The Cape Town Adolescent Antiretroviral Cohort (CTAAC) is a prospective, descriptive cohort study that began in July 2013. Recruitment and enrolment took place over a period of 18 months during which 515 HIV-infected adolescents on antiretroviral therapy (ART) and 110 HIV-uninfected controls all between the ages of 9 and 14 years were enrolled. The participants were recruited from eight sites around Cape Town.
• Red Cross War Memorial Children’s Hospital
• Tygerberg Hospital
• Groot Schuur Hospital
• Gugulethu Community Health Centre
• Nolungile Community Health Centre
• Crossroads Community Health Centre
• Mitchell’s Plain Community Health Centre
• Masiphumelele Youth Centre
Study participants are followed every 6 months for 48 months with the visits taking place at the Research Centre for Adolescent and Child Health (REACH) at the Red Cross War Memorial Children’s Hospital. Participants undergo a clinical examination and a number of investigations are performed which include the collection of biological specimens (blood, urine, sputum, nasal swabs and stool), lung function testing, echocardiographs and ECGs, audiology testing, ultrasound and chest x-rays among others.
A nested neuroHIV sub-study of about 200 HIV-infected adolescents and about 50 HIV-uninfected controls between the ages of 9 and 11 years at the time of enrolment underwent neuropsychiatric evaluation and neuroimaging at baseline. This is being repeated at 36 months.
The aim of the CTAAC study is to investigate markers of chronic disease processes and progression in perinatally HIV-infected adolescents on antiretroviral therapy (ART). It focuses on five key areas (general adolescent development; neurocognitive function; pulmonary disease; cardiovascular function and musculoskeletal disease).
The specific aims of the study are:
To characterize physical and psychosocial development in a large cohort of perinatally-infected adolescents on ART and to investigate the predictors of development throughout adolescence.
To describe the neuropsychiatric status of children over time through neuroimaging and neurocognitive testing and associations with features of HIV disease and its management.
To describe the spectrum and progression of pulmonary disease, its association with opportunistic infection (OI) history, and the prevalence, natural history and determinants of subclinical chronic pulmonary changes.
To investigate the evolution of cardiovascular dysfunction, using measures of cardiac structure/function and endothelial dysfunction, and relate these to markers of HIV disease and ART use.
To investigate patterns in the associations between abnormal neurological, pulmonary and cardiovascular structure and function in HIV-infected adolescents and to investigate the shared risk factors for multi-system pathology.