Cape Town Adolescent Antiretroviral Cohort (CTAAC)

开普敦青少年抗逆转录病毒队列 (CTAAC)

• 批准号: 8386676
• 负责人: Heather Joy Zar
• 金额: $ 64.18万
• 依托单位: UNIVERSITY OF CAPE TOWN
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8386676
• 关键词: 15 year old; AIDS/HIV problem; Acute; Address; Adolescence; Adolescent; Adolescent Development; Africa; Africa South of the Sahara; African; Age; Anti-Retroviral Agents; Area; Asia; Behavior; Brain; Cardiac; Cardiology; Cardiovascular Pathology; Cardiovascular Physiology; Cardiovascular system; Child; Chronic; Chronic Disease; Chronic lung disease; Clinical; Complex; Control Groups; Data; Development; Diagnosis; Disease; Enrollment; Epidemiology; Evaluation; Evolution; Exposure to; Face; Family; Functional disorder; Gender; Goals; HIV; HIV Infections; Health; Heart; Infection; Inflammatory Response; Lead; Life; Life Expectancy; Long-Term Care; Long-Term Effects; Lung; Lung diseases; Measures; Medical History; Metabolic; Natural History; Neurocognitive; Neurologic; Opportunistic Infections; Outcome; Pathology; Pattern; Personal Satisfaction; Population; Positioning Attribute; Prevalence; Process; Prospective Studies; Pulmonary Pathology; Pulmonology; Recording of previous events; Research; Research Infrastructure; Research Personnel; Respiratory physiology; Risk Behaviors; Risk Factors; Risk-Taking; Services; Shapes; Site; Socioeconomic Status; South Africa; Staging; Stigmatization; Structure; Support System; System; Time; Viremia; Work; aged; antiretroviral therapy; body system; cardiovascular risk factor; cohort; experience; follow-up; improved; innovation; neurocognitive test; neuroimaging; neuropsychiatry; patient population; pediatric human immunodeficiency virus; psychologic; psychosocial; pulmonary function; treatment adherence

DESCRIPTION (provided by applicant): The purpose of the Cape Town Adolescent Antiretroviral Cohort (CTAAC) is to investigate chronic disease processes in perinatally HIV-infected South African adolescents. The focus is on four key domains: the impact of chronic HIV infection on development; the neuropsychiatric manifestations of HIV in adolescence; the development of chronic lung disease; and early markers of cardiovascular dysfunction. Throughout, the emphasis of this research is on understanding the interactions between chronic disease processes across organ systems. The proposal will enroll 520 perinatally-infected children ages 9-14 years established on antiretroviral therapy. We will follow these children with regular measures (including measures of physical and psychological development, clinical well-being, lung function, cardiovascular status, and emergent risk behaviours) at 6-monthly intervals over 36 months. A control group of 80 HIV-negative controls will be matched on age, gender and socioeconomic status, in order to collect normative data on key parameters. A nested substudy will provide intensive neuropsychiatric evaluation and neuroimaging over time (n=200 HIV-infected children with 50 HIV-negative controls). Analyses will document the prevalence and natural history of chronic disease measures in each of the three organ systems, and then examine the associations between neuropsychiatric, cardiovascular and pulmonary pathology. There are specific hypotheses that: (i) HIV-infected children who initiated ART at an early age and/or disease stage will have fewer sequelae of chronic disease, and will experience less progression in system-specific chronic disease processes (either neurological, pulmonary and cardiovascular); (ii) Children with poorly controlled HIV viraemia during follow-up will experience greater progression in system-specific chronic disease manifestations; and (iii) Children with chronic disease manifestations in one organ system are more likely to have multi-system involvement and shared risk factors. The CTAAC team is comprised of leading South African researchers in pediatric HIV, neuropsychiatry, pulmonology, cardiology and epidemiology, who have pioneered research into the health of HIV-infected children and adolescents in sub-Saharan Africa. CTAAC represents a critical opportunity to address innovative scientific questions and advance our understanding the long-term effects of chronic HIV disease in order to promote the health of perinatally-infected young people as they grow older around the world. PUBLIC HEALTH RELEVANCE: As older children infected with HIV survive longer with antiretroviral therapy (ART) across Africa and Asia, they are likely to experience more effects from chronic HIV disease and ART use. However little is known about the development of chronic diseases in these children, particularly involving the heart and circulatory system, the lungs, and the brain. This information is important in understanding how HIV/AIDS influences other diseases in children and adolescents, and in turn, how best to improve the health of HIV infected children over time.

描述（由申请人提供）：开普敦青少年抗逆转录病毒队列（CTAAC）的目的是研究围产期感染HIV HIV感染的南非青少年的慢性病过程。重点是四个关键领域：慢性艾滋病毒感染对发育的影响；艾滋病毒在青春期的神经精神表现；慢性肺部疾病的发展；和心血管功能障碍的早期标记。在整个过程中，这项研究的重点是了解器官系统慢性疾病过程之间的相互作用。该提案将在抗逆转录病毒疗法上建立的9-14岁儿童注册520名周期感染的儿童。我们将在36个月内以6个月的间隔间隔6个月，以6个月间隔间隔6个月间隔6个月间隔6个月的间隔，以定期采取定期措施（包括临床和心理发展，肺部功能，心血管状况和紧急风险行为的措施）跟随这些儿童。为了收集关键参数的规范数据，将在年龄，性别和社会经济状况上匹配80个HIV阴性控制的对照组。随着时间的流逝，嵌套的蛋白质将提供密集的神经精神病学评估和神经影像学（n = 200个HIV感染儿童，具有50个HIV阴性对照）。分析将记录三个器官系统中每一个中慢性疾病度量的患病率和自然历史，然后检查神经精神病，心血管和肺病理学之间的关联。有特定的假设：（i）在早期和/或疾病阶段发起艺术的艾滋病毒感染儿童的慢性疾病后遗症较少，并且在系统特异性慢性疾病过程（神经，肺和心血管疾病）中的进展较小； （ii）随访期间患有HIV病毒血症不良的儿童将经历 系统特异性慢性疾病表现的进展更大； （iii）一个器官系统中患有慢性疾病表现的儿童更有可能具有多系统参与和共同的危险因素。 CTAAC团队由南非艾滋病毒，神经精神病学，肺科学，心脏病学和流行病学领域的主要研究人员组成，他们率先研究了撒哈拉以南非洲艾滋病毒感染的儿童和青少年的健康。 CTAAC代表了解决创新的科学问题并促进我们理解慢性艾滋病毒疾病的长期影响的关键机会，以促进周围年轻人在世界各地成长的年轻人的健康。 公共卫生相关性：随着年龄较大的艾滋病毒感染的儿童在非洲和亚洲的抗逆转录病毒疗法（ART）生存更长的时间，他们可能会从慢性艾滋病毒疾病和艺术使用中获得更多影响。然而，这些儿童的慢性疾病的发展知之甚少，特别是涉及心脏和循环系统，肺部和大脑。这些信息对于了解艾滋病毒/艾滋病如何影响儿童和青少年的其他疾病很重要，进而如何最好地改善随着时间的推移艾滋病毒感染儿童的健康。