This application is for the renewal of the Study to Help the AIDS Research Effort (SHARE), which is the Baltimore-Washington DC site of the Multicenter AIDS Cohort Study (MACS). The MACS was funded by NIAID and NCI in 1983, with sites in Baltimore-Washington, Chicago, Pittsburgh, and Los Angeles to study the natural history of HIV infection in men who have sex with men. With the advent of effective combination antiretroviral therapy (cART), the MACS became also a study of the treated history of HIV infection, including the relationship between long-term controlled HIV infection and chronic diseases associated with aging. MACS participants, including 1808 enrolled in SHARE, have been followed semiannually since 1984 and have provided questionnaire data, physical exam data, laboratory data (including HIV serostatus, T cell subset measurements, and HIV viral load measurements), and a large repository of plasma, serum, cryopreserved peripheral blood mononuclear cells, and other specimens. Evaluating and following the prevalent and incident cases of HIV infection in SHARE and the MACS has provided key insights into risk factors for infection with HIV, monitoring and mechanisms of progression of HIV infection once it is established, host defense against HIV, genetic factors affecting HIV pathogenesis, and use, efficacy, and adverse effects of different types of therapy for HIV and related illnesses. SHARE and MACS are currently recruiting new participants who are receiving more recent cART regimens that are more potent, safer, and more convenient than older regimens, and which are initiated earlier in the course of HIV infection;this recruitment will be completed by the end of the current funding period in March, 2014.
The specific aims of SHARE for the 2014-9 renewal period reflect those of the MACs and are to determine: the effect of evolving, earlier initiated c ART regimens on HIV-induced inflammation and immune dysfunction;the occurrence of and risk factors for emerging, non-AIDS-defining, high morbidity outcomes according to HIV infection and new c ART regimens;the determinants for incidence, progression and survival of malignancies, both AIDS- and non-AIDS-defining;the biologic and physiologic effects of treated HIV infection on the aging process;the relationships of substance use and psychosocial factors of aging in HIV infection with adherence, coping skills, resiliency, depression and quality of life and genetic factors associated with resistance to and control of HIV infection. SHARE will contribute to these goals through leadership of eight MACS working groups focusing on these topics, and through local studies focusing on liver disease, energy metabolism, cytomegalovirus infection, and regulation of immune activation and inflammation.
These aims can be achieved only through continued follow-up of this extremely well-characterized cohort. SHARE and the MACS should continue to play a leading role in studies that will foster better treatments and prevention of HIV infection.

Public Health Relevance

This application is for renewal for 5 years of the Baltimore-Washington DC site of the Multicenter AIDS Cohort Study (MACS), a longstanding study of the natural and treated histories of HIV infection in four US cites (Baltimore-Washington, Los Angeles, Pittsburgh, Chicago) which has made many important contributions to the treatment and understanding of HIV infection since 1984. For the next 5 years, we propose to follow men already enrolled in Baltimore and Washington, DC, replacing those who are lost to the study with new participants, in order to better define the benefits and adverse effects of newer medication combinations to treat HIV, to understand better the long-term consequences of living with HIV including possible effects on chronic diseases and aging, and to improve treatment and prevention of HIV infection.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01AI035042-22
Application #
8699944
Study Section
Special Emphasis Panel ()
Program Officer
Roe, Joanad'Arc C
Project Start
1993-04-01
Project End
2019-03-31
Budget Start
2014-04-10
Budget End
2015-03-31
Support Year
22
Fiscal Year
2014
Total Cost
$1,498,036
Indirect Cost
$362,846
Name
Johns Hopkins University
Department
Microbiology/Immun/Virology
Type
Schools of Public Health
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Jotwani, Vasantha; Scherzer, Rebecca; Estrella, Michelle M et al. (2016) Brief Report: Cumulative Tenofovir Disoproxil Fumarate Exposure is Associated With Biomarkers of Tubular Injury and Fibrosis in HIV-Infected Men. J Acquir Immune Defic Syndr 73:177-81
Cesar, Carina; Koethe, John R; Giganti, Mark J et al. (2016) Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America. J Int AIDS Soc 19:20684
Martinez-Picado, Javier; McLaren, Paul J; Erkizia, Itziar et al. (2016) Identification of Siglec-1 null individuals infected with HIV-1. Nat Commun 7:12412
Rachlis, Beth; Karwa, Rakhi; Chema, Celia et al. (2016) Targeted Spontaneous Reporting: Assessing Opportunities to Conduct Routine Pharmacovigilance for Antiretroviral Treatment on an International Scale. Drug Saf 39:959-76
Wada, Nikolas I; Bream, Jay H; Martínez-Maza, Otoniel et al. (2016) Inflammatory Biomarkers and Mortality Risk Among HIV-Suppressed Men: A Multisite Prospective Cohort Study. Clin Infect Dis 63:984-90
Friedman, M Reuel; Coulter, Robert W S; Silvestre, Anthony J et al. (2016) Someone to count on: social support as an effect modifier of viral load suppression in a prospective cohort study. AIDS Care :1-12
Koethe, John R; Jenkins, Cathy A; Lau, Bryan et al. (2016) Rising Obesity Prevalence and Weight Gain Among Adults Starting Antiretroviral Therapy in the United States and Canada. AIDS Res Hum Retroviruses 32:50-8
Buchacz, Kate; Lau, Bryan; Jing, Yuezhou et al. (2016) Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000-2010. J Infect Dis 214:862-72
Brener, Michael I; Post, Wendy S; Haberlen, Sabina A et al. (2016) Comparison of Insulin Resistance to Coronary Atherosclerosis in Human Immunodeficiency Virus Infected and Uninfected Men (from the Multicenter AIDS Cohort Study). Am J Cardiol 117:993-1000
Sacktor, Ned; Skolasky, Richard L; Seaberg, Eric et al. (2016) Prevalence of HIV-associated neurocognitive disorders in the Multicenter AIDS Cohort Study. Neurology 86:334-40

Showing the most recent 10 out of 521 publications