We are proposing a collaborative, comprehensive, multidisciplinary, multicenter integrated programme of innovative and relevant research on AIDS in South Africa to address the appropriate treatment for adults and children in a family model, TB prevention, and the development of less costly diagnostic and monitoring laboratory tests. The primary aim of this program is to contribute knowledge that will assist in safeguarding the household from the effects of the HIV/AIDS epidemic. We propose to do this with five projects and three cores that are linked via tight communication including email, conference calls and face-to-face meetings. All address the problem of """"""""Safeguard the Household by"""""""": * Identifying HIV+ positive people in Cape Town and Soweto. * Identifying those family members who are positive. * Testing simple treatment regimens for those age one year to adult which can be administered in primary care settings, where often there are no physicians. * Testing whether early treatment in infancy and treatment interruption influence the outcome of disease in children. * Studying the impact of HAART on HIV morbidity and mortality in a well circumscribed and well described township in Cape Town where many of our families are located. * Testing the efficacy of a new pneumococcal conjugate vaccine and hemophilus vaccination in infants of the same cohort. * To obtain cells and plasma on all of our families at baseline for further analyses of HIV Clade C characteristics, host genetics and host immune response and their impact on disease progression and response to therapy. * Developing and validating better, cheaper ways to diagnose and monitor HIV infection, and to store and transport blood samples. The projects are supported by three cores, which serve all the projects in order to provide: * Effective administrative and research support, including data management and statistics, regulatory affairs and centralized pharmacy functions . * Efficient and accurate laboratory services from a laboratory group with extensive experience in research work and a well developed and certified laboratory system. * A unique program of training and capacity development that recognizes the effects of apartheid on South. Africa's research establishment and will strive to create expertise and ability, particularly in previously disadvantaged groups, that will help sustain an effective research infrastructure into the future. In addition this program will provide for dissemination of research findings to policy makers and key role-players, to help ensure the rapid translation of research into action.
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