Multicenter AIDS Cohort Study (MACS)

The Multicenter AIDS Cohort Study (MACS) - now part of the MACS-WIHS Combined Cohort Study (MWCCS) investigates the epidemiology of human immunodeficiency virus (HIV) infection among men who have sex with men. Over 7,000 participants volunteered for semiannual interview, physical examination, and laboratory testing across the 325 years of the study, in four metropolitan areas of Los Angeles, Chicago, Baltimore/Washington (DC) and Pittsburgh. The study aimed to identify risk factors for occurrence and clinical expression of the HIV infection, and to establish a repository of biologic specimens for future study. Study visits included detailed questions covering HIV-related symptoms and utilization of health services, demographic and psychosocial characteristics, a quality of life survey, a physical examination, a detailed form on medications used as prophylaxis and/or treatment, a neuropsychological screening and examination, blood samples to do measure hematologic variables including enumeration of T-cell subsets and HIV viral load and evaluate genetic risk factors via genome wide association studies using data generated using the Infinium Multi-Ethnic Global BeadChip genotyping array in all participants. Men who have sex with men, with and without HIV infection were enrolled in the MACS. MACS data continues to be available through the merged MWCCS cohort.]]>
Study Population Men who have sex with men, with and without HIV infection were enrolled in the MACS. All MACS participants who consented for genetic testing were eligible for inclusion in this study. Criteria Inclusion Criteria for MACS cohort varied by enrollment wave, in later waves it included: HIV negative, or HIV positive and no history of highly active antiretroviral therapy (HAART), or Documented recent HAART initiation with no AIDS diagnosis prior to HAART initiation. Sexual intercourse with men or at least 5 male or female partners in the 5 years prior to enrollment. Exclusion Criteria for MACS cohort varied by enrollment wave, in later waves it included: Injection drug use within 1 year of enrollment. Perinatally acquired HIV infection. ]]>
The MACS study began in 1984 when 4954 men were enrolled. In 1987 a second enrollment occurred involving 668 men. Early contributions included studies about seroconversion risk, T cell decline, PCP prophylaxis guidelines, progression to AIDS, survival time, KS and NHL risk, and host genetics. In 1996 during the early HAART era, some findings included topics such as treatment effect on HIV disease progression, cellular activation, cytokine disruption and NHL risk, treatment interruptions. In 2001-2003 a third enrollment phase allowed the inclusion of 1350 men and generation of knowledge regarding population effectiveness of treatment, improved neuropsychological function, effect of host genetics on treatment effectiveness, adverse events and treatment guidelines. Recent contributions since 2014 include research about aging with HIV, comorbidities, serological biomarkers of activation and inflammation, long term non-progression.]]>