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NIH multicenter AIDS cohort study commemorates 25 years of discovery

The longest U.S. study of people with HIV/AIDS will be honored at a 25th anniversary commemoration on May 12, 2009, at the Carnegie Institution for Science in Washington, D.C. The Multicenter AIDS Cohort Study (MACS) has significantly contributed to the scientific understanding of HIV, AIDS and the effects of antiretroviral therapy through more than 1,000 publications, many of which have guided public health policy and the clinical care of people with HIV. MACS investigators prospectively study the natural and treated history of HIV infection in thousands of homosexual and bisexual men at sites in Baltimore, Chicago, Pittsburgh and Los Angeles.

Guests will hear a keynote address by Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. NIAID and the National Cancer Institute developed the MACS and have been its principal sponsors.

"The MACS has been one of the most rigorous and productive epidemiologic HIV/AIDS studies in history," says Dr. Fauci. "The MACS led key studies that linked sexual behavior to HIV transmission, determined the median period of time between HIV infection and the onset of AIDS, showed that an imbalance of T-cell types precedes AIDS, and made a multitude of other pivotal discoveries that advanced HIV/AIDS research."

An extraordinary characteristic of the MACS is its 25 years of behavioral and biological data and specimens from men who have sex with men, before and after they became infected with HIV, before and after they were diagnosed with AIDS, and before and after they began highly active antiretroviral therapyalong with data from a control group of same-aged, HIV-free men who have sex with men. Comparing these before-and-after specimens and data from HIV-infected and uninfected individuals has yielded numerous seminal discoveries, including:

  • How best to diagnose HIV infection
  • The direct relationship between viral loadthe amount of HIV in bloodand progression of HIV disease
  • The link between low numbers of certain immune cells called CD4 T cells in the blood and progression to clinical AIDS
  • The central role of immune activation in the origin and development of HIV disease
  • Identifying unique features of long-term non-progressors (people infected with HIV whose bodies naturally limit viral replication) and people with genetic resistance to the virus
  • How to best manage the care and treatment of people with HIV, from preventive care for Pneumocystis pneumonia to antiretroviral therapy
  • The epidemiology of the virus that causes Kaposi's sarcoma, an AIDS-defining cancer, in HIV-infected patients
  • The interaction between aging and HIV infection
  • The epidemiology of major diseases that occur in conjunction with HIV/AIDS, including diseases of the heart, liver, kidneys and brain and certain cancers

Since the study's inception in April 1984, the MACS has cumulatively enrolled nearly 7,000 men who have sex with men. Today, 2,525 men participate in the study, the others having diedusually from AIDSor dropped out of the study. About half of the current participants are infected with HIV, and nearly 90 percent of that group takes antiretroviral therapy.

More than 200 investigators and staff belong to the MACS collaborative research team. Through behavioral questionnaires and the collection of biological specimens, study staff gather 8,500 separate pieces of information from each participant every six months, generating a gold mine of data and specimens for investigation. The scientific community and the public can access much of the MACS data, and study investigators actively pursue collaborations with outside researchers who propose studies of high scientific quality to the MACS leadership.

Along with Dr. Fauci, the anniversary event's guest speakers will include Jeffrey Crowley, director of the White House Office of National AIDS Policy; Christopher H. Bates, acting director of the Office of HIV/AIDS Policy at the U.S. Department of Health and Human Services; Gregg Gonsalves, an internationally renowned HIV activist; Shannon Hader, M.D., M.P.H., Director of the District of Columbia HIV/AIDS Administration; a participant from each of the four MACS sites; and Richard Kaslow, M.D., M.P.H., a MACS founding investigator. Potomac Fever, the a cappella ensemble of the Gay Men's Chorus of Washington, D.C., will provide entertainment.

The event will take place from 7:00 pm to 9:30 pm on May 12 in the Carnegie Institution for Science at 1530 P St. NW in Washington, D.C.


Contact: Laura Sivitz
NIH/National Institute of Allergy and Infectious Diseases

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