International epidemiologic Database to Evaluate AIDS (West Africa) Core

描述(由申请人提供)：WADA(西非抗逆转录病毒治疗数据库)合作是西非队列之间的独特合作，其使命是对艾滋病毒1型和2型感染者的预后和结果进行假设驱动的流行病学研究，包括成人、孕妇和儿童。这项研究将侧重于需要大样本患者的科学问题，这些问题是贡献队列无法单独回答的，并且与现有项目不重叠。第一年期间的活动将侧重于对现有数据进行横断面分析，全面审查现有数据在基线和后续行动期间的核心项目的完整性，以及开发工具以标准化、协调和改进各地点的数据收集。2-5年的研究议程和具体假设将根据第一年活动的结果最终确定，重点放在以下四个领域：方案问题(获得抗逆转录病毒治疗的机会和后续损失)；成人、儿童和孕妇的监测和治疗结果；临床反应，特别关注结核病、机会性感染、免疫重建综合症和乙肝合并感染；艾滋病毒-2感染的护理。更多的研究问题将集中在随后几年，预计在五年内解决大约30个已完成的项目和分析。在六个西非国家的六个主要城市，共有17个队列--每个队列都在进行中，并有自己的内部治理结构和财政支持--同意提供过去几年从2345名感染艾滋病毒的儿童和33245名成年患者中收集的数据。这项申请的区域协调中心将设在法国波尔多。这个大学团队(Francois Dabis教授，ISPED，Victor Segalen大学)在西非的流行病学艾滋病毒队列研究方面拥有长期的经验，在科特迪瓦的阿比让设有办事处。它还在这类国际合作方面有丰富的经验，包括根特妇女和儿童艾滋病毒问题小组和ART-LINC合作。国际反兴奋剂机构将负责实施世界反兴奋剂机构的合作。每年将从附属队列收集数据，一旦合并到世界反兴奋剂机构的主数据库中，将为各种项目和分析提取数据。这一过程将每年重复一次，以便对附属队列中收集的最新数据进行分析。世界反兴奋剂机构在西非是一项史无前例的工作，其独特的设计将由具有丰富经验的调查人员领导，以促进更好地了解和治疗撒哈拉以南非洲所有年龄、性别和背景的艾滋病毒感染者所需的公共卫生知识。撒哈拉以南非洲是需求未得到满足的最大的大陆，但艾滋病毒治疗方案仍在持续、迅速和大规模地推出。

DESCRIPTION (provided by applicant): The WADA (West Africa Data Base on Antiretroviral Therapy) Collaboration is a unique collaboration among cohorts in West Africa with a mission to conduct hypothesis-driven epidemiological research on the prognosis and outcome of HIV type 1 and 2-infected people, including adults, pregnant mothers, and children. The research will focus on scientific questions requiring a large sample size of patients which the contributing cohorts cannot answer individually and which do not overlap with existing projects. Activities during Year 1 will focus on cross-sectional analyses of existing data, a comprehensive examination of the available data in terms of completeness of core items at baseline and during follow-up, and the development of instruments to standardize, harmonize and improve data collection across sites. The research agenda and specific hypotheses for Years 2-5 will be finalized based on the results of Year 1 activities, with a focus on the following four areas: programmatic issues (access to ant- retroviral treatment and losses to follow up); monitoring and outcomes of treatment in adults, children and pregnant women; clinical response, with a special interest for tuberculosis, opportunistic infections, immune reconstitution syndrome and hepatitis B coinfection; care of HIV-2 infection. Additional research questions will be focused in the subsequent years, with the expectation to address around 30 completed projects and analyses over five years. A total of 17 cohorts in six major cities in six West African countries - each ongoing and with their own internal governance structure and financial support - have agreed to contribute data collected already over the past years from a collective number of 2,345 HIV-infected children and 33,245 adult patients. The regional coordinating centre for this application will be located in Bordeaux, France. This university team (Prof Francois Dabis, ISPED, Universite Victor Segalen) has a long lasting experience in epidemiological HIV cohort research in West Africa, with an office in Abidjan, Cote d'lvoire. It also has extensive experience with international collaborations of this kind including the Ghent Group on HIV in Women and Children and the ART-LINC Collaboration. ISPED will be responsible for the implementation of the WADA Collaboration. Data will be collected from affiliated cohorts every year and once merged into a main WADA database, data extracts will be made for the various projects and analyses. This process will be repeated annually allowing for the analysis of the most contemporary data collected in the affiliated cohorts. WADA is an unprecedented undertaking in West Africa, with a unique design, lead by investigators with extensive experience, that will advance the public health knowledge required to better understand and treat HIV-infected persons of all ages, genders and backgrounds in sub-Saharan Africa, the continent with the largest unmet needs but with onqoing, rapid and massive roll-out of HIV treatment programmes.