During this past year DC PFAP has made substantial progress in the following areas 1. The DC Cohort database has over 8000 patients enrolled. The program is enrolling at all sites. Data analysts are looking at merged data. This database is providing unique, real time granularity for the city HIV population. The data is meshed with the DC Department of Health data base to enhance its utility for analyzing the city epidemic. 2. The prevention protocols have exceeded expectations in terms of enrolling African American men and women in studies to assess their risk behavior. Based on superior enrollment and retention of subjects, the DC investigators have been invited to participate In PREP studies have been completed with DC sites being among the leaders in enrollment and retention in follow up. 3. The HPTN test and treat protocol is actively enrolling at DC sites. 4. The HCV program has active interventional studies: including SYNERGY and CONQUER. The ERADICATE and SPARE studies were recently completed. This year we began the ACSEND protocol, enrolling 600 patients from the DC clinics evaluating the efficacy, implementation, safety, and long-term outcomes of community based treatment of hepatitis C genotype 1 monoinfection and HIV-coinfection utilizing ledipasvir/sofosbuvir (LDC/SOF) as per treatment guidelines. All studies performed are investigator initiated studies which recruit almost exclusively among the citys underserved populations. Studies completed in the past three years have included unique studies of various combination regimens in HIV infected and uninfected patients. The program has focused on science based studies looking at mechanisms of action and correlates of response in tissue and in blood. The program has also focused on approaches that can shorten the duration of therapy, and which can utilize non specialists for delivery of care. 5. The mental health program has launched studies at Family Medicine investigating optimal ways to assess depression in minority communities. This assessment tool will be useful for determining what interventions are useful to improve adherence with HIV and HCV therapeutics. 6. Neurocognitive Studies. A multidisciplinary group including investigators from NINDS, NIMH, NIAID and CC are developing strategies to form a cohort of patients with a range of cognitive abilities who can be followed and intensively studied prospectively. These studies use NIH intramural imaging facilities and NINDS flow and virology facilities to characterize this patient population much more intensively than extramural studies are currently doing. This project is fulfilling all of its missions ahead of schedule. The program is working effectively with the DC Center for AIDS Research and with community and academic partners to build a strong AIDS research network in DC.
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