Longitudinal Study of HIV and Aging in Brazil

项目摘要/摘要 这项研究将调查流行病学、临床意义以及免疫学和传染性决定因素。 关于巴西老年艾滋病毒携带者(PWH)与衰老相关疾病和结局的研究。在一定程度上，这是长期- HIV感染和持续炎症的长期影响，老年PWH的非传染性比率很高 疾病(NCDs)和早发的老年综合征，包括虚弱、残疾和认知能力下降。 然而，艾滋病毒并不是唯一一种可以引起炎症和其他免疫性疾病的慢性感染 与这些结果相关的变化。我们对其他慢性感染如何流行到低和 中等收入国家影响老年综合征的发病机制和流行病学。一个 巴西是一个拥有大量老年威尔斯亲王的中等收入国家，有全面的艾滋病毒护理历史 以及地方性慢性感染。这项多样化的纵向研究将招募PWH进行抗逆转录病毒治疗。 ≥在三个巴西城市的50岁年龄(n=360岁50-64岁和n=340岁≥65岁)评估 结核病、HTLV-1、恰加斯病、弓形虫病等混合感染对流行病学的影响 以及衰老相关发病的免疫学途径。我们将研究这两个基因之间的联系 经确认的非传染性疾病的混合感染和健康的社会决定因素。我们将前瞻性地评估如何 合并感染的个体和累积负担预测老年综合征的发生。我们将对一部小说进行评估 筛查工具，以评估老年PWH对包括死亡在内的不良临床结果的脆弱性， 住院和新的残疾。这项研究还将调查联合感染如何影响肺炎的生物途径 炎症，有助于NDDC的发展和老年综合征的建立 在拉丁美洲艾滋病毒观察性研究方面的富有成效的合作，这项研究具有独特的地位 提供迫切需要的高质量数据，以便在全球范围内了解艾滋病毒感染者的老龄化情况。它将提供新奇的 对周围PWH经历的对衰老细胞机制的感染贡献的多样性的洞察 环球网。

Project Summary / Abstract This study will investigate the epidemiology, clinical implications, and immunologic and infectious determinants of aging-related diseases and outcomes in older people with HIV (PWH) in Brazil. In part a result of the long- term effects of HIV infection and ongoing inflammation, older PWH experience high rates of non-communicable diseases (NCDs) and early onset of geriatric syndromes including frailty, disability, and cognitive decline. However, HIV is not alone as a chronic infection that can cause inflammation and other immunological changes associated with these outcomes. Our knowledge of how other chronic infections endemic to low-and middle-income countries affect the pathogenesis and epidemiology of geriatric syndromes in is lacking. A middle-income country with a large population of older PWH, Brazil has a history of comprehensive HIV care as well as endemic chronic infections. This diverse, longitudinal study will recruit PWH on antiretroviral therapy ≥50 years of age in three Brazilian cities (n=360 ages 50-64years and n=340 ages ≥65 years) to evaluate the ways coinfections such as TB, HTLV-1, Chagas disease, toxoplasmosis, and others affect the epidemiology and immunologic pathways of aging-related morbidity. We will examine the association of syndemics of coinfections and social determinants of health with validated NCDs. We will prospectively evaluate how individual and cumulative burden of coinfections predict incident geriatric syndromes. We will evaluate a novel screening tool to assess vulnerability of older PWH for adverse clinical outcomes including death, hospitalization, and new disability. This study will also investigate how coinfections affect biologic pathways of inflammation which contribute to development of NDCs and geriatric syndromes Building upon established and productive collaborations in HIV observational research in Latin America, this study is uniquely positioned to provide urgently needed, high-quality data to understand aging with HIV in a global context. It will offer novel insights into a diversity of infectious contributions to cellular mechanisms of aging experienced by PWH around the globe.