The Adolescent Master Protocol (AMP) Up Series Project

项目总结 疾病控制和预防中心估计，2016年，有11,915人患有 美国围产期获得性艾滋病毒(PHIV)，包括10,101名青少年和年轻人。全球，1.7 有100万15岁以下的儿童携带艾滋病毒，并接受有效的抗逆转录病毒药物治疗。 预计能活到青春期、青壮年和以后。 青少年主协议(AMP)旨在评估艾滋病毒感染的长期影响和 多个域上的抗逆转录病毒药物。AMP招募了451名7-16岁的艾滋病毒携带者和227名儿童 2007-09年围产期艾滋病毒暴露但未感染(PHEU)。AMP UP和AMP UP Lite 研究(AMP UP系列)被开发为允许对感染艾滋病毒的年轻人进行持续随访 (YAPHIV)18岁以上，包括AMP参与者，以评估他们的身心健康 向成人期过渡。这些创新研究有着相似的目标，旨在促进长期的 定期随访，收集年度在线和医学图表摘要数据。 AMP出版了许多有影响力的出版物，成果丰硕。AMP UP产生了重要的影响 信息--包括社会支持的作用和自我管理医疗保健的能力 过渡到成人临床护理，产后病毒血症和早期HPV相关宫颈的高风险 损伤。然而，艾滋病毒和抗逆转录病毒对青壮年健康的长期影响仍在继续。这个 从幼年起收集的关于之前AMP UP参与者的大量子集的全面数据 在AMP中提供了宝贵的机会来评估艾滋病毒和ARV的早期、心理健康、神经认知 功能和家庭动态会影响成人的结果。AMP UP系列的具体目标是： 1.确定艾滋病毒感染、抗逆转录病毒药物以及个人、社会和结构因素对以下方面的影响：向 成人和成人护理；大脑结构和神经功能；学术、职业、情感和 社会功能；精神健康；服药和保健依从性；性行为；以及物质使用。 2.确定艾滋病毒的传染性和非传染性并发症及其与抗逆转录病毒药物和艾滋病毒的关系。 3.调查遗传、表观遗传、病毒学、炎症性和免疫学因素对疾病进程的影响 艾滋病毒感染、其并发症、治疗反应以及艾滋病毒缓解/治愈的可能性。

PROJECT SUMMARY The Centers for Disease Control and Prevention estimates that in 2016, there were 11,915 persons with perinatally-acquired HIV (PHIV) in the U.S., including 10,101 adolescents and young adults. Globally, 1.7 million children under the age of 15 are living with HIV and with effective antiretroviral medications (ARVs) are expected to survive into adolescence, young adulthood and beyond. The Adolescent Master Protocol (AMP) was designed to evaluate long-term effects of HIV infection and ARVs on multiple domains. AMP enrolled 451 children with PHIV between ages 7-16 years and 227 children living with perinatal HIV exposure but uninfected (PHEU) from 2007-09. The AMP Up and AMP Up Lite studies (AMP Up Series) were developed to allow for continued follow-up of young adults with PHIV (YAPHIV) beyond 18 years of age, including AMP participants, to assess physical and mental health as they transition to adulthood. These innovative studies share similar objectives and are designed to facilitate long- term follow-up with annual online and medical chart abstracted data collection. AMP has been highly productive with numerous influential publications. AMP Up has yielded important information – including the role of social support and ability to self-manage health care on a successful transition to adult clinical care, and the high risk of postpartum viremia and early HPV-associated cervical lesions. Yet the long-term effects of HIV and ARV on health in young adulthood are still unfolding. The comprehensive data collected since early childhood on a substantial subset of AMP Up participants previously in AMP provides the invaluable opportunity to assess how early HIV and ARV, mental health, neurocognitive function, and family dynamics impact adult outcomes. The specific aims of the AMP Up Series are to: 1. Define the impact of PHIV infection, ARVs, and individual, social and structural factors on: the transition to adulthood and adult care; brain structure and neurological functioning; academic, vocational, emotional and social functioning; mental health; medication and health care adherence; sexual behaviors; and substance use. 2. Identify infectious and non-infectious complications of HIV and their associations with ARVs and HIV. 3. Investigate genetic, epigenetic, virologic, inflammatory, and immunologic factors which impact the course of HIV infection, its complications, the response to treatment, and potential for HIV remission/cure.