Longitudinal Study of HIV and Aging in Brazil

巴西艾滋病毒与老龄化的纵向研究

• 批准号: 10616796
• 负责人: Jessica L Castilho
• 金额: $ 69.47万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 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/10616796
• 关键词: Adult; Affect; Age; Age Years; Aging; Area; Assessment tool; Atherosclerosis; Automobile Driving; 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; Elderly; Epidemic; Epidemiology; Evaluation; Geriatric Assessment; Geriatrics; Germany; HIV; HIV Infections; Health Policy; Hospitalization; Human Herpesvirus 8; Human T-lymphotropic virus 1; Immunologics; Immunology; Impaired cognition; Income; Individual; Induction of Apoptosis; Infection; Inflammation; Inflammatory; Institution; Knowledge; Laboratories; Latin America; Life Expectancy; Ligands; Link; Long-Term Effects; Longitudinal Studies; Lymphocyte; Macrophage; Measures; Mediating; Medical Economics; Morbidity - disease rate; Neurocognitive Deficit; Observation in research; Older Population; Onset of illness; Outcome; Pathogenesis; Pathway interactions; Persons; Positioning Attribute; Productivity; Protein Isoforms; Quality of life; Recording of previous events; Research; Research Personnel; Resources; Risk Factors; Screening procedure; Socioeconomic Factors; Source; South America; Standardization; Syndrome; TNF gene; Toxoplasmosis; Translational Research; Trypanosoma cruzi; Tuberculosis; United States; United States National Institutes of Health; Validation; Viral; antiretroviral therapy; behavioral economics; chemokine; chronic infection; co-infection; comorbidity; cytokine; disability; early onset; effective therapy; epidemiologic data; epidemiology study; experience; falls; frailty; functional decline; human old age (65+); improved; infection burden; inflammatory marker; insight; low and middle-income countries; mitochondrial dysfunction; modifiable risk; mycobacterial; novel; pathogen; predict clinical outcome; prospective; public health relevance; recruit; risk prediction; risk stratification; senescence; social health determinants; socioeconomics; syndemic; telomere; translational study

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.

项目摘要 /摘要 这项研究将研究流行病学，临床意义以及免疫学和感染性决定者 巴西艾滋病毒（PWH）老年人的与衰老有关的疾病和结局。在一部分的结果 艾滋病毒感染和持续感染的期限影响，较旧的PWH经历了高率的高率 疾病（NCD）和老年综合症的早期发作，包括脆弱，残疾和认知能力下降。 但是，艾滋病毒并不孤单，因为可能引起感染和其他免疫学的慢性感染 与这些结果相关的更改。我们了解其他慢性感染如何低到低和 缺乏中等收入国家影响老年综合征的发病机理和流行病学。一个 中等收入国家拥有大量较老的PWH，巴西拥有综合艾滋病毒护理史 以及内构慢性感染。这项潜水员的纵向研究将在抗逆转录病毒疗法上招募PWH 三个巴西城市（n = 360岁50-64岁，n = 340岁≥65岁）的≥50岁≥50岁）来评估 TB，HTLV-1，Chagas疾病，弓形虫病等的共同感染方式影响流行病学 与衰老相关的发病率的免疫学途径。我们将研究 与经过验证的NCD的卫生共同感染者和社会决定者。我们可能会评估如何 共同感染的个体和累积燃烧预测了入口老年综合征。我们将评估一本小说 筛选工具评估较旧PWH的脆弱性，以了解包括死亡，包括死亡的晚期临床结果 住院和新残疾。这项研究还将研究共感染如何影响 炎症有助于建立后NDC和老年综合症的发展 拉丁美洲的艾滋病毒观察研究的生产性合作，这项研究是独一无二的 提供急需的高质量数据，以在全球环境中了解艾滋病毒的衰老。它将提供小说 对PWH周围衰老体验的细胞机制的多种传染性贡献的见解 地球。