达国家使用抗逆转录病毒和机会性感染预防的各种战略的影响。这项建议有以下三个具体目标： 1)在以患者为导向的艾滋病毒疾病研究中为年轻研究人员提供指导。 2)利用正在进行的与艾滋病毒相关的多学科建模和成果研究作为培训年轻研究人员的平台。 3)利用这些努力，在各种美国和国际环境中解决关键的艾滋病毒临床管理问题。 利用临床流行病学、决策分析和模拟建模的方法，Freedberg博士建议在过去十年的工作基础上扩展，将更多的时间和精力集中在世界各地艾滋病毒管理的前沿问题上。通过在结果研究方法方面为研究员和初级教员提供更多的指导，弗里德伯格博士将在提高这一以患者为导向的艾滋病毒相关研究这一重要领域的研究能力方面产生乘数效应。

DESCRIPTION (provided by applicant): Improvements in HIV treatment have dramatically reduced AIDS-related morbidity and mortality in the United States and Europe. More recently, lower drug prices and an increased focus on the global HIV epidemic has created tremendous momentum toward the development of HIV treatment programs in less developed countries in Africa, Asia and the Caribbean. With a distinguished track record of patient-oriented HIV outcomes research, Dr. Freedberg proposes to build on over 10 years of experience examining the clinical impact, cost, and cost-effectiveness of alternative HIV care strategies and to expand opportunities for junior investigators to develop skills in these areas. Research will focus in three main areas: optimal management strategies for HIV in the US, the cost-effectiveness of different strategies for HIV testing, and the impact of various strategies for antiretroviral use and opportunistic infection prophylaxis in less developed countries. This proposal has the following three specific aims: 1) To provide mentoring for young investigators in patient-oriented research in HIV disease. 2) To use ongoing multidisciplinary HIV-related modeling and outcomes research as a platform for training young investigators. 3) To utilize these efforts to address critical HIV clinical management questions in a variety of US and international settings. Using methods of clinical epidemiology, decision analysis, and simulation modeling, Dr. Freedberg proposes to expand on the past decade of work to focus added time and energy into questions at the forefront of HIV management throughout the world. By providing increased mentoring to fellows and junior faculty in the methods of outcomes research, Dr. Freedberg will create a multiplicative effect in increasing research capability in this important area of HIV-related patient-oriented investigation.