We are proposing a collaborative, comprehensive, multidisciplinary, multicenter integrated programme ofinnovative and relevant research on AIDS in South Africa to address the appropriate treatment for adults andchildren in a family model, TB prevention, and the development of less costly diagnostic and monitoring laboratorytests.The primary aim of this program is to contribute knowledge that will assist in safeguarding the household from theeffects 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 primarycare settings, where often there are no physicians (Project 1) Testing whether early treatment in infancy and treatment interruption influence the outcome of diseasein children (Project 2) Studying the impact of HAART on HIV morbidity and mortality in a well circumscribed and welldescribed township in Cape Town where many of our families are located (Project 3) Testing the efficacy of a new pneumococcal conjugate vaccine and hemophilus vaccination in infants ofthe same cohort (Project 4)* To obtain cells and plasma on all of our families at baseline for further analyses of HIV Clade Ccharacteristics, host genetics and host immune response and their impact on disease progression andresponse to therapy (Study 1 of Project 5) Developing and validating better, cheaper ways to diagnose and monitor HIV infection, and to store andtransport blood samples (Study 2 and 3 of Project 5)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 affairsand centralized pharmacy functions (Core A) Efficient and accurate laboratory services from a laboratory group with extensive experience in researchwork and a well developed and certified laboratory system (Core B) A unique program of training and capacity development that recognizes the effects of apartheid on SouthAfrica's research establishment and will strive to create expertise and ability, particularly in previouslydisadvantaged groups, that will help sustain an effective research infrastructure into the future. In additionthis program will provide for dissemination of research findings to policy makers and key role-players, tohelp ensure the rapid translation of research into action (Core C)
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