VACS Scientific Meeting 2008 WELCOME!

Recognition of Special Guests Steering Committee Yale Leadership VHA Leadership NIH Leadership

Coffee, Bathrooms, Food, etc. Orientation Coffee, Bathrooms, Food, etc.

Where We’ve Been--Where We’re Going Coordinating Center Update (Kristin Mattocks) VC and VACS Enrollment, FU, and other updates Tissue and DNA Bank Current proposals Website Scientific Update (Kristin Mattocks) Grants Publications, Presentations, Abstracts Committees Workgroups Database Update (Amy) Where We Are Going (Amy Justice): Intervention Plans

Virtual Cohort (VC) Update (Reminder) Scope of Study 1998 to present Baseline HIV infected patients at initiation of HIV care Controls selected and followed in same calendar year Administrative (patient treatment file), laboratory (DSS), pharmacy data (PBM), death data (BIRLS, inpatient mortality) Working on CCR, Medicare, MI Data from EPRP, and Cancer Registry Data Subjects 33,420 HIV infected veterans 66,840 Age, race/ethnicity, region 2:1 matched controls Last updated as of: September 30th, 2004

VACS 8 Update 8 Sites HIV+ 1:1 Group matched to HIV- Baseline 2002 age, race/ethnicity, and site primary care pts. Baseline 2002 Ongoing annual follow up surveys (FU 4 in field) Have access to all VA databases Local electronic medical records National VA databases (ICR, PBM, BIRLS, Patient treatment files, DSS, etc.) Requesting access to Medicare data, Cancer Registry, MI data from EPRP

VACS 8 Enrollment/FU Update (We Are Not a Survival Cohort) HIV+ HIV- Total Enrollment Last Year 186 160 346 3484 3450 6934 Follow Up 4th FU 57% 44% 50%

FU4 by Site

VACS Enrollment By Race/Ethnicity

VC & VACS Enrollment By Age

Current Proposals (n=72) 00 concept sheets pending 13 writing committees finalized 05 prioritized, awaiting data 07 data just cut 25 analyses underway 08 abstracts recently submitted 14 papers submitted/ in review/ in revision

DNA and Tissue Bank (Completed 8/31/07) HIV+ HIV- Total Unique Pts 1656 892 2548 DNA Samples Tissue Samples 1542 867 2409

New Website

Active Core Support Grants Period K $ NIAAA U10: Alcohol in HIV+/- Veterans (Justice) 9/06-8/11 13,273 NIA/NHLBI RO1: Unexplained Anemia (Berliner) 12/06-11/10 1,635 VA Fellowship in Medical Informatics (Brandt) 7/06-- NIAAA R21: Alcohol BI HIV+Kenyans (Papas) 7/07-6/09 345 NHLBI R01: HIV-Associated Lung Disease (Crothers) 10/07-9/12 3,965 VA Merit: Returning OIF/OEF Veterans Cohort (Brandt) 1/08-12/11 900 NIAAA R01: Computer Simulation Alcohol & HIV Sub-Saharan Africa (Braithwaite) 2,210 VA HSR&D REAP: Pain Research, Informatics, Medical Comorbidities (Kerns) 10/08-- 306 NHLBI R01: HIV(HCV) and CVD (Freiberg/Justice) 9/08-8/13 4,558

Active Collaborative Grants Period VA Clinical Dollars: Smoking Cessation (Crothers) 7/07-1/09 VA HSR&D: Medical Informatics Consortium (Samore) 10/08-9/12 NIMH P30: C. for Interdisc. Research on AIDS (Cleary) 9/01-6/13 NIAID R01: Harvard Causal Modeling (Hernan) 12/06-12/07 NCI U01: NA-ACCORD (Moore) 7/07-6/11 Medical Research Council UK: ART-CC (Sterne) 2/08-2/11

Career Development Awards Awardee Source Award Date Progress Joseph Goulet VA HSR&D N/A Revise and Resubmit Nancy Kim Kristin Mattocks AMFAR Will submit HSR&D Vincent LoRe NIAID 7/07 In process KrisAnn Oursler NIA 1/07 Adeel Butt NIDA 10/03 Submitted RO1s Submitted R-21 (NIDDK) Matthew Freiberg NIAAA 9/05 NHLBI R01 Kristina Crothers NIH/NCRR 7/05 NHLBI RO1 Scott Braithwaite NIAAA, RWJFS NIAAA R01 Shawn Fultz Joined VHA Leadership

Publications 2007-Oct 2008 Original Scientific Publications (28 total) 14 VACS Research(5 in press) 7 Collaborative with other cohorts (3 in press) 3 Other VA databases 4 Related work (2 in press) Reviews/Chapters (3, 2 in press) Original Papers Under Review (16) Abstracts (40, 10 under review)

Cores & Science Committees Biostatistics (J. Goulet; publications slide) Simulation (S. Braithwaite; presentation) Faculty (A. Justice; CDAs, projects, grants slides) Science Committees Alcohol and Behavior (D. Fiellin; sessions) Tissue Banking (C. Rinaldo; session) Informatics (C. Brandt; database, intervention pilots)

Active Workgroups HAART Naïve (N. Gandhi; presentation) Liver (J. Lim; presentation) Pulmonary (K. Crothers; presentation) Cardiovascular (M. Freiberg; presentation) Behavioral Interventions (R. Papas; presentation) Informatics Interventions (N. Kim; presentation) Endpoints (K. Crothers; slide) Cancer (J. King, R. Dubrow; slide)

Clinical Endpoint Arbitration Initial Targets Decompensated liver cirrhosis (Vin LoRe) MI & other vascular events (Matt Freiberg) HIV and “non-HIV” Pneumonias (Kristina Crothers) Methodology Develop/validate algorithm for likely cases Central, electronically assisted, chart review Adjudicate cases using two clinical reviewers If disagree, full committee review

Cancer VA national cancer registry Trained registrars at major VA facilities Detailed data on Pathologic diagnosis Clinical staging Treatment Applying to get data on all VACS subjects