The National Institutes of Health (NIH) has awarded a seven-year grant totalling $17 million to researchers at Emory University to study the impact of chronic health conditions – including heart, lung, blood and sleep disorders – that affect men and women living with HIV.

The grant, which is administered by the National Heart, Lung, and Blood Institute, is part of a newly formed Multicenter AIDS Cohort Study (MACS) / Women’s Interagency HIV Study (WIHS) Combined Cohort Study (MACS/WIHS-CSS) that was created by merging two highly successful long-term multi-site studies. MACS, begun in 1984 focused exclusively on men, and WIHS, begun in 1993,  focused exclusively on women. Emory has been supported through WIHS since 2013, and is one of 13 new MACS/WIHS-CSS centers funded nationally, plus a data center.

“The overarching goal of the new MACS/WIHS CCS will be to promote healthy aging among individuals living with HIV by unravelling the individual and combined effects of age, sex and race/ethnicity on HIV status,” says Igho Ofotokun, MD, MSc, one of the principal investigators of the Emory study. 

“This is necessary because even as advances in HIV/AIDS management are making it increasingly possible for individuals with HIV to live near-normal life spans, people with even well-controlled HIV infection frequently experience illnesses unrelated to their HIV, including cardiovascular disease, musculo-skeletal diseases, pulmonary and sleep disorders, cancer, neurocognitive disorders and depression at rates and severities that are worse than in the general population.”

Ofotokun is professor of medicine (infectious diseases) in Emory University School of Medicine and co-director of the NIH-funded Emory Center for AIDS Research (CFAR) Clinical Research Core. The grant’s other principal investigator, Anandi Sheth, MD, MSc, is associate professor of medicine (infectious diseases) in Emory School of Medicine and a senior investigator with the Emory CFAR. Both Ofotokun and Sheth are clinician-scientists in the Grady Health System Infectious Diseases Program at the Ponce Clinic in Atlanta.

“Emory is extremely well positioned to sponsor a MACS/WIHS CSS,” adds Sheth. “More than 10,000 men and women with HIV receive care in Emory-affiliated clinics each year and, in addition to the Center for AIDS Research, the university also is home to several other NIH-supported HIV research networks, including the HIV Vaccine Trials Network (HVTN), the HIV Prevention Trials Network (HPTN), and the AIDS Clinical Trials Group (ACTG).”

Gina M. Wingood, ScD, MPH, is a co-principal investigator on the new grant. Wingood is Sidney and Helaine Lerner Professor of Public Health Promotion and director of the Lerner Center for Public Health Promotion at the Mailman School of Public Health at Columbia University. Prior to relocating to Columbia in 2015, Dr. Wingood was a professor of Behavioral Sciences and Health Education at Emory’s Rollins School of Public Health and a co-director of the Emory CFAR Prevention Science Core.

“The Emory MACS/WIHS CCS is an exciting opportunity to add a substantive contribution to research aimed at mitigating the suffering caused by HIV/AIDS in the United States and around the world,” says Wingood.

The program aims to make these research advances:

• Identify biomarkers of increased risk for chronic disorders in people living with HIV.
• Determine how antiretroviral therapy affects other medical conditions and their treatments
• Develop strategies for more effective interventions and treatments for HIV infection and other medical conditions.
• Learn about the role of chronic immune activation and inflammation due to HIV infection in other health conditions. 

“The MACS/WIHS CCS is an exciting, trans-NIH study of chronic conditions related to HIV infection in this era of effective antiretroviral therapy,” says Dr. Sean Altekruse, the Project Officer at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health. “Investigators across the 14 research sites have formed a great team, and over the next seven years they will address many HIV-related science interests of the NIH.”

The MACS/WIHS CCS research team will also be able to leverage long-standing pre-existing collaborations with multiple county health departments and community-based organizations in Atlanta including the internationally famous SisterLove, Inc.

More than 12,000 people nationwide have participated in MACS and WIHS studies nationwide since 1984, resulting in groundbreaking discoveries about diagnosing and managing HIV; the link between low immune cell counts and AIDS; and genetic, metabolic and other factors that influence how HIV infection may progress to AIDS. The Combined Cohort Study will build upon the information from these participants with new research directed at co-existing medical conditions. The new cohort will include earlier participants as well as new participants, including a special focus on black and Hispanic populations and residents of southern states.