Web site: http://statepi.jhsph.edu/macs/macs.htmlPrepared by CAMACS

Fax: 410-955-7587

May 2011

The MACS is funded by the National Institute of Allergy and Infectious Diseases, with additional supplemental funding from the National Cancer Institute and the National Heart, Lung and Blood Institute.   UO1-AI-35042, UL1-RR025005, UO1-AI-35043, UO1-AI-35039, UO1-AI-35040, UO1-AI-35041.

DOSSIER Updates May 2012

CAMACS• Planning and design of studies• Coordination of data acquisition

– Form development– Codebooks– Data transfer

• Standardization and data management– Edits and updates– Data security

• Data analysis, statistical computing and methodological research

September 1995

, AB (negs)

Continuous Outcome Ascertainment

• Seroconversion (seronegatives only)

• Clinical Outcomes (medical records confirmation)

– AIDS diagnoses– Non-AIDS diagnoses

• Cardiovascular disease• Cerebrovascular disease• Kidney disease • Liver disease• Lung infection, bacterima, septicemia• Malignancies• Neurologic

– Mortality

November 2004

Composition & Size of Cohort

0

1

2

3

4

5

1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010

May 2011

Visit (Calendar year)

# P

arti

cip

ants

(th

ou

san

ds)

Seronegative

Seroconverter

Seroprevalent

* 1710 have been administratively censored

MACS Database(as of May 2012)

May 2012

Publications (published & in press) 11,229

Participants 6,992

Person-Years 89,752

Variables 12,305

Repository aliquots 1,638,409 (plasma, serum, cells, urine)

HIV+ HIV-

Person-Visits 58,287 74,588

CD4 Measurements 53,641 59,619

HIV RNA Measurements 35,822 1,218

Retention of LA MACS Participants (including active and those who died; through 09/30/07)

% HIV- % HIV+ % Seroconverters

European-American 92.6 94.0 87.3

African-American 67.4 78.6 100

Hispanic-American 76.1 84.3 81

Total 85.3 90.4 87.3

Combined = 1530/1728=88.5%

Incidence* of Seroconversion in the MACS by Center

0

10

20

30

40

50

60

84 86 88 90 92 94

Calendar Time (years)

Inci

den

ce

September 1995

Baltimore

Chicago

Pittsburgh

Los Angeles

Kingsley, Zhou, . . ., Muñoz - AJE 1991 (update)

* Incidence = # of seroconverters per 1,000 person-semesters

June 1997

Likelihood of Developing AIDS in Three Years

0%

20%

40%

60%

80%

100%

>750501-750

351-500201-350

<200

Mellors, Muñoz, . . ., Rinaldo - Ann Int Med 1997

June 1997

>30K>55K

10K – 30K20K – 55K

3K – 10K7K – 20K

501 – 3K 1501 – 7K

<500 bDNA<1501 RT-PCR

Plasma Viral Load (copies/ml in thousands)

CD4+T-lymphocyte

Count(cells/mm3)

Proportion Surviving AIDS by Year of DiagnosisAssumed currently alive at 6/30/99 if contacted since 6/30/98

Jacobson, Kirby, . . ., Schrager - AJE 1993 (update)

October 1999

0.0

0.2

0.4

0.6

0.8

1.0

Years After Initial Clinical AIDS Diagnosis

0 2 4 6 8 10

1984-851986-871988-901991-941995-98

Pro

po

rtio

n S

urv

ivin

g A

IDS

MACS Subgroups of Particular Interest

• Long-term seropositive individuals with minimal declines in CD4 levels

• Seropositive individuals with rapid declines in CD4 levels

• Long-term survivors with low CD4 levels

• Seroconverters

• High-risk seronegatives

• Seropositives on treatment

• >55 years old

Key Factors in the Success of the MACS

• The commitment and sacrifice of the participants

• The staff members of the MACS

• Strong laboratory support

UCLA MACS Staff

John Oishi, Study Coordinator

Kevin Barrett, Data Manager/Programmer

Max Hechter, Coordinator

Charles Doran, Administrative Specialist

Nicole Hadjioannou, SRA, Clinical Follow-up

MACS Clinic Staff

LA Men’s Study, Wilshire Site

–Dennis Miles, Site Manager –May Htike, Lead Examiner–Daniel Cheng, SRA, Senior Interviewer–Tuan Nguyen, Examiner –Alan Ernst, Interviewer

Los Angeles Gay & Lesbian Center

–Eduardo Mercado, Coordinator –Ray Mercado, Coordinator

Harbor-UCLA Medical Center

–Carlos Aquino, Coordinator –Lisa Siquieros, Assistant Coordinator–Gilbert Papilla, Assistant Coordinator

LA MACS Investigators• Beth Jamieson Andrew Levine• John Fahey Jordan Lake• Anthony Butch Otto Yang• Steve Young Peter Anton• Najib Aziz Elizabeth Breen• Oto Martinez Karl Goodkin• Rita Effros Mathew Wright• Barbara Visscher Richard Wight• Jonathan Braun Pamina Gorbach• Eric Miller Steve Shoptaw• Mallory Witt Zuofeng Zhang• Dorothy Wiley Shenaz Hussain• Harry Vinters• Many students