MULTICENTER AIDS COHORT STUDY

描述(由申请人提供)： 本申请是竞争性地更新多中心艾滋病队列研究(MACS)合作协议(1 UO1-AI-35041)匹兹堡部分的提案的B部分，是CAMAC提交的A部分综合提案的配套部分。这项请求是为了再提供五年的支持，对匹兹堡互助会的原始和最近招募的男男性接触者队列进行临床随访和实验室测试。互委会目前的首要任务是加强我们在治疗干预方面的流行病学和发病机制信息。我们需要描述治疗的长期使用模式，这些模式在治疗效果方面是有影响的。我们的具体目标是为Mac强调队列保留和维护、生物样本采购以及针对血脂异常、糖尿病、脂肪营养不良和心血管疾病的中心脂/胰岛素/血糖测试。这些是：(1)描述接受治疗的艾滋病毒感染的不断演变的自然历史，并确定HAART时代与艾滋病毒相关的长期结果的决定因素和趋势。我们将确定抗逆转录病毒治疗对发病率、替代标志物和存活率的影响。 期待。这包括特别强调我们最近扩大的年轻非裔美国MSM队列，他们在最初的Mac队列中代表不足，但在美国保持着异常高的艾滋病毒感染流行率。(2)维持匹兹堡互委会纵向收集的流行病学数据和生物标本储存库框架，作为促进自然病史和发病机制研究的平台。(3)对匹兹堡互委会艾滋病毒血清阳性和血清阴性的男男性接触者进行所需的临床和实验室测试。(4)对MACs的一个子样本进行心血管测试(电子束计算机断层扫描[EBCT]、颈动脉内膜中层厚度[IMT]和EKG测试)，以解决与HAART接受者心血管疾病风险相关的关键问题。我们相信，通过这些目标，以及通过与匹兹堡互委会密切相关的艾滋病毒感染免疫发病机制的子研究，我们将为互委会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.