State of the Network TREAT Asia Network Annual Meeting Chiang Mai, Thailand October 2008
Research Community Education
TAHOD Program Update Current recruitment of ~4,000 patients from 17 sites in 12 countries 11 th data transfer in September 08 Retrospective cancer study, 14 sites 17 participating centers South Korea: Yonsei University, Seoul India: YRG Care, Chennai Institute of Infectious Diseases, Pune Japan: Int l Medical Center of Japan, Tokyo People's Republic of China: Beijing Ditan Hosp, Beijing Queen Elizabeth Hosp, Hong Kong Taiwan: National Yang-Ming University, Taipei Thailand: HIV-NAT/ Thai Red Cross, Bangkok Ramathibodi Hosp, Bangkok Chiang Mai University, Chiang Mai Philippines: Research Institute of Tropical Medicine, Manila Cambodia: NCHADS, Phnom Penh Malaysia: Sungai Buloh Hosp, Kuala Lumpur University of Malaya, Kuala Lumpur Singapore: Tan Tock Seng Hosp, Singapore Indonesia: Udayana University, Bali Papua New Guinea: Port Moresby General Hosp, PNG
Major Accomplishments 9 abstracts 12th International Workshop on HIV Observational Databases, Malaga, 28 Mar International AIDS Conference, Mexico City, 3-8 Aug 20th Annual Australasian Society for HIV Medicine (ASHM) Conference, Perth, 17-20 Sep Ninth International Congress on Drug Therapy in HIV Infection, Glasgow, UK, 9 13 Nov Ongoing and Future Analyses Patient characteristics and treatment outcomes associated with protease inhibitor use in the Asia-Pacific region; Prevalence and risk factors of metabolic complications and cardiovascular diseases among HIVinfected persons undergoing HAART in the Asia-Pacific region; AIDS-related and other mortality rates in the TREAT Asia Observational Database and the Australian HIV Observational Database during the HAART era; Deferred modification of antiretroviral regimen following treatment failure in Asia: results from The TREAT Asia HIV Observational Database; Anemia following AZT (IeDEA global analysis led by TAHOD)
Future Plans Scientific writing skills workshop 20-22 March 2009, Bangkok TAHOD investigators to work with medical journalist/communications experts to develop basic skills for writing concept sheets, abstracts, and manuscripts
Access to 2 nd -line ARVs Pediatric sites N=15 Abacavir Didanosine 1=easy 2=somewhat difficult 3=difficult 4=cannot or do not use
Access to 2 nd -line ARVs Pediatric sites N=15 Tenofovir Lopinavir/ritonavir 1=easy 2=somewhat difficult 3=difficult 4=cannot or do not use
Access to 2 nd -line ARVs Adult sites N=17 Abacavir Didanosine 1=easy 2=somewhat difficult 3=difficult 4=cannot or do not use
Access to 2 nd- line ARVs Adult sites N=17 Tenofovir Lopinavir/ritonavir 1=easy 2=somewhat difficult 3=difficult 4=cannot or do not use
Most Common 2 nd -line Regimens Pediatric and Adult NRTI, N=31 Abacavir-didanosine d4t or AZT in backbone* Tenofovir option Other None *8 (53%) of 15 pediatric sites
TASER Program Update TASER-M 635 patients enrolled in 7 sites from 4 countries; Thailand Malaysia Philippines Hong Kong 3 additional sites will join TASER-M in 2009 TASER-S 110 patients enrolled in 4 sites from 3 countries Thailand Philippines Hong Kong 1 additional site will join TASER-S in 2009
Major Accomplishments Building intra-network collaboration Laboratory technical support and training Thailand, Taiwan, Papua New Guinea, Indonesia Ongoing and future analyses TASER cohort profile HIV drug resistance review in Asia HIV Drug Resistance Mutations among Antiretroviral-naïve HIV-infected Patients in Asia
Future Plans 12 th Bangkok Symposium on HIV Medicine TASER PIs to participate in a TREAT Asiasponsored session on management of treatment failure and resistance Development of a pilot training on statistical analysis of longitudinal clinical and drug resistance data NCHECR, Brown University Assist TASER sites in exploring their local data and generating new analyses
TAQAS Program Update Major Accomplishments Round 5 in April 2008 15 labs in 11 countries Asia=12; Africa=2; USA=1 Detection of ~95% of resistance mutations over 5 rounds Abstract presented at the International AIDS Conference, Mexico City Future Plans 20 labs to participate in 2009 TASER Scoring System Explore methods for and feasibility of the use of dried blood spots for genotyping
US CDC Method of sampling patients ~100 mcl blood/spot 2-5 spots collected http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/2962.jpg
TApHOD Program Update September 2008: Second Data Transfer 1854 patients in 11 sites in 5 countries Cambodia, Indonesia, India, Malaysia, and Thailand Retrospective data on 1046 patients 1991 to present 3 new sites in Vietnam with ethical clearance
Major Accomplishments Ongoing and future analyses Cohort Profile Mortality Site Survey Opportunistic Infections Adolescents CD4 and growth Orphanhood Capacity building data management November 06 survey: 56% of sites with an electronic database
TApHOD Access Database
Future Plans Scientific writing skills workshop TApHOD investigators to work on developing basic skills for writing concept sheets, abstracts, and manuscripts Expanding features of our Access database More options for sites to work with their own data
IeDEA Collaboration of 7 regional centers to examine the impact of HIV and treatment on a global level Africa (Central, East, Southern, West), Asia, Latin America and Caribbean, North America Representing Asia: TAHOD + AHOD adult data component TApHOD pediatric data component 17 TREAT Asia participants on the 5 working groups
Community Program Update Treatment Literacy Cambodia, China, Indonesia, Vietnam 25 PLHA self-support and other organizations Reaching >2500 PLHA Purple Sky Network 7 national/provincial MSM Technical Working Groups in the Greater Mekong Sub-region
Major Accomplishments Focus on support for women Cambodia, Indonesia, Vietnam Characterizing experiences through data Cost-effectiveness analysis in China Capacity-building needs of MSM groups Policy South-to-South Exchange Chinese and Vietnamese government officials at the Thai Ministry of Public Health
Future Plans Explore linking care, treatment, and clinical research to the community Think Tank Report AIDS Care China s role in improving adherence through PLHAdriven clinic management 1500 patients in 2 provinces
Education and Training Building research capacity 2-year project (June 2010), funded by AusAID Cambodia, China, Indonesia, Papua New Guinea, Philippines Specific aims Assess research capacity and training needs Develop training curricula GCRP, HIV medicine, human subjects protections Provide technical assistance awards Transfer of technology and expertise between sites
Funding Support and Grants Management 77 sub-awards and contracts executed in FY08 Bangkok tracking ethical clearance and managing reporting to donors New York managing contracts and reporting from sites Renewal agreements 9 3 1½ pages
Network Support National Centre in HIV Epidemiology and Clinical Research, Sydney Data management, biostatistical analysis, development of research agenda, grant management TREAT Asia, BKK and amfar, NY Program and administrative support, development of research agenda, grant applications and management
Major Program Donors TAQAS TASER TAHOD AHOD TApHOD Pediatric Network Community Treatment Literacy Purple Sky Network Education Dutch MoFA/Aids Fonds US NIH (NIAID, NCI) amfar US NIH (NICHD) Austrian AIDS Life Association Positive Action, Glaxo Smith Kline USAID/Family Health International AusAID