North American AIDS Cohorts on Collaboration and Design (NAACCORD)

描述(由申请人提供)： 北美-艾滋病群体研究和设计合作(NAACCORD)始于2006年，是leDEA倡议区域1的代表。NAACCORD的22个单地点和多地点临床和经典流行病学艾滋病毒队列涵盖了北美境内的大多数艾滋病毒/艾滋病队列。美国和加拿大的100多个网站提供了从超过10万名艾滋病毒感染者和15万名未感染艾滋病毒的参与者那里收集的数据。在过去的4年里，我们建立了一个强大的协作基础设施，利用了一个涵盖基础科学、临床研究、流行病学、数据信息学和生物统计学的多学科研究小组的人才和专业知识。我们在解决我们最初的目标方面卓有成效，并将我们的科学重点扩大到北美艾滋病毒方面具有当代重要性的几个领域。我们的合作处于有利地位，能够成功回答当今实践中的关键问题。我们对下一个供资周期有三个广泛定义的目标：目标1：确定北美艾滋病毒感染的临床流行病学，重点是老龄化和非艾滋病并存的发病率和决定因素。目标2：提供有关北美艾滋病毒感染治疗的当前和不断变化的趋势、结果和比较有效性的独特数据，重点放在艾滋病毒治疗的时机和ART的初始使用、长期病毒抑制、免疫恢复和临床疾病进展的决定因素、丙型肝炎合并感染的影响和耐药性的发展。目标3：充分利用我们庞大的样本量，量化和识别与重要罕见事件相关的因素，并支持翻译研究。NA协议是一项世界级的合作，由成熟的艾滋病毒同龄人很好地处于有利地位，为这些与美国和加拿大当代相关的问题提供明确的答案。此外，我们将扩大与其他leDEA地区的合作，以便随着疫情治疗的成熟，通报未来资源有限地区的经验，并确定和了解可能为未来全球研究和临床护理提供信息的治疗、结果和预后因素方面的差异。 相关性： NA-ACCORD是北美存在的艾滋病毒群体中最全面的合作。其庞大的样本量、数据的全面性和质量，再加上最先进的统计方法的专家使用，将使我们能够为美国和加拿大艾滋病毒感染者的护理工作中具有当代重要性的关键问题提供答案。

DESCRIPTION (provided by applicant): The North American-AIDS Cohort Collaboration on Research and Design (NA-ACCORD) began in 2006 as the representative of Region 1 of the leDEA initiative. The 22 single and multi-site clinical and classical epidemiologic HIV cohorts of the NA-ACCORD encompass most HIV/AIDS cohorts within North America. Over 100 sites in the US and Canada contribute data collected from over 100,000 HIV-infected and 150,000 HIV-uninfected participants. During the last 4 years, we established a strong collaborative infrastructure that capitalizes on the talents and expertise of a multi-disciplinary group of investigators that span basic science, clinical research, epidemiology, data informatics and biostatistics. We have been highly productive in addressing our original Aims and expanding our scientific focus to several areas of contemporary importance in HIV in North America. Our collaboration is well-positioned to successfully answer the key questions in practice today. We have three broadly-defined aims for the next funding cycle: Aim 1: Determine the clinical epidemiology of HIV infection in North America, with a focus on aging and the incidence and determinants of non-AIDS co-morbidities. Aim 2: Provide unique data on current and evolving trends, outcomes and comparative effectiveness of treatment of HIV infection in North America, with a focus on the timing of presentation for HIV care and the initial use of ART, determinants of long-term viral suppression, immune recovery, and clinical disease progression, the impact of hepatitis C co-infection, and the development of resistance. Aim 3: Capitalize on our large sample size to quantify and identify factors associated with important rare events and support translational research. The NA-ACCORD is a world-class collaboration of established HIV cohorts well-positioned to provide definitive answers to these issues of contemporary relevance in the U.S. and Canada. In addition, we will expand our collaboration with other leDEA regions to both inform future experience in resource-limited regions as the treatment of the epidemics mature, and to identify and understand differences in treatment, outcomes and prognostic factors that might inform future research and clinical care globally. RELEVANCE: The NA-ACCORD is the most comprehensive collaboration of HIV cohorts that exists within North America. Its large sample size, the comprehensiveness and quality of its data, combined with the expert use of state- of-the-art statistical methods will allow us to provide answers to critical questions of contemporary importance for the care of HIV-infected individuals in the U.S. and Canada.