The Southern California WIHS Consortium (SCWC) was established in 1994, and currently consists of 5 sites, including the USC School of Medicine (LAC-USC Medical Center; 5P21 HIV/AIDS Clinic; Maternal-Child- Adolescent (MCA) HIV Clinic); the ,AIDS Healthcare Foundation; Prototypes; Santa Barbara Department of Health; and the University of Hawaii. The SCWC has taken a leadership role in developing and implementing the scientific agenda and infrastructure of the national laboratory effort in the WIHS. `Additionally, we have provided leadership in defining differences in HIV-1 RNA and infectious virus in various compartments, including blood, genital and oral secretions. We have provided leadership in the area of malignant disease as well. The active SCWC cohort currently consists of 231 HIV + women (67.6% retention through visit #14 at 7 years), and 55 HIV - women (50.5% retention). The compliance of our site during WIHS II for pap smears was 93.5%, for CVL repository was 94%, and for saliva was 91.4%. Methods for improving retention have been developed for the expansion and WIHS III, and have already proven effective.
The specific aims of the core WIHS study will be pursued by the SCWC. In addition, we have developed a scientific initiative that seeks to determine the degree of carotid intimal thickening (CIT) among HIV + women on HAART (N=60), HIV + women not on HAART (N=60), and HIV negative comparators (N=30). Participants will be selected based upon presence of two risk factors for coronary heart disease (CHD), independent of the use of HAART. Baseline B-mode ultrasonography will be performed at baseline in all groups, and results will be analyzed. This information will provide important information in itself, and will also serve as preliminary data for a future longitudinal study, for which we will apply for additional funding.
The specific aims of this scientific initiative are: (1) To determine the prevalence and degree of carotid intima-media thickening in HIV infected women versus HIV negative women at risk, matched in terms of risk factors for CHD; (2) To estimate the magnitude of the mean differences in CIT among HIV negative women, HIV positive women on HAART, and HIV positive women who have not been exposed to HAART; (3) To estimate the standard deviation of CIT in WIHS subjects; and for the longitudinal study (4) To determine the relationship between CIT and use of protease inhibitor containing HA.ART therapy; (5) To determine the relationship between CIT and parameters of HIV disease, including HIV-1 RNA level, CD4 cell count, and history of clinical AIDS defining illness; and (6) To determine the relationship between continued HAART use, HIV-1 disease parameters, other traditional risk factors for CHD, and progression of ClT and/or development of clinical evidence of CHD.
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