Since 1993, The Washington Metropolitan Consortium has enrolled and retained a representative cohort of HIV infected and HIV uninfected women and is in the process of recruiting an additional number of younger women in order to continue its investigations of the consequences of HIV infection and its treatment in this population. Although significant progress has been made in both our understanding and treatment of HIV, curative therapy is still not available and the chronically administered complex therapies used to treat HIV are not always successful. Treatment with highly active antiretrovirals (HAART) appears to be associated with a wide range of adverse effects and the impact of other co-pathogens such as HPV and HCV has yet to be fully elucidated. Additionally, the early cohort of infected women is aging, and the effects of age and changes in sex steroids both on the long term outcomes of HIV and the effects of HAART treatment needs investigation. The WMW has joined with centers around the country and with sites across the metropolitan Washington region to develop a scientific plan (outlined in Part A) to address these issues. A successful and flexible infrastructure has been established to allow us to accomplish these scientific aims and to assure ongoing retention of this important cohort. The WMW has successfully participated in all elements of the WIHS protocol, and has actively supported the infrastructure of the national WIHS. WMW investigators have participated in all of the major WIHS scientific initiatives. Additionally, the WMW has established both a local specimen repository and contributes to the national specimen repository .As the study has matured, an increasing number of collaborations have been established with local investigators to allow for broader access to the rich repository of WIHS specimens and the WMW seeks to expand its local epidemiologic expertise to allow for on-site data analysis. This application will describe both our accomplishments to date and the structure that we have established to allow us to move forward with the scientific agenda as outlined in Part A and to continue to expand our local collaborations in order to better define the status of women with HIV and to bring to fruition the promises of a sustainable treatment of this devastating disease.
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