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Women's Interagency HIV Study

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The Women's Interagency HIV Study (WIHS) was established in August 1993 to investigate the impact and progression of HIV disease in women. The WIHS enrolls both HIV-positive and HIV-negative women. The core portion of the study includes a detailed and structured interview, physical and gynecologic examination, and laboratory testing. The WIHS participants are also asked to enroll in various sub-studies, such as cardiovascular, metabolic, musculoskeletal, and neurocognition. New proposals for WIHS sub-studies are submitted for approval by various scientific investigators from around the world.

Funding

The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health (ORWH). WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA).

Clinical sites

WIHS clinical sites are located in and around 10 cities in the United States and are headed by Principal Investigators: Bronx, NY (Kathryn Anastos); Brooklyn, NY (Howard Minkoff, Deborah Gustafson); Washington, DC (Mary Young); San Francisco, CA (Ruth Greenblatt, Bradley Aouizerat, Phyllis Tien); Chicago, IL (Mardge Cohen); Miami, FL (Margaret Fischl, Lisa Metsch); Chapel Hill, NC (Ada Adimora); Atlanta, GA (Igho Ofotokun, Gina Wingood); Birmingham, AL (Michael Saag, Mirjam-Colette Kempf); and Jackson, MS (Deborah Konkle-Parker). The WIHS Data Management and Analysis Center (Stephen Gange, Elizabeth Golub) is located in Baltimore, MD. Each consortium is affiliated with local research institutes to see study participants and has its own Community Advisory Board.

Recruitment

WIHS has been funded in five cycles to date:

  • WIHS I: November 1, 1992 – October 31, 1997
  • WIHS II: November 1, 1997 – October 31, 2002
  • WIHS III: November 1, 2002 – December 31, 2007
  • WIHS IV: January 1, 2008 – December 31, 2012
  • WIHS V: January 1, 2013 - December 31, 2017

Initial enrollment into the WIHS occurred between October 1994 and November 1995. The total initial enrollment for the WIHS was 2,056 HIV-positive women and 569 HIV-negative women.[1] Since WIHS recruited its initial population, several new trends developed as the HIV epidemic evolved, all of which argued for an expansion of the WIHS cohort. First, despite careful follow-up of the cohort, the inevitable course of illness and time had led to attrition and death. Additionally, increased sample sizes were needed because the effectiveness and consequences of Highly Active Antiretroviral Therapy (HAART) added new strata to many key analyses, and decreased the incidence of clinical outcomes. And finally, as the original cohort continued to age, it became less able to support studies of risk behaviors, sexually transmitted diseases, and reproductive function. Thus, WIHS funding was augmented in 2001 to empower the study to efficiently and precisely meet the study’s specific aims through the recruitment of additional women. Total enrollment in 2001-02 (WIHS visits 15 and 16) was 738 HIV-positive and 403 HIV-negative participants.[2] Beginning in January 2011, the WIHS opened enrollment again, in order to replace those women who had died during WIHS III and WIHS IV. Total enrollment in 2011-12 (WIHS visits 35-37) was 276 HIV-positive and 95 HIV-negative participants. In the summer of 2013, the WIHS will begin enrolling approximately 800 women from the WIHS Southern sites (Atlanta, GA; Chapel Hill, NC; Miami, FL; Birmingham, AL; Jackson, MS). All potential study participants undergo an initial screening to determine study eligibility. If the woman is willing to take part in the study and gives informed consent, she will participate in an in-depth interview, physical exam, and specimen collection.

Key Publications

  • Gandhi, et al. A Single-Nucleotide Polymorphism in CYP2B6 Leads to >3-Fold Increases in Efavirenz Concentrations in Plasma and Hair Among HIV-Infected Women. J Infect Dis 2012;206(9):1453‐61.[3]
  • Parrinello, et al. Cytomegalovirus Immunoglobulin G Antibody Is Associated With Subclinical Carotid Artery Disease Among HIV-Infected Women. J Infect Dis 2012;205(12):1788‐96.[4]
  • Levine, et al. HIV As a Risk Factor for Lung Cancer in Women: Data From the Women’s Interagency HIV Study. J Clin Oncol 2010;28(9):1514‐1519.[5]
  • Keller, et al. Risk of Cervical Precancer and Cancer Among HIV-Infected Women With Normal Cervical Cytology and No Evidence of Oncogenic HPV Infection. JAMA 2012;308(4):362-369.[6]
  • Kitahata, et al. Effect of early versus deferred antiretroviral therapy for HIV on survival. N Engl J Med 2009;360(18):1815‐1826.[7]

See also

References

  1. ^ Barkan, et al. The Women's Interagency HIV Study. WIHS Collaborative Study Group. Epidemiology 1998; 9:117-125.
  2. ^ Bacon, et al. The Women's Interagency HIV Study: an Observational Cohort Brings Clinical Sciences to the Bench. Clinical and Diagnostic Laboratory Immunology 2005; 12:1013‐1019.
  3. ^ Gandhi, et al. A Single-Nucleotide Polymorphism in CYP2B6 Leads to >3-Fold Increases in Efavirenz Concentrations in Plasma and Hair Among HIV-Infected Women. J Infect Dis 2012;206(9):1453‐61.
  4. ^ Parrinello, et al. Cytomegalovirus Immunoglobulin G Antibody Is Associated With Subclinical Carotid Artery Disease Among HIV-Infected Women. J Infect Dis 2012;205(12):1788‐96.
  5. ^ Levine, et al. HIV As a Risk Factor for Lung Cancer in Women: Data From the Women’s Interagency HIV Study. J Clin Oncol 2010;28(9):1514‐1519.
  6. ^ Keller, et al. Risk of Cervical Precancer and Cancer Among HIV-Infected Women With Normal Cervical Cytology and No Evidence of Oncogenic HPV Infection. JAMA 2012;308(4):362-369.
  7. ^ Kitahata, et al. Effect of early versus deferred antiretroviral therapy for HIV on survival. N Engl J Med 2009;360(18):1815‐1826.
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