Longitudinal Study of HIV and Aging in Brazil

巴西艾滋病毒与老龄化的纵向研究

基本信息

批准号：
10468938
负责人：
Jessica L Castilho
金额：
$ 64.83万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-15 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10468938
关键词：
Adult Affect Age Age-Years Aging Apoptosis Area Assessment tool Atherosclerosis Automobile Driving Behavioral Biological Biology of Aging Brazil Canada Cardiometabolic Disease Caribbean region Caring Central America Cessation of life Chagas Disease Chronic Cities Clinical Clinical Research Clinical assessments Collaborations Country Cytomegalovirus Data Development Disease Outcome Elderly Epidemic Epidemiology Evaluation Geriatric Assessment Geriatrics Germany HIV HIV Infections Health Policy Herpesviridae Hospitalization Human Human T-lymphotropic virus 1 Immunologics Immunology Impaired cognition Income Individual Infection Inflammation Inflammatory Institution Investigation Knowledge Laboratories Latin America Life Expectancy Ligands Link Long-Term Effects Longitudinal Studies Lymphocyte Measures Mediating Medical Morbidity - disease rate Neurocognitive Deficit Observation in research Older Population Onset of illness Outcome Pathogenesis Pathway interactions Persons Positioning Attribute Protein Isoforms Quality of life Recording of previous events Research Research Personnel Resources Risk Risk Factors Screening procedure Socioeconomic Factors Source South America Standardization Syndrome TNF gene TNF-related apoptosis-inducing ligand Toxoplasmosis Trypanosoma cruzi Tuberculosis United States United States National Institutes of Health Validation Viral antiretroviral therapy chemokine chronic infection clinical predictors co-infection comorbidity cytokine disability early onset effective therapy epidemiologic data epidemiology study experience falls frailty functional decline human old age (65+)improved inflammatory marker insight low and middle-income countries macrophage mitochondrial dysfunction modifiable risk mycobacterial novel outcome prediction pathogen prospective public health relevance recruit risk stratification senescence social health determinants socioeconomics syndemic telomere translational study

项目摘要

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.

项目概要/摘要本研究将调查流行病学、临床意义以及免疫学和感染性决定因素巴西艾滋病毒感染者 (PWH) 的老龄化相关疾病和结果的部分原因是长期的。 HIV 感染和持续炎症的长期影响，老年感染者非传染性疾病的发病率很高疾病 (NCD) 和早发的老年综合症，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学问题的慢性感染。我们对其他慢性感染如何流行的了解与这些结果相关。中等收入国家缺乏影响老年综合征的发病机制和流行病学。巴西是拥有大量老年感染者的中等收入国家，拥有全面艾滋病毒护理的历史这项多样化的纵向研究将招募艾滋病患者进行抗逆转录病毒治疗。巴西三个城市的 ≥50 岁人士（n=360 名 50-64 岁，n=340 名 ≥65 岁）来评估结核病、HTLV-1、恰加斯病、弓形虫病等合并感染影响流行病学的方式我们将研究与衰老相关的发病率的相关性和免疫学途径。我们将前瞻性地评估如何与已验证的非传染性疾病合并感染和健康的社会决定因素。合并感染的个体和累积负担可预测老年综合症的发生率。用于评估老年感染者对不良临床结果（包括死亡）的脆弱性的筛查工具这项研究还将调查合并感染如何影响生物途径。炎症有助于 NDC 和老年综合征的发展拉丁美洲艾滋病毒观察研究方面的富有成效的合作，这项研究具有独特的定位提供急需的高质量数据，以了解全球范围内艾滋病毒导致的老龄化情况。深入了解感染者对衰老细胞机制的多样性贡献地球仪。