Multicenter AIDS Cohort Study

本申请是竞争性更新匹兹堡组成部分的建议书的B部分， 多中心艾滋病队列研究（MACS）合作协议（1UO 1-AI-35041）， CAMACS提交的A部分综合提案。MACS始于1983年， 男男性行为者（MSM）艾滋病自然史研究。这一要求是为了增加 五年的支持，临床随访和实验室检测队列的男男性接触者在匹兹堡 MACS。匹兹堡MACS的广泛目标是实现A部分主MACS的具体目标 应用，并在匹兹堡当地进行专门研究，以提高我们的流行病学和发病机制 与治疗干预有关的知识，以及免疫和预防措施的发展 疫苗。我们的具体目标是确定艾滋病毒感染的长期自然和治疗史， 男男性接触者，描述对艾滋病毒治疗的反应，包括心理和行为预测因素， 检查HIV和长期HIV治疗暴露对脂肪代谢障碍、糖尿病、心血管疾病的影响， 疾病、肝病、恶性肿瘤、神经认知功能、物质使用、肾病和其他 结果，评估衰老对艾滋病毒和艾滋病毒治疗的临床过程的影响， 宿主遗传学和HIV之间的关系，定义HIV发病机制，描述HIV相关癌症，包括 确定危险因素，确定影响艾滋病毒传播和疾病的社会行为因素 进展，表征伴随感染及其对HIV疾病进展的影响，检查 药物滥用对抗逆转录病毒治疗效果的影响，保持纵向收集 流行病学数据和生物标本储存库，作为促进自然历史的平台， 发病机制研究，在匹兹堡MACS中进行MSM的临床和实验室测试，包括T细胞 亚群、抗HIV抗体、HIV病毒载量、B型肝炎病毒和丙型肝炎病毒检测、血脂/胰岛素/血糖 水平，肝功能检查，肾功能和心血管研究。这项研究直接关系到 国家卫生研究院的使命是治疗和预防艾滋病毒感染和艾滋病。 相关性（参见说明）： 作为MACS研究联盟的一部分，匹兹堡MACS建议继续其25年的科学研究， 调查艾滋病毒/艾滋病的自然史。这项研究提供了深入了解艾滋病毒的机制， 艾滋病毒感染，艾滋病毒治疗的效果，以及艾滋病毒治疗和预防疫苗的开发 感染它与美国国立卫生研究院的艾滋病毒/艾滋病公共卫生项目高度相关。

This application is Part B of a proposal for a competing renewal to the Pittsburgh component of the Multicenter AIDS Cohort Study (MACS) Cooperative Agreement (1UO1-AI-35041), the companion to the Part A composite proposal that is being submitted by CAMACS. The MACS began in 1983 as a longitudinal study of the natural history of AIDS in men who have sex with men (MSM). This request is for an additional five years of support for clinical follow-up and laboratory testing of the cohort of MSM in the Pittsburgh MACS. The broad objectives of the Pittsburgh MACS is to fulfill the specific aims of the Part A master MACS application, and do special studies locally in Pittsburgh to enhance our epidemiologic and pathogenesis knowledge in relation to treatment intervention, and development of immunotherapeutic and prophylactic vaccines. Our specific aims are to determine the long-term natural and treated history of HIV infection in MSM, characterize the responses to HIV therapy, including psychological and behavioral predictors, examine the effects of HIV and prolonged HIV therapy exposure on lipodystrophy, diabetes, cardiovascular disease, liver disease, malignancies, neurocognitive function, substance use, kidney disease, and other outcomes, assess the effects of aging on the clinical course of HIV and HIV therapy, examine the interaction between host genetics and HIV, define HIV pathogenesis, characterize HIV-associated cancers including identification of risk factors, determine socio-behavioral factors that affect HIV transmission and disease progression, characterize concomitant infections and their effects on HIV disease progression, examine the effects of substance abuse on antiretroviral treatment effectiveness, maintain longitudinally collected epidemiological data and biological specimen repository as a platform to facilitate natural history and pathogenesis studies, perform clinical and lab testing of MSM in the Pittsburgh MACS, including T cell subsets, anti-HIV Ab, HIV viral load, hepatitis B virus and hepatitis C virus testing, serum lipid/insulin/glucose levels, liver function tests, renal function and cardiovascular studies. This research has direct relevance to the mission of the NIH to cure and prevent HIV infection and AIDS. RELEVANCE (See instructions): As part of the MACS research consortium, the Pittsburgh MACS proposes to continue its 25 year scientific investigation into the natural history of HIV/AIDS. This research provides insight into the mechanisms of HIV infection, the effects of HIV therapy, and development of therapeutic and preventative vaccines for HIV infection. It is highly relevant to HIV/AIDS public health programs of the NIH.