Monitoring and modelling prognosis in the era of HAART (Extension to Strategic Grant G0100221)

目前，艾滋病毒感染者可获得由不同药物组合组成的高效治疗方法。这些治疗大大降低了获得性免疫缺陷综合征（艾滋病）的风险和死亡风险。自1996年提供这些治疗以来，因感染艾滋病毒或因感染艾滋病毒而死亡的成年人的死因发生了变化。抗逆转录病毒治疗队列合作（ART- cc）的目的是研究开始联合治疗的艾滋病毒感染者的严重疾病和死亡率。这项合作由布里斯托尔大学的一个小团队协调，并由一个由同组代表组成的指导委员会管理。我们最新的数据集包含来自16项队列研究（长期跟踪艾滋病毒感染者的研究）的45,000名艾滋病毒感染者的数据。本补助金的资助期为2008年2月至2011年1月。我们的目标是(1)描述开始联合治疗的患者的艾滋病风险、艾滋病定义疾病以及各种原因和特定原因导致的死亡；(2)确定对随后的死亡风险具有相似影响的疾病组，并在现有有效治疗方法的情况下对这些疾病进行分类；(3)检查有效治疗时代的死亡原因，并与一般人群的死亡率进行比较；(4)使用队列研究和临床试验的数据来比较不同的药物方案；(5)检查不同地区、研究和环境之间的结果差异，并与低收入国家的姊妹合作项目进行比较。在本应用程序所涵盖的期间内，我们将派生两次更新的数据集。一个专家委员会将对死因进行分类。我们将比较艾滋病毒感染者与一般人群的死亡率。这项研究的结果将与艾滋病毒感染者的护理直接相关。

Highly effective treatments, consisting of a combination of different drugs, are now available for people infected with HIV. These treatments have dramatically reduced the risk of acquired immune deficiency syndrome (AIDS) and the risk of death. Since 1996, when these treatments became available, causes of death among adults dying with or due to HIV-infection have changed. The aim of the ART Cohort Collaboration (ART-CC) is to study rates of serious diseases and death in HIV-infected patients who have started combination therapy. The collaboration is coordinated by a small team at Bristol University, and admininistered by a steering committee of cohort representatives. Our most recent dataset contains data on 45,000 HIV-infected individuals combined from 16 cohort studies (studies in which HIV-infected individuals have been followed over time). The present grant covers the period February 2008 to January 2011. Our objectives are (1) To describe the risk of AIDS, AIDS-defining illnesses and deaths from all causes and specific causes in patients starting combination therapy; (2) To define groups of illnesses that have similar implications for the subsequent risk of death, and to propose a classification of these illnesses that is relevant now that effective treatments are available; (3) To examine causes of death in the era of effective treatment, and death rates compare with the general population; (4) To use data from both cohort studies and clinical trials to compare different drug regiments; (5) To examine how outcomes differ between regions, studies, and settings and to conduct comparisons with a sister collaboration in low-income countries. We will derive updated datasets twice during the period covered by the present application. An expert committee will classify causes of death. We will compare mortality rates in HIV-infected individuals with those in the general population. The results of this research will be of direct relevance to the care of HIV-infected patients.