MULTICENTER AIDS COHORT STUDY

描述（由申请人提供）： 本申请是多中心艾滋病队列研究（MACS）合作协议（1UO 1-AI-35041）匹兹堡部分竞争性更新提案的B部分，是CAMACS提交的A部分复合提案的附件。 这一请求是为匹兹堡MACS中最初和最近招募的MSM队列的临床随访和实验室检测提供额外五年的支持。 MACS目前的首要任务是加强我们与治疗干预相关的流行病学和发病机制信息。我们需要描述长期的治疗模式，这是治疗效果方面的后果。我们的具体目标强调队列保留和维护，生物标本采购和血脂异常，糖尿病，脂肪代谢障碍和心血管疾病的中心脂质/胰岛素/葡萄糖检测。这些措施是：（1）描述经过治疗的HIV感染的演变自然史，并确定HAART时代HIV相关长期结局的决定因素和趋势。 我们将确定抗逆转录病毒疗法对疾病发生率、替代标志物和生存率的影响 期待这包括特别强调我们最近扩大的年轻，非洲裔美国男男性接触者的队列，他们在最初的MACS队列中代表性不足，但在美国保持了不寻常的更高的艾滋病毒感染率。(2)维护匹兹堡MACS纵向收集的流行病学数据和生物标本库框架，作为促进自然史和发病机制研究的平台。(3)在匹兹堡MACS对HIV血清阳性和阴性MSM进行所需的临床和实验室检测。 (4)对MACS的子样本进行心血管检测（电子束计算机断层扫描[EBCT]、颈动脉内膜中层厚度[IMT]和EKG检测），以解决HAART接受者中与心血管疾病风险相关的关键问题。 我们相信，通过这些目标，以及通过与匹兹堡MACS密切相关的HIV感染免疫发病机制的子研究，我们将为MACS的科学议程和目标做出重大贡献。

DESCRIPTION (provided by applicant): This application is Part B of a proposal for a competing renewal of the Pittsburgh component of the Multicenter AIDS Cohort Study (MACS) Cooperative Agreement (1UO1-AI-35041), the companion to the Part A composite proposal that is being submitted by CAMACS. This request is for an additional five years of support for clinical follow-up and laboratory testing of the original and recently recruited cohort of MSM in the Pittsburgh MACS. The current priority of the MACS is to enhance our epidemiologic and pathogenesis information in relation to treatment intervention. We need to describe the long-term patterns of therapy use that are consequential in terms of treatment efficacy. Our specific aims emphasize cohort retention and maintenance, biological specimen procurement and central lipid/insulin/glucose testing for dyslipidemia, diabetes, lipodystrophy and cardiovascular disease for the MACS. These are: (1) To characterize the evolving natural history of treated HIV infection and identify the determinants and trends of long-term HIV-related outcomes in the era of HAART. We will determine the effect of anti-retroviral therapies on disease incidence, surrogate markers and survival expectation. This includes special emphasis on our recently expanded cohort of young, African-American MSM, who were underrepresented in the original MACS cohort, yet maintain an inordinately greater prevalence of HIV infection in the USA. (2) To maintain the longitudinally collected epidemiological data and biological specimen repository framework of the Pittsburgh MACS as a platform to facilitate natural history and pathogenesis studies. (3) To perform the required clinical and laboratory testing of HIV seropositive and seronegative MSM in the Pittsburgh MACS. (4) To perform cardiovascular testing (Electron Beam Computed Tomography [EBCT], carotid intima media thickness [IMT], and EKG testing) on a sub-sample of the MACS to address key questions related to risk of cardiovascular disease among HAART recipients. We believe that through these aims, as well as through substudies on the immunopathogenesis of HIV infection that are closely linked to the Pittsburgh MACS, we will significantly contribute to the scientific agenda and goals of the MACS.