WADA (West Africa Database on Antiretroviral Therapy) Collaboration

描述（由申请人提供）：WADA（西非抗逆转录病毒治疗数据库）合作是西非队列之间的独特合作，其任务是对包括成人、孕妇和儿童在内的1型和2型艾滋病毒感染者的预后和结果进行假设驱动的流行病学研究。研究将集中在需要大量患者样本的科学问题上，这些问题的贡献群体无法单独回答，也不会与现有项目重叠。第1年期间的活动将集中于对现有数据进行横断面分析，在基线时和后续行动期间全面审查现有数据的核心项目的完整性，以及制订工具，使各地点的数据收集标准化、协调和改进。2-5年级的研究议程和具体假设将根据一年级活动的结果最后确定，重点放在以下四个领域：方案问题（获得抗逆转录病毒治疗和后续损失）；成人、儿童和孕妇的监测和治疗结果；临床反应，特别关注结核病、机会性感染、免疫重建综合征和乙型肝炎合并感染；照料HIV-2感染。更多的研究问题将在接下来的几年中集中进行，预计将在五年内完成约30个项目和分析。西非六个国家六个主要城市共有17个队列——每个队列都在进行中，有自己的内部治理结构和财政支持——已同意提供过去几年从2 345名感染艾滋病毒的儿童和33 245名成年患者那里收集的数据。这一申请的区域协调中心将设在法国波尔多。该大学团队（Victor Segalen大学ISPED Francois Dabis教授）在西非开展流行病学艾滋病毒队列研究方面具有长期经验，在科特迪瓦阿比让设有办事处。它在这类国际合作方面也有丰富的经验，包括妇女和儿童感染艾滋病毒根特小组和ART-LINC合作。ISPED将负责世界反兴奋剂机构合作的实施。每年将从附属队列收集数据，一旦合并到世界反兴奋剂机构的主要数据库中，将为各种项目和分析提取数据。这一过程将每年重复一次，以便分析在附属队列中收集的最新数据。世界反兴奋剂机构在西非是一项前所未有的事业，其设计独特，由具有丰富经验的调查人员领导，将促进所需的公共卫生知识，以便更好地了解和治疗撒哈拉以南非洲所有年龄、性别和背景的艾滋病毒感染者。撒哈拉以南非洲大陆的需求未得到满足的人数最多，但艾滋病毒治疗方案正在不断、迅速和大规模推出。

DESCRIPTION (provided by applicant): The WADA (West Africa Data Base on Antiretroviral Therapy) Collaboration is a unique collaboration among cohorts in West Africa with a mission to conduct hypothesis-driven epidemiological research on the prognosis and outcome of HIV type 1 and 2-infected people, including adults, pregnant mothers, and children. The research will focus on scientific questions requiring a large sample size of patients which the contributing cohorts cannot answer individually and which do not overlap with existing projects. Activities during Year 1 will focus on cross-sectional analyses of existing data, a comprehensive examination of the available data in terms of completeness of core items at baseline and during follow-up, and the development of instruments to standardize, harmonize and improve data collection across sites. The research agenda and specific hypotheses for Years 2-5 will be finalized based on the results of Year 1 activities, with a focus on the following four areas: programmatic issues (access to ant- retroviral treatment and losses to follow up); monitoring and outcomes of treatment in adults, children and pregnant women; clinical response, with a special interest for tuberculosis, opportunistic infections, immune reconstitution syndrome and hepatitis B coinfection; care of HIV-2 infection. Additional research questions will be focused in the subsequent years, with the expectation to address around 30 completed projects and analyses over five years. A total of 17 cohorts in six major cities in six West African countries - each ongoing and with their own internal governance structure and financial support - have agreed to contribute data collected already over the past years from a collective number of 2,345 HIV-infected children and 33,245 adult patients. The regional coordinating centre for this application will be located in Bordeaux, France. This university team (Prof Francois Dabis, ISPED, Universite Victor Segalen) has a long lasting experience in epidemiological HIV cohort research in West Africa, with an office in Abidjan, Cote d'lvoire. It also has extensive experience with international collaborations of this kind including the Ghent Group on HIV in Women and Children and the ART-LINC Collaboration. ISPED will be responsible for the implementation of the WADA Collaboration. Data will be collected from affiliated cohorts every year and once merged into a main WADA database, data extracts will be made for the various projects and analyses. This process will be repeated annually allowing for the analysis of the most contemporary data collected in the affiliated cohorts. WADA is an unprecedented undertaking in West Africa, with a unique design, lead by investigators with extensive experience, that will advance the public health knowledge required to better understand and treat HIV-infected persons of all ages, genders and backgrounds in sub-Saharan Africa, the continent with the largest unmet needs but with onqoing, rapid and massive roll-out of HIV treatment programmes.