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.
AIDS is one of the largest pandemics in history that remarkably, in the 35 years since its first description, the etiologic agent was identified, accurate 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.
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