2011 was a transformative year in HIV research, providing evidence and raising hope that the HIV epidemic globally can potentially be not only controlled but also effectively aborted in our lifetime through both prevention and cure. Effective primary prevention through microbicides, pre-exposure prophylaxis and treatment of persons living with HIV (PLWH) seems within our reach. Equally important, basic science advances suggest that cure is possible through activation and/or elimination of HIV proviral DNA from host cells. We propose a WIHS scientific agenda that informs these possible routes to defeating HIV, through investigations of genital tract innate immune factors protecting against HIV-infection;identification of epigenetic changes in the provirus that may define a target for cure;and elucidating cell-to-cell viral transfer. We will continue to use WIHS's robust database to inform effective treatment for women and persons of African descent. Of the 34.0 million PLWH globally more than half of are women, and more than 75% are of African ancestry;nearly all studies of the efficacy of antiretroviral therapy (ART) are in men of European descent. Thus, epidemiologic and translational investigation of population- based effectiveness of ART in WIHS, which is 100% women and >60% of African descent, will provide critical information for patients and providers both in the US and globally. Further, with 18 years of prospective data collection the WIHS is able to investigate clinical manifestations in aging populations, including studies of changes in the genital tract with reproductive aging. The Bronx WIHS has provided both operational excellence and scientific leadership nationally since WIHS's inception in 1993. In WIHS V we will continue to lead the WIHS-wide investigations in HPV and cervical neoplasia;cardiovascular disease and inflammation;genital tract mucosal immunology and virology;immunogenetics;HIV virology;musculoskeletal manifestations of HIV disease;and host characteristics influencing population based effectiveness of ART. We will also continue our excellent operational performance in providing high volume, complete, high quality data both for the WIHS core activities, and all substudies.
With the tools to end the epidemic potentially in the view, it is imperative both to monitor the effectiveness of ART in a diverse population, and also to continue investigations of pathogenesis and the correlates of protection from HIV infection. WIHS provides a flexible and effective platform for prospective investigations for understanding of HIV infection and its treatment.
|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|
|Kuniholm, Mark H; Hanna, David B; Landay, Alan L et al. (2015) Soluble CD163 is associated with noninvasive measures of liver fibrosis in hepatitis C virus- and hepatitis C virus/human immunodeficiency virus-infected women. Hepatology 61:734-5|
|Adedimeji, Adebola A; Hoover, Donald R; Shi, Qiuhu et al. (2015) Sexual Behavior and Risk Practices of HIV Positive and HIV Negative Rwandan Women. AIDS Behav 19:1366-78|
|Aka, Peter V; Kuniholm, Mark H; Pfeiffer, Ruth M et al. (2014) Association of the IFNL4-?G Allele With Impaired Spontaneous Clearance of Hepatitis C Virus. J Infect Dis 209:350-4|
|Pyra, Maria; Weber, Kathleen; Wilson, Tracey E et al. (2014) Sexual minority status and violence among HIV infected and at-risk women. J Gen Intern Med 29:1131-8|
|Sirotin, Nicole; Hoover, Donald R; Shi, Qiuhu et al. (2014) Food insecurity with hunger is associated with obesity among HIV-infected and at risk women in Bronx, NY. PLoS One 9:e105957|
|Weber, Stefanie; Weiser, Barbara; Kemal, Kimdar S et al. (2014) Epigenetic analysis of HIV-1 proviral genomes from infected individuals: predominance of unmethylated CpG's. Virology 449:181-9|
|Massad, L Stewart; Pierce, Christopher B; Minkoff, Howard et al. (2014) Long-term cumulative incidence of cervical intraepithelial neoplasia grade 3 or worse after abnormal cytology: impact of HIV infection. Int J Cancer 134:1854-61|
|Massad, L Stewart; Xie, Xianhong; Burk, Robert et al. (2014) Long-term cumulative detection of human papillomavirus among HIV seropositive women. AIDS 28:2601-8|
|Benning, Lorie; Golub, Elizabeth T; Anastos, Kathryn et al. (2014) Comparison of lower genital tract microbiota in HIV-infected and uninfected women from Rwanda and the US. PLoS One 9:e96844|
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