NATURAL HISTORY OF HTLV-III/LAV INFECTION

Project: Research project

Project Details

Description

Early in the epidemic of the Acquired Immunodeficiency
Syndrome (AIDS), intravenous drug abusers (IVDA's) were
identified as a group at increased risk for disease. This high risk
group comprises at a minimum 25% of all domestic cases of AIDS
and approximately 34% of cases in New York City. Presently it is
estimated that between 25 to 87% of the 200,000 IVDA's in the
New York Metropolitan area are infected with HIV. This
population is of further importance because it represents a major
route of transmission of infection to other adult populations and
to children. Nonetheless, insufficient information exists about
the epidemiology and natural history of both infection and disease
due to HIV among IVDA. We propose to perform a natural history study of HIV seropositive
and seronegative IVDA cohorts enrolled in the Montefiore Drug
Abuse Treatment Program (DATP). The DATP provides long term
methadone maintenance for opiate addiction and is uniquely
suited for careful longitudinal studies of IVDA because of high
retention rates and close medical monitoring of program patients.
This study will be based upon and carry forward the results of a
seroprevalence and case control study of 500 enrollees in the
DATP which is nearing completion. The prevalence study has
provided two large cohorts of IVDA, one seropositive and one
seronegative, which will now be followed longitudinally. In
addition, to determining the incidence of and natural history of
HIV infection in this population, we will seek to identify the
variables which may be associated with seroconversion and
progression to disease. These will include demographic
chacateristics, drug use type, frequency, duration and specific
practices, sexual orientation and practices and psychosocial and
biologic co-factors. In addition, several hypothesis generated by
the prevalence study will be further tested, i.e., importance of
cocaine use, needle sharing, etc. Finally, the psychologic and
behavioral impact of notification of serologic and disease status
will be monitored in a standardized protocol and educational
inteventions will be evaluated to determine their effect upon risk
reduction. At Montefiore DATP, both HIV seropositive and seronegative
participants will be screened prospectively at 6 months intevals.
Screening will consist of a detailed standardized interview
designed to elicit demographic and drug use variables, complete
physical exams, testing for HIV antibodies, and immunologic
function and selected HIV cultures. This longitudinal study will be linked to ongoing studies of
heterosexual transmission, household transmission and vertical
transmission and pregnancy outcome which are supported by the
Centers for Disease Control. Data generated from these cohorts will be entered and stored in a
fully developed and functioning computerized data management
system allowing for sophisticated statistical analysis.
StatusFinished
Effective start/end date4/1/873/31/92

Funding

  • National Institutes of Health

ASJC

  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases
  • Internal Medicine
  • Epidemiology

Fingerprint Explore the research topics touched on by this project. These labels are generated based on the underlying awards/grants. Together they form a unique fingerprint.