The WIHS is the largest and longest-duration cohort study of HIV infection in women in the U.S. The San Francisco Bay Area WIHS (SF WIHS) application is focused on continuing our contributions to WIHS: 1. Enrollment and retention of participants (including HIV+ women who are not in care) via a regional consortium and generation of complete and high quality data and specimens, 2. The vigorous participation of site investigators in the WIHS scientific process, and 3. Proposal of new aims that address key issues concerning processes and conditions associated with excess morbidity in HIV+ women in the current treatment era. The new aims feature special emphasis on vascular injury and pain and were selected because they concern key morbidities in potent antiretroviral therapy (cART) treated women, involve sex dimorphic phenomena, and may be influenced by gonadal aging. Vascular measures include indicators of medium (Ankle Brachial Index) and very small vessel condition (measures of retinal vessel caliber). We put forward an increased focus on functional outcomes, including specific organ functional measures, and total physical fitness and morphology (such as kyphosis). The pain studies take the unique approach of assessing what participants mean when they report pain, assess genetic contributions and examine outcomes that include physical function. We also propose to continue our work to measure long term exposure to antiretroviral drugs (ARVs) using hair samples, which are producing high impact reports concerning the pharmacology of ARVs in women and continuation of the WIHS Genetics Unit that was recently established in SF WIHS and is conducting Genome-Wide Association Studies.
The WIHS is the largest United States study of HIV, the virus that causes AIDS, in women. Even now, when good treatments are available for HIV, women living with HIV have more health problems and an increased chance of death, than women without HIV. Research is needed to better understand why HIV medicines do not eliminate the problems of poor health among women living with HIV infection. This grant application proposes continuation of the San Francisco WIHS site (SF WIHS). Our WIHS site has performed very well in terms of enrolling women and retaining them in the study. We also support many of the scientific leaders in WIHS. Besides continuing the WIHS core study, we propose new studies that will examine injury to blood vessels (including studies of the eye), hormonal conditions, how tenofovir levels affect the kidneys and bones, and we will study chronic pain in women living with HIV.
|Scherzer, Rebecca; Bacchetti, Peter; Messerlian, Geralyn et al. (2015) Impact of CD4+ lymphocytes and HIV infection on Anti-Müllerian Hormone levels in a large cohort of HIV-infected and HIV-uninfected women. Am J Reprod Immunol 73:273-84|
|D?Souza, Gypsyamber; Burk, Robert D; Palefsky, Joel M et al. (2014) Cervical human papillomavirus testing to triage borderline abnormal pap tests in HIV-coinfected women. AIDS 28:1696-8|
|Jotwani, Vasantha; Scherzer, Rebecca; Abraham, Alison et al. (2014) Does HIV infection promote early kidney injury in women? Antivir Ther 19:79-87|
|Ghartey, Jeny; Kovacs, Andrea; Burk, Robert D et al. (2014) Genital tract HIV RNA levels and their associations with human papillomavirus infection and risk of cervical precancer. J Acquir Immune Defic Syndr 66:316-23|
|Shaked, Iftach; Hanna, David B; Gleißner, Christian et al. (2014) Macrophage inflammatory markers are associated with subclinical carotid artery disease in women with human immunodeficiency virus or hepatitis C virus infection. Arterioscler Thromb Vasc Biol 34:1085-92|
|Baxi, Sanjiv M; Greenblatt, Ruth M; Bacchetti, Peter et al. (2014) Common clinical conditions - age, low BMI, ritonavir use, mild renal impairment - affect tenofovir pharmacokinetics in a large cohort of HIV-infected women. AIDS 28:59-66|
|Uldrick, Thomas S; Pipkin, Sharon; Scheer, Susan et al. (2014) Factors associated with survival among patients with AIDS-related primary central nervous system lymphoma. AIDS 28:397-405|
|Cook, Judith A; Burke-Miller, Jane K; Grey, Dennis D et al. (2014) Do HIV-positive women receive depression treatment that meets best practice guidelines? AIDS Behav 18:1094-102|
|Karim, Roksana; Mack, Wendy J; Kono, Naoko et al. (2014) T-cell activation, both pre- and post-HAART levels, correlates with carotid artery stiffness over 6.5 years among HIV-infected women in the WIHS. J Acquir Immune Defic Syndr 67:349-56|
|Rebeiro, Peter F; Horberg, Michael A; Gange, Stephen J et al. (2014) Strong agreement of nationally recommended retention measures from the Institute of Medicine and Department of Health and Human Services. PLoS One 9:e111772|
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