Modern antiretroviral treatments alter the progression of disease, enabling the majority of HIV+ individuals to live near-normal life spans. Yet, over 25% of patients in the US fail to achieve long-term virologic suppression, and even for those who do, there remains the threat of multiple comorbid complications. The critical questions that arise are how will clinicians maximize treatment success, assess the sociobehavioral barriers to linkage and persistent engagement in care, understand the causes of treatment and non-treatment related complications of HIV disease, and develop interventions that maximize health and well-being of HIV infected persons over many decades of life. To address these questions, investigators need access to clinical outcomes information that is tightly linked to biologic specimens and socio-biologic data to enable translational research. The CFAR Network of Integrated Clinical Systems (CNICS) project is an established resource that has contributed substantially to the contemporary HIV research agenda. Established in 2002 and funded as an R24 research platform in 2006, CNICS is a clinic-based research network that reflects the outcomes of clinical decisions and management options used in the care of HIV infected individuals at 8 CFAR sites: UAB, U Washington, UCSF, UCSD, Case Western Reserve, Fenway Health (Brown / Harvard), U North Carolina, and Johns Hopkins. Quality-controlled data from the electronic medical records (EMRs) at each site are stored in a secure centralized repository and are linked to patient reported outcomes obtained at regular intervals, geospatial data, and to biologic specimens stored in repositories and readily available for use in translational research projects. The mission of CNICS is to provide access to the specimen and data repository to any investigator who submits an approved concept proposal. In this fashion, CNICS is a 'peer-reviewed open access' research platform available to investigators worldwide.
The specific aims for this competitive renewal of CNICS are to: 1: Collect high quality data from a representative sample of patients; 2: Distribute data and specimens to a diverse array of scientists; and 3: Expand and formalize a state of the art mentoring program.

Public Health Relevance

AIDS is one of the largest pandemics in history that remarkably, in the 35 years since its first description, the etiologic agent was identified, accurae tests to detect its presence were created, and over 25 novel drugs developed. This has turned a universally fatal disease into a chronic, manageable condition. Owing to the rapid emergence of both the disease and its treatment, many unanswered questions regarding the long-term outcomes of patients remain proving that ongoing research is needed to help answer these questions.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Resource-Related Research Projects (R24)
Project #
5R24AI067039-12
Application #
9270494
Study Section
Special Emphasis Panel (ZAI1)
Program Officer
Mckaig, Rosemary G
Project Start
2006-09-30
Project End
2021-08-31
Budget Start
2017-09-01
Budget End
2018-08-31
Support Year
12
Fiscal Year
2017
Total Cost
Indirect Cost
Name
University of Alabama Birmingham
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
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Lee, Jennifer S; Cole, Stephen R; Achenbach, Chad J et al. (2018) Cancer risk in HIV patients with incomplete viral suppression after initiation of antiretroviral therapy. PLoS One 13:e0197665
AIDS-defining Cancer Project Working Group of IeDEA, COHERE in EuroCoord (2018) Non-Hodgkin lymphoma risk in adults living with HIV across five continents. AIDS 32:2777-2786
Pence, Brian W; Bengtson, Angela M; Boswell, Stephen et al. (2018) Who Will Show? Predicting Missed Visits Among Patients in Routine HIV Primary Care in the United States. AIDS Behav :
Elion, Richard A; Althoff, Keri N; Zhang, Jinbing et al. (2018) Recent Abacavir Use Increases Risk of Type 1 and Type 2 Myocardial Infarctions Among Adults With HIV. J Acquir Immune Defic Syndr 78:62-72
Fredericksen, Rob J; Mayer, Kenneth H; Gibbons, Laura E et al. (2018) Development and Content Validation of a Patient-Reported Sexual Risk Measure for Use in Primary Care. J Gen Intern Med 33:1661-1668
Hartzler, Bryan; Dombrowski, Julia C; Williams, Jason R et al. (2018) Influence of Substance Use Disorders on 2-Year HIV Care Retention in the United States. AIDS Behav 22:742-751
Grover, Surbhi; Desir, Fidel; Jing, Yuezhou et al. (2018) Reduced Cancer Survival Among Adults With HIV and AIDS-Defining Illnesses Despite No Difference in Cancer Stage at Diagnosis. J Acquir Immune Defic Syndr 79:421-429
Bilal, Usama; McCaul, Mary E; Crane, Heidi M et al. (2018) Predictors of Longitudinal Trajectories of Alcohol Consumption in People with HIV. Alcohol Clin Exp Res 42:561-570
Edwards, Jessie K; Cole, Stephen R; Hall, H Irene et al. (2018) Virologic suppression and CD4+ cell count recovery after initiation of raltegravir or efavirenz-containing HIV treatment regimens. AIDS 32:261-266

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