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DOSSIER Updates
May 2012
Web site: http://statepi.jhsph.edu/macs/macs.html
Prepared by CAMACS
Fax: 410-955-7587
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, UL1RR025005, UO1-AI-35043, UO1-AI-35039, UO1-AI-35040, UO1-AI-35041.
May 2011
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
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Cardiovascular disease
Cerebrovascular disease
Kidney disease
Liver disease
Lung infection, bacterima, septicemia
Malignancies
Neurologic
– Mortality
November 2004
Composition & Size of Cohort
# Participants (thousands)
5
Seronegative
Seroconverter
4
Seroprevalent
3
2
1
0
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
Visit (Calendar year)
* 1710 have been administratively censored
May 2011
MACS Database
(as of 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
May 2012
Retention of LA MACS Participants (including active
and those who died; through 09/30/07)
% HIV-
% HIV+
% Seroconverters
92.6
67.4
76.1
94.0
78.6
84.3
87.3
100
81
Total
85.3
Combined = 1530/1728=88.5%
90.4
87.3
European-American
African-American
Hispanic-American
Incidence* of Seroconversion in the MACS by Center
Kingsley, Zhou, . . ., Muñoz - AJE 1991 (update)
60
Incidence
Baltimore
50
Chicago
40
Pittsburgh
Los Angeles
30
20
10
0
84
86
88
90
92
94
Calendar Time (years)
* Incidence = # of seroconverters per 1,000 person-semesters
September 1995
June 1997
Likelihood of Developing AIDS in Three Years
Mellors, Muñoz, . . ., Rinaldo - Ann Int Med 1997
100%
80%
60%
40%
<200
201-350
351-500
CD4+
501-750 T-lymphocyte
>750
Count
20%
0%
>30K
>55K
10K – 30K 3K – 10K 501 – 3K
20K – 55K 7K – 20K 1501 – 7K
<500
bDNA
<1501 RT-PCR
(cells/mm3)
Plasma Viral Load (copies/ml in thousands)
June 1997
Proportion Surviving AIDS by Year of Diagnosis
Assumed currently alive at 6/30/99 if contacted since 6/30/98
Jacobson, Kirby, . . ., Schrager - AJE 1993 (update)
Proportion Surviving AIDS
1.0
1984-85
1986-87
1988-90
1991-94
1995-98
0.8
0.6
0.4
0.2
0.0
0
2
4
6
8
10
Years After Initial Clinical AIDS Diagnosis
October 1999
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
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Beth Jamieson
John Fahey
Anthony Butch
Steve Young
Najib Aziz
Oto Martinez
Rita Effros
Barbara Visscher
Jonathan Braun
Eric Miller
Mallory Witt
Dorothy Wiley
Harry Vinters
Many students
Andrew Levine
Jordan Lake
Otto Yang
Peter Anton
Elizabeth Breen
Karl Goodkin
Mathew Wright
Richard Wight
Pamina Gorbach
Steve Shoptaw
Zuofeng Zhang
Shenaz Hussain