UNIVERSITY OF ALABAMA AT BIRMINGHAM
Data for this study comes from CNICS, which is a multi-center collaborative project to create and maintain the CFAR Network of Integrated Clinical Systems (CNICS), a clinical cohort for longitudinal studies in HIV.The CNICS Network provides anonymized demographic, clinical laboratory, outcomes and HIV resistance data on a large racially and ethnically diverse cohort of HIV patients in 9 major urban centers in the US and provides a unique opportunity to study HIV transmission, treatment, resistance, and clinical outcomes in relation to gender, race, ethnicity and HIV risk-factors. The cohort has considerable numbers of women (15-
16%) and African American patients (26-27%), which have been used for our ongoing CNICS study (002)
entitled: Clinical Consequences of Resistance. The goals of CNICS 002 are to evaluate the prevalence of
HIV antiretroviral (ARV) regimen failure and drug resistance, and the consequences of resistance for clinical disease progression (to new AIDS-defining illness or death). Results from this study have shown differences in prevalence of triple class ARV exposure and regimen failure among women and African Americans, suggesting the cohort has the power to illustrate differences in these populations. The proposed study seeks to expand CNICS 002 project to include targeted analysis of resistance patterns for women and racial/ethnic minorities as described below. The goals of this study are: (1) To determine the prevalence of multiple-class ARV exposure, virologic failure, ARV resistance, and transmitted drug resistance in the CNICS cohort by gender, race, and ethnicity and to determine if prevalence is changing over time. (2) To evaluate differences in clinical consequences of drug resistance by gender, race and ethnicity. (3) To use phylogenetic analysis to
evaluate HIV transmission patterns in relation to gender, race and ethnicity.