Core G: Clinical and Comorbidity Research

项目总结/摘要 抗逆转录病毒疗法（ART）已经极大地改变了艾滋病毒疾病的进展，但新出现的并发症， 艾滋病病毒从慢性免疫激活和代谢变化时，病毒在很大程度上受到抑制的驱动 在当代ART时代的发病率和死亡率。威尔斯亲王医院患上心血管疾病、糖尿病、 癌症，认知和功能下降，比未感染的对照组年轻10-15岁。老年 综合征，如虚弱和多发性硬化症，在威尔斯亲王医院越来越普遍，导致更多 住院和死亡。因此，迫切需要对PWH中的衰老进行研究。2023-28 CCR 核心将利用25年来开发的无与伦比的资源组合， 跨学科的临床，流行病学，社会行为，转化和基础研究的接口， 艾滋病毒和老龄化通过以下具体目标。AIM 1.目标扩展的UW艾滋病毒信息 系统，UW HIV队列和新的IT支持新兴的HIV研究优先事项：开发，测试和 扩大创新技术的规模，以确定新的数据和裁定关键的共病结果，并扩大这些 多中心HIV研究联盟的平台，如CFAR综合临床系统网络 （CNICS）。AIM 2.通过艾滋病毒和艾滋病交叉点的共病研究改善临床结果 老龄化：营造一个包容性的合作研究环境，让当地专家和环境服务机构参与艾滋病毒研究， 相关的科摩罗研究合作组织（CRCs）进行高影响力的研究，重点是 预防和治疗心血管疾病，代谢，神经，肺部，肝脏疾病，癌症，衰老和新兴 威尔斯亲王医院的新冠肺炎等优先事项。CCR对大型多中心艾滋病毒网络（如CNICS）的核心领导 和北美艾滋病队列研究与设计合作组织（NA-ACCORD）， 为PWH在北美的数据和标本，增加了研究的范围和普遍性。 AIM 3.支持临床、转化和基础艾滋病毒研究，加强社区参与： 提供高质量的临床数据，可行性和研究设计咨询，分析数据集， 判定的结果（例如，中风）和患者报告的结果（PRO），如目前的物质使用， 标本和合格的研究参与者来自一个单一的实体。核心将连接研究团队和临床 团队和社区，以告知研究优先事项，促进研究实施，并更好地参与 代表性不足的群体，以促进公平和包容。目标4：指导下一代艾滋病毒 研究者：CCR核心多学科导师团队，拥有流行病学，数据科学， 健康信息学、生物统计学、临床医学、基础和转化研究将在研究设计方面培训ESI， 方法（定性，定量），统计分析，手稿和赠款写作，并促进参与 在CRC和多中心HIV网络中（例如，CNICS、NA-ACCORD、国际流行病学数据库， 评估艾滋病（IeDEA）联盟），以支持下一代艾滋病毒研究人员的发展。

Project Summary/Abstract Antiretroviral therapy (ART) has dramatically altered HIV disease progression, but emerging complications of HIV from chronic immune activation and metabolic changes when the virus is largely suppressed are driving morbidity and mortality in the contemporary ART era. PWH develop cardiovascular disease (CVD), diabetes, cancer, cognitive and functional decline at ages 10-15 years younger than uninfected controls. Geriatric syndromes such as frailty and multimorbidity are becoming increasingly prevalent in PWH, leading to more hospitalizations and deaths. Thus, there is an urgent need for research on aging in PWH. The 2023-28 CCR Core will leverage an unparalleled combination of resources developed over 25 years to support interdisciplinary clinical, epidemiologic, socio-behavioral, translational, and basic research at the interface of HIV and aging through the following specific aims. AIM 1. Target expansion of the UW HIV Information System, UW HIV Cohort and novel IT to support emerging HIV research priorities: develop, test, and scale innovative technologies to ascertain new data and adjudicate key comorbid outcomes and extend these platforms to multi-center HIV research consortia such as the CFAR Network of Integrated Clinical Systems (CNICS). AIM 2. Improve clinical outcomes through comorbidity research at the intersection of HIV and aging: foster an inclusive, collaborative research environment engaging local experts and ESI in HIV- associated Comorbidity Research Collaborations (CRCs) conducting high-impact research focused on prevention and treatment of CVD, metabolic, neurologic, pulmonary, liver disease, cancer, aging and emerging priorities such as COVID-19 in PWH. CCR Core leadership of large multi-center HIV networks, such as CNICS and the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), facilitates access to data and specimens for PWH across North America, increasing the scope and generalizability of research. AIM 3. Support clinical, translational and basic HIV research and enhance community engagement: provide high-quality clinical data, consultation on feasibility and study design, analytic datasets with adjudicated outcomes (e.g., strokes) and patient-reported outcomes (PROs) such as current substance use, specimens, and eligible study participants from a single entity. The Core will connect study teams to clinical teams and the community to inform research priorities, facilitate study implementation and better engage with underrepresented groups to advance equity and inclusion. AIM 4: Mentor the next generation of HIV investigators: CCR Core multidisciplinary mentorship team with expertise in epidemiology, data science, health informatics, biostatistics, clinical medicine, basic and translational research will train ESI in study design, methods (qualitative, quantitative), statistical analysis, manuscript and grant writing, and facilitate participation in CRCs and multi-center HIV networks (e.g., CNICS, NA-ACCORD, International epidemiologic Databases to Evaluate AIDS (IeDEA) consortium) to support development of the next generation of HIV researchers.