Pregnancy and Response to Antiretroviral Therapy in South Africa

南非的妊娠和抗逆转录病毒治疗的反应

• 批准号: 8779000
• 负责人: Daniel J Westreich
• 金额: $ 19.26万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-27 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8779000
• 关键词: Pregnancy; Response; Antiretroviral; Therapy; South; Pregnancy; Response; Antiretroviral; Therapy; South

The overall goal of this proposal remains unchanged and is to investigate the effect of pregnancy on response to highly active antiretroviral therapy (HAART) among HIV-i- women in treatment in Johannesburg, South Africa. In addition, we will continue developing the advanced quantitative epidemiologic methods described in the training component ofthe K99 portion of this grant. Prevalence of HIV among pregnant women in South Africa is substantially higher than that among other adults. Despite extensive study of interventions for the prevention of mother to child transmission of HIV, and response to antiretroviral therapy during and after such interventions, little is known about the effect of pregnancy itself on responses to and retention in therapy. Fully understanding the effect of pregnancy on maternal responses to HAART is essential to providing good clinical care to H1V+ women in Africa and elsewhere. To address these questions, this work proposes to examine the effect of pregnancy on immunologic responses to HAART, clinical (AIDS/death) responses to HAART, and to adherence to HAART and retention in care. Because it is impossible (and highly unethical) to randomize the exposure of pregnancy, this study will rely on high quality clinical data collected in the Themba Lethu Clinic in Johannesburg, South Africa, an urban antiretroviral therapy clinic associated with the Clinical HIV Research Unit at the University ofthe Witwatersrand. The Principal Investigator of the proposed work, Dr. Daniel Westreich, has a strong track record in producing high quality research in collaboration with investigators and clinicians at the Clinic. The analysis of these data will require the use of structural models, an advanced body of epidemiologic methods.

该提案的总体目标保持不变，是研究怀孕对南非约翰内斯堡治疗中HIV-I-I-妇女对高度活性抗逆转录病毒疗法（HAART）反应的影响。此外，我们将继续开发该赠款K99部分培训部分中描述的先进的定量流行病学方法。 南非孕妇中艾滋病毒的患病率大大高于其他成年人。尽管对预防母亲对艾滋病毒传播的母亲的干预进行了广泛研究，以及在这种干预期间和之后对抗逆转录病毒疗法的反应，但对怀孕本身对治疗的反应和保留的影响知之甚少。完全了解怀孕对Haart的孕产妇反应的影响对于为非洲和其他地方的H1V+妇女提供良好的临床护理至关重要。为了解决这些问题，这项工作建议检查怀孕对HAART免疫反应的影响，临床（艾滋病/死亡）对Haart的反应， 并遵守Haart和保留护理。由于不可能（而且高度不道德）将怀孕暴露随机暴露，因此这项研究将依靠南非约翰内斯堡的Themba Lethu诊所收集的高质量临床数据，这是一个城市抗逆转录病毒疗法诊所，这是与Witwatersrand大学的临床HIV研究单位相关的城市抗逆转录病毒疗法。拟议作品的主要研究者丹尼尔·韦斯特里希（Daniel Westreich）博士在与诊所的研究人员和临床医生合作生产高质量研究方面具有良好的记录。这些数据的分析将需要 结构模型的使用，一种流行病学方法的高级体系。