Despite the important contributions of both epidemiologic and basic
science research during the past decade, important gaps exist in our
current understanding of both the natural history and pathogenesis of
HIV infection. Most recently, the substantial clinical efficiency of
protease inhibitors has clearly been shown to extent significantly
disease-free survival and death, as a result of dramatic reductions in
HIV viral load. However, the exact virologic changes and immunological
mechanisms which contribute to long-term survival are still unknown. We
therefore propose to continue the Pittsburgh portion of the MACS by
further intensive follow-up of a selected, HIV-infected cohort in order
to further scientific understanding of the natural history and
pathogenesis of HIV infection. The specific objectives and research plan
emphasize the cohort-maintenance and biological specimen procurement
aspects of the proposed continuation of the Pittsburgh MACS. Additional
specific aims will focus on the strengths of the Pittsburgh
investigators through collaborations in the areas of HIV viral load
dynamics, HIV-specific cellular immune responses, sexual transmission
dynamics and the newly identified lipodystrophy associated with HAART
treatment modalities. We also propose to provide the MACS-wide
coordination of the malignancy/autopsy program in order to investigate
the incidence and determinants of cancer in HIV-infected gay/bisexual
men. This includes storage of all MACS autopsies, SNOMED coding and
distribution of autopsy tissue for research proposals to MACS and non-
MACS investigators.
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- The DCCPS Team.