IeDEA West -Africa collaboration

描述(由申请人提供)： WADA(西非抗逆转录病毒治疗数据库)合作是西非人群之间的独特合作，其任务是对艾滋病毒-1和艾滋病毒-2感染者的预后和结果进行假设驱动的流行病学研究，包括成人、孕妇、正在接受护理和一般治疗的儿童以及感染艾滋病毒的儿童。我们的五年研究计划将重点放在需要大样本患者的科学问题上，这些问题是贡献队列无法单独回答的，也不会与现有项目重叠。在下一轮LEDEA的五年中，世界反兴奋剂机构的总体目标是：1)衡量西非长期联合抗逆转录病毒疗法(ART)的有效性，并评估影响结果的因素；2)通过提高成人和儿童个人和人口层面的临床监测能力，提高西非可持续提供抗逆转录病毒疗法的能力；3)记录整个西非艾滋病毒方案中接受护理的艾滋病毒感染者的发病率负担。到目前为止，世界反兴奋剂机构合作在当前leDEA周期中汇编的汇集数据库包括在26个诊所发起抗逆转录病毒治疗的33,815名艾滋病毒感染成人和3,533名艾滋病毒感染儿童。下一轮将涉及9个国家(贝宁、布基纳法索、科特迪瓦、加纳、几内亚比绍、马里、尼日利亚、塞内加尔、多哥)的27个艾滋病毒中心(成人：16个，儿科：11个)。其中，两个新的国家(几内亚比绍和多哥)和五个艾滋病毒诊所(三个成人诊所和两个儿科诊所)是新的合作中心。世界反兴奋剂机构由法国波尔多大学波尔多公共卫生学院(ISPED)世界反兴奋剂机构协调中心(弗朗索瓦·达比斯教授)和设在科特迪瓦阿比让的以研究为导向的非政府组织PAC-CI主办的世界反兴奋剂机构区域办事处联合协调。该研究小组在观察艾滋病毒研究方面拥有长期的经验，包括在西非进行大规模预期队列研究，并将继续和扩大目前由leDEA资助的周期。每年将按照标准化程序从关联队列中收集数据。参与中心的能力建设将包括为当地人力资源提供资金、数据质量培训、现场技术支持和年度会议，以加强技术和科学网络。优先研究议程将涉及以下主题：保留护理、艾滋病毒-2和艾滋病毒-1/艾滋病毒-2感染的自然病史、癌症、疟疾、乙肝、妊娠结局、药物警戒、青少年和儿童获得和护理效率。 相关性： 评估艾滋病毒护理方案效率的临床和业务研究需要可靠的信息系统和能力建设，以长期维持这一活动。世界反兴奋剂机构的合作已经实施了一个艾滋病毒护理中心网络，并将加强其对癌症、疟疾、乙肝和药物不良反应等疾病研究的承诺。将通过组织血库来加强艾滋病毒-2队列，儿童将从感染艾滋病毒时开始登记。

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 outcomes of HIV-1 and HIV-2-infected people, including adults, pregnant mothers, and children in care and generally on treatment, as well as HIV-exposed children. Our five-year research plan will focus on scientific questions requiring a large sample size of patients that the contributing cohorts cannot answer individually and which do not overlap with existing projects. During the five years of the next leDEA round, the overall aims of WADA are:1)to measure the effectiveness of combination antiretroviral treatment (ART) in West Africa in the long term, and to assess factors that influence outcomes; 2) to increase the capacity for delivering ART durably in West Africa by increasing the capacity for monitoring clinical outcomes at the individual and population levels in adults and children; 3) to document the morbidity burden in HIV- infected individuals in care in HIV programs throughout West Africa. To date, the pooled database assembled by the WADA Collaboration in the current leDEA cycle includes 33,815 HIV-infected adults and 3,533 HIV- infected children who initiated ART in 26 clinics. The next round will involve 27 HIV centers (adults: 16, pediatrics: 11) in nine countries (Benin, Burkina Faso, Cote d'lvoire, Ghana, Guinea Bissau, Mali, Nigeria, Senegal, Togo). Among them, two new countries (Guinea Bissau and Togo) and five HIV clinics (three adult clinics and two pediatric clinics) are new collaborating centers. WADA is jointly coordinated by the WADA Coordinating Center at the Bordeaux School of Public Health (ISPED) in Bordeaux University, France (Prof. Francois Dabis) with a WADA Regional Office hosted by PAC-CI, a research-oriented non-governmental organization situated in Abidjan, Cote d'lvoire. This research team has a long-lasting experience in observational HIV research including large-scale prospective cohorts in West Africa and will continue and expand the ongoing leDEA-funded cycle. Data will be collected from affiliated cohorts every year according to standardized procedures. Capacity building in participating centers will include funding for local human resources, training on data quality, on-site technical support and annual meetings to reinforce the technical and scientific network. The priority research agenda will address the following topics: retention in care, natural history of HIV-2 and HIV-1/HIV-2 infections, cancer, malaria, hepatitis B, pregnancy outcomes, pharmacovigilance, adolescent and pediatric access and efficiency of care. RELEVANCE: Clinical and operational research assessing the efficiency of HIV care programs require reliable information systems and capacity building for sustaining this activity in the long term. The WADA collaboration has already implemented a network of HIV care centers and will reinforce its commitment to study morbidities including cancer, malaria, hepatitis B and adverse drug reactions. The HIV-2 cohort will be strengthened with the organization of a blood bank Children will be enrolled from the time of HIV exposure.