1. VACS Scientific Meeting 2008
WELCOME!

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

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

4. 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

6. 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

7. 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

8. 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%

9. FU4 by Site

10. VACS Enrollment By Race/Ethnicity

11. VC & VACS Enrollment By Age

12. 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

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

14. New Website

15. 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

16. 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

17. 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

18. 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)

19. 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)

20. 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)

21. 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

22. 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