HIV Infection, Antiretroviral Therapy, Cancer Incidence and Progression

HIV 感染、抗逆转录病毒治疗、癌症发病率和进展

• 批准号: 7870387
• 负责人: Michael J Silverberg
• 金额: $ 14.03万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7870387
• 关键词: AIDS/HIV problem; Accounting; Adverse effects; Adverse event; Affect; Age; Award; Biology; Biometry; Biostatistical Methods; Cancer Etiology; Caring; Cessation of life; Clinic; Clinical; Clinical Management; Cohort Studies; Data; Data Set; Databases; Doctor of Philosophy; Educational workshop; Electronics; Environment; Epidemiology; Goals; HIV; HIV Infections; Highly Active Antiretroviral Therapy; Human Papillomavirus; Incidence; Individual; Institution; K-Series Research Career Programs; Knowledge; Laboratories; Link; Malignant Neoplasms; Mediating; Mentors; Outcome; Patients; Persons; Pharmacy facility; Population; Population Study; Prognostic Factor; Reading; Regimen; Registries; Research; Research Project Grants; Research Training; Resources; Risk; Risk Factors; Sample Size; Shapes; Site; Toxic effect; Training; administrative database; antiretroviral therapy; base; cancer epidemiology; cancer risk; cancer therapy; cancer viral etiology; career; clinical care; comparison group; design; disease registry; follow-up; improved; interest; meetings; member; multidisciplinary; outcome forecast; programs; response; skills; symposium; tumor progression

DESCRIPTION (provided by applicant): This Career Development Award application describes an integrated training and research program for Michael Silverberg, Ph.D., MPH designed to provide expertise in the topic of cancers in an aging HIV-infected population. Dr. Silverberg's interests in the viral etiology of cancers, focusing on human papillomavirus, as well as the benefits and consequences of long-term highly-active antiretroviral therapy (HAART) use, have shaped his commitment to the study of cancers in HIV patients, which account for one-third of deaths in this group. Three retrospective cohort studies are proposed using laboratory, pharmacy and clinical databases of Kaiser Permanente, and include 18,000 HIV-infected and 180,000 HIV-uninfected persons followed from 1996 to 2006. These research projects aim to: 1) compare cancer incidence by HIV status and HAART use; 2) compare cancer progression by HIV status and HAART use; and, 3) identify adverse events associated with concomitant HAART use and cancer therapy. Study strengths include the large size, individual data on HAART and traditional cancer risk and prognostic factors, stable and extended follow-up, precise linking of disease registries, and inclusion of HIV-uninfected controls. Career goals that will be achieved during the award period are: 1) acquiring expertise in cancer epidemiology and biology; 2) attaining proficiency in advanced biostatistical methods; 3) obtaining knowledge of clinical management of HIV and cancer; and 4) developing academic and professional skills. The tradition of outcomes-oriented research at the Division of Research at Kaiser Permanente, supplemented by the resources at several academic institutions provide the ideal environments to achieve these goals. A strong team of mentors has been assembled to provide diverse expertise in cancer etiology, epidemiology, biostatistics and clinical care. These skills are essential for the multidisciplinary environment of Kaiser Permanente. Career goals will also be met through coursework, directed reading, focused biostatistics training, clinic observations, attendance at conferences and workshops, and through research. It is not known why cancer risk is increased among HIV-infected patients or why prognosis is often worse. It is also not known which cancers are affected by long-term HAART use or if simultaneous HAART use and cancer therapy is associated with side effects. The results of this research may be informative to those providing care to HIV-infected patients with or at-risk for cancer.

描述（由申请人提供）：该职业发展奖申请介绍了Michael Silverberg博士的集成培训和研究计划，旨在在老龄化HIV感染的人群中提供癌症主题的专业知识。 Silverberg博士对癌症病毒病因的兴趣，重点是人类乳头瘤病毒，以及长期高度活跃的抗逆转录病毒疗法（HAART）使用的益处和后果，塑造了他对艾滋病毒患者对癌症患者的研究的承诺，这是该组死亡的三分之一。提出了三项回顾性队列研究，使用Kaiser Permanente的实验室，药房和临床数据库进行了研究，其中包括1996年至2006年的18,000名HIV感染者和180,000名HIV未感染的人。这些研究项目的目的是：1）与HIV癌症的发生率和HAART使用相比； 2）比较艾滋病毒状况和HAART使用的癌症进展； 3）确定与HAART使用和癌症治疗相关的不良事件。研究优势包括大尺寸，有关HAART和传统癌症风险和预后因素的个人数据，稳定和扩展的随访，疾病登记处的精确联系以及包括HIV未感染的控制。在奖励期间将实现的职业目标是：1）获得癌症流行病学和生物学方面的专业知识； 2）获得高级生物统计学方法的熟练程度； 3）获得艾滋病毒和癌症临床管理知识； 4）发展学术和专业技能。在Kaiser Permanente的研究部，以成果为导向的研究的传统补充了几个学术机构的资源，为实现这些目标提供了理想的环境。一支强大的导师团队已经组装，以提供癌症病因，流行病学，生物统计学和临床​​护理方面的多种专业知识。这些技能对于Kaiser Permanente的多学科环境至关重要。职业目标还将通过课程，定向阅读，专注的生物统计学培训，诊所观察，参加会议和研讨会以及通过研究来实现。尚不清楚为什么感染HIV的患者癌症风险会增加，或者为什么预后通常会恶化。尚不清楚哪些癌症受长期使用的影响，或者同时使用HAART使用和癌症治疗与副作用有关。这项研究的结果对于为患有癌症或处于癌症的HIV感染患者提供护理的人可能会提供信息。