North American AIDS Cohorts Collaboration on Research and Design (NAACCORD) Renewal

 描述(由申请人提供)：自2006年以来，北美-艾滋病队列研究和设计合作(NA-ACCORD)一直代表leDEA倡议的区域1。NA-ACCORD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美国和加拿大境内的大多数艾滋病毒/艾滋病队列。美国和加拿大的200多个网站提供了从15万名艾滋病毒感染者那里收集的数据。我们已经建立了强大的协作基础设施，利用了跨基础科学、临床研究、流行病学、 数据信息学和生物统计学。我们在实现我们以前的目标方面卓有成效，并将我们的科学重点扩展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，可以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：评估和描述北美艾滋病毒感染的临床过程，重点是老龄化、主要非艾滋病合并症和预期寿命。目的2：描述北美通过病毒抑制参与艾滋病毒护理的连续过程，并将连续过程扩展到包括长期保留、使用抗逆转录病毒疗法对临床结果和预期寿命的影响。目的3：评估新的直接作用抗病毒药物(DAA)对HIV和丙型肝炎(HCV)混合感染者的进展和转归的影响。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。

 DESCRIPTION (provided by applicant): The North American-AIDS Cohort Collaboration on Research and Design (NA-ACCORD) has represented Region 1 of the leDEA initiative since 2006. The 22 single and multi-site clinical and classical epidemiologic HIV cohorts of the NA-ACCORD encompass most HIV/AIDS cohorts within the US and Canada. Over 200 sites in the US and Canada contribute data collected from 150,000 HIV-infected participants. We have established a strong collaborative infrastructure that capitalizes on the talents and expertise of multi-disciplinary group of investigators that span basic science, clinical research, epidemiology, data informatics and biostatistics. We have been highly productive in addressing our previous Aims and expanding our scientific focus to several areas of contemporary importance in HIV in North America, and our collaboration is well- positioned to answer the key questions in practice today. We have three broadly-defined aims for the next funding cycle: Aim 1: Assess and characterize the clinical course of HIV infection in North America, with a focus on aging, major non-AIDS comorbidities and life-expectancy. Aim 2: Characterize the HIV Care Continuum in North America from engagement in HIV care through viral suppression, and extend the Continuum to include long-term retention, utilization of ART to clinical outcomes and life-expectancy. Aim 3: Assess the impact of new direct-acting antivirals (DAAs) on the progression and outcomes of HIV and hepatitis C (HCV) disease in HIV-HCV co-infected persons. 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.