MWCCS: Bronx Clinical Research Site for the MACS-WIHS Combined Cohort Study
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PROJECT SUMMARY/ABSTRACT With increasingly effective and widespread access to antiretroviral therapy (ART), people with HIV (PWH) are now living nearly normal lifespans. As PWH age, they experience a high burden of chronic comorbidities at younger than expected age despite suppressive ART. Although mechanisms remain unclear, the premature development of non-AIDS comorbidities including cardiovascular and metabolic diseases, are thought to be related to inflammation and immune activation, suggesting that HIV may both accentuate and accelerate aging. The MACS-WIHS Combined Cohort Study (MWCCS), with long-term follow up over 30 to 40 years provides a platform for critically important translational studies of cardiovascular disease (CVD), metabolic disorders, aging, and HIV disease progression. The Bronx Clinical Research Site (CRS) will continue to provide scientific leadership in three specific areas: cardiovascular disease, metabolic disorders and microbiome science, and in the context of HIV we will: (1) characterize dietary determinants of the gut microbiota and related metabolomic and proteomic signatures and their associations with CVD risk and outcomes, (2) determine correlates of vascular function and associations with cardiac structure and function, and (3) assess how risk factors for CVD have changed in the INSTI era, focusing on predicted 10-year CVD risk, subclinical atherosclerosis and cardiac dysfunction, and adjudicated CVD events. The Bronx CRS will provide innovative scientific leadership in studying CVD among PWH with a longitudinal echocardiography study and a high-caliber Echocardiography Reading Center, including cutting-edge cardiovascular imaging, and the study of CVD in relation to multi-omics among PWH. The Bronx CRS will continue to follow our large numbers of well-characterized persons living with and without HIV that reflect our local New York City HIV epidemic. This will allow us to investigate the impact of age, sex, and race/ethnicity on CVD, metabolic disorders, aging, and HIV disease progression across the lifespan, as well as other areas including but not limited to HPV and other co-infections, cancer, behavioral health, inflammation, and immune function. We will maintain the Bronx CRS’s currently outstanding contributions in participation and cohort retention rates; collection of high-quality core data and specimens; and data completeness and quality monitoring.
