Cohort profile: the Centers for AIDS Research Network of Integrated Clinical Systems

作者：Mari M. Kitahata, Benigno Rodríguez, Richard Haubrich, S Boswell, William C. Mathews, Michael M. Lederman, William B. Lober, Stephen E. Van Rompaey, Heidi M. Crane, R. D Moore, Melanie Bertram, James Kahn, M. S. Saag · 发表于：International Journal of Epidemiology · 年份：2008 · 被引用次数：302 · 研究领域：HIV/AIDS Research and Interventions、HIV/AIDS drug development and treatment、HIV-related health complications and treatments

Highly active antiretroviral therapy (HAART) delays disease progression and death.1–4 However, the treatments incompletely control HIV replication,5–7 only partially restore immune function,8,9 have significant short- and long-term toxicities,10–14 and eventually fail in many patients with consequent development of HIV drug resistance.6 Thus, there is increasing need for information to guide HIV-infected patients and their providers in making decisions regarding optimal use of antiretroviral therapies. Although clinical trials provide valuable information about efficacy and side effects of antiretroviral treatment, they have limited size, duration and power to detect effects on clinical outcomes, focusing instead on surrogate endpoints such as virologic failure, treatment discontinuation or composite outcome measures.15 Outside the clinical trial setting, there is tremendous heterogeneity among HIV-infected patients. The prevalence and impact of important health conditions such as hepatitis C virus (HCV) co-infection, mental illness and substance abuse likely contribute to increased toxicity and decreased clinical effectiveness of HAART regimens among the broader spectrum of patients treated in routine care. Cohorts with significant diversity in HIV disease severity, comorbidities and demographic distributions are required to provide information regarding long-term outcomes and complications of HIV infection in the modern HAART era. The Centers for AIDS Research (CFAR) Networ...