Cohort Profile: Caribbean, Central and South America Network for HIV research (CCASAnet) collaboration within the International Epidemiologic Databases to Evaluate AIDS (IeDEA) programme

The HIV/AIDS epidemic has evolved in its third decade to be an unprecedented human catastrophe of global scale and importance. Although an historic response for change and intervention has led to decreased rates of new infections and HIV-associated mortality in many communities the enormity of the pandemic continues to overwhelm already constrained resources everywhere. Improved understanding of antiretroviral therapy (ART) responses and viral and host characteristics both within and between diverse settings and populations is needed to guide initiatives in HIV prevention and treatment worldwide. The merging of existing clinical and research data related to HIV infection and its associated disorders answers questions that currently cannot be addressed using randomized trials or single sources of data. Cohorts such as MACS WIHS HIVRN EuroSida and the Swiss HIV Cohort have produced important observations regarding the epidemiology and long-term outcomes of HIV-infected individuals residing in North America and Europe both before and after the era of highly active antiretroviral therapy (HAART). Assessments of short-term response to HAART in recently expanded single-site programmes have been reported globally. Collaborations such as TAHOD and ART-LINC have allowed short-term evaluation of antiretroviral programmes in resource-limited settings from several continents and recently comparisons of outcomes in the first year of ART between low- and high-income countries have been reported. (excerpt)