Primary Infection Resource Consortium (PIRC)

摘要 在美国，艾滋病毒的发病率仍在增加，尽管在以下方面做出了巨大努力：（i）尽早诊断艾滋病毒感染; 尽可能，（ii）让新诊断的人接受护理，（iii）开始对所有人进行抗逆转录病毒治疗 感染者。圣地亚哥原发性感染资源联盟（PIRC）一直在解决 二十年来围绕这些问题不断变化的挑战。PIRC是世界上规模最大、研究最深入的 在美国急性和早期HIV感染（AEH）个体的良好表征的队列。它有 为超过325篇同行评审的原创研究手稿提供了必要的支持，涵盖了广泛的领域， 领域，并包括许多国家卫生研究院艾滋病毒研究的优先领域，包括：艾滋病毒的发病率，战略，以改善 艾滋病毒检测和进入预防服务等。此应用程序代表我们的PIRC R24的更新 （AI 106039）建议继续实施这一高效计划，支持所需的基础设施 识别，表征，并与科学同事分享临床和生物学数据， 目标的实现取决于能否获得这些生物样本和数据。建议的R24更新申请 包括PIRC和艾滋病研究中心（CFAR）综合网络之间的新合作。 临床系统（CNICS）开发一个扩展的和协同的资源，以服务于生物医学研究， 在AEH地区。总的来说，PIRC支持：1）艾滋病毒筛查计划，以检测和分期急性，近期 和慢性感染，2）伴侣服务，以确定新诊断的艾滋病毒AEH参与者的性接触者 (i.e., 3）立即提供抗逆转录病毒疗法，4）迅速与护理挂钩，5）监测抗逆转录病毒疗法 坚持和持续参与护理，6）估计推定艾滋病毒传播的方法和6） AEH生物储存库。整个生物储存库和与这些特征良好的参与者相关的数据， 可供合格的调查人员使用，只需要对概念提案进行内部审查和批准。的 建议的R24更新申请将解决以下具体目标：目标1。社区HIV检测 急性和早期艾滋病毒（AEH）感染分期。我们建议确定120名新诊断的艾滋病毒感染者 每年在加州圣地亚哥大学：47 AEH感染和73慢性感染的参与者。 目标2.加强艾滋病毒预防和治疗的连续性。我们将评估时间的变化， 针对协调一致的努力，艾滋病毒治疗级联，以支持新诊断的艾滋病毒患者立即接受抗逆转录病毒治疗 PIRC参与者。AEH期间确定的受试者将随访长达5年， 受试者将在诊所接受长达90天的随访。目标3。共享资源。我们将利用AEH 样本和参与者资源，以支持与原发性HIV相关的其他NIH研究合作 感染CNICS中AEH受试者的共同入组将利用经验证的 结果和纵向阻力数据由CNICS提供。PIRC将作为一种资源， 高质量的基础、临床和转化研究。

ABSTRACT HIV incidence is still increasing in the U.S. despite intense efforts to: (i) diagnose HIV infection as early as possible, (ii) engage newly diagnosed individuals into care and (iii) start antiretroviral therapy (ART) for all infected persons. The San Diego Primary Infection Resource Consortium (PIRC) has been tackling the evolving challenges around these issues for twenty years. The PIRC is the largest, most intensively studied and well-characterized cohort of acute and early HIV infected (AEH) individuals in the United States. It has provided essential support to over 325 peer-reviewed original research manuscripts, spanning a wide range of fields, and including many NIH priority areas for HIV research, including: HIV incidence, strategies to improve HIV testing and entry into prevention services, etc. This application represents a renewal of our PIRC R24 (AI106039) with the proposal to continue this highly productive program, supporting the infrastructure needed to identify, characterize, and share clinical and biological data with scientific colleagues whose research objectives rely upon access to these biological samples and data. The proposed R24 renewal application includes a new collaboration between PIRC and the Center for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) to develop an expanded and synergistic resource to serve biomedical research in the area of AEH. Overall, the PIRC supports: 1) an HIV screening program to detect and stage acute, recent and chronic infection, 2) partner services to identify sexual contacts of newly HIV diagnosed AEH participants (i.e., “index” subjects), 3) immediate provision of ART, 4) prompt linkage to care, 5) monitoring of ART adherence and continued engagement in care, 6) methods to estimate putative HIV transmission and 6) an AEH biorepository. This entire biorepository and data associated with these well characterized participants are available to qualified investigators, requiring only internal review and approval of a concept proposal. The proposed R24 renewal application will address the following Specific Aims: Aim 1. Community HIV Testing and Acute and Early HIV (AEH) Infection Staging. We propose to identify 120 newly HIV diagnosed persons per year at the University of California San Diego: 47 AEH infected and 73 chronically infected participants. Aim 2. Improve Continuum of HIV Prevention and Treatment. We will evaluate temporal changes in the HIV treatment cascade in response to coordinated efforts to support immediate ART in newly HIV diagnosed PIRC participants. Subjects identified during AEH will be followed for up to 5 years, while chronically infected subjects will be followed in clinic for up to 90 days. Aim 3. Shared Resources. We will leverage AEH specimen and participant resources to support additional NIH research collaborations related to primary HIV infection. Co-enrollment of AEH participants in CNICS will leverage the clinical monitoring of validated outcomes and longitudinal resistance data provided by CNICS. The PIRC will serve as a resource to support high quality basic, clinical and translational research related to AEH.