As a multicenter, prospective cohort study The Women's Interagency HIV Study (WIHS) is designed to directly address key hypotheses related to the natural history and clinical manifestation of HIV among women. During WIHS-III (12/02-11/07), WIHS scientific Aims are to 1) develop, refine, and evaluate composite measures of antiretroviral therapy (ART) exposure and relate these measures to markers of HIV disease progression, 2) define the treated history of HIV-1 infection and the individual determinants, including host and viral genetic factors, of clinical, virologic and immunologic response to highly-active antiretroviral therapy (HAART), 3) evaluate adverse events associated with ART, 4) investigate the long term effects of HIV, and use of HMRT, on the incidence/natural history of viral co-infections that cause disease in women with or at risk for HIV, focusing on human papillomavirus infection and cervical neoplasia, and hepatitis C virus infection and liver disease, 5) evaluate the effects of age, ovulatory function, menopause and its treatment on the course of HIV infection and response to ART, 6) describe the epidemiology of HIV- associated cancers in women, and further define the natural history of malignancies in women on HAART , and 7) evaluate the oral manifestations of HIV disease. Chicago WIHS will use its nine years of successful retention strategies to engage and retain 390 participants (295 HIV+, 95 HIV-) at four clinical sites including150 participants at the oral site through six month visit cycles. These will include interviews, exams, blood, gynecologic and oral specimens, medical record abstractions, registry matches, and local and centralized laboratory analysis. Chicago WIHS will contribute the highest quality data, lead and participate in epidemiologic analyses, and disseminate the results and scientific information learned from this research initiative. As our site-specific scientific initiative, we will investigate immune recovery in HIV infected women on HMRT with particular interest in the effects of age, drug use, exogenous hormones and menopause on immune recovery.
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