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Harvard Affiliated HIV Clinical Cohort Submission Form
Represent your study in the Harvard University Center for AIDS Research HIV Cohort Catalogue
http://cfar.globalhealth.harvard.edu/pages/research-cohorts
Please contact Alberto or Meral for any questions at
alberto_ottoboni@harvard.edu
,
meral_pasha@harvard.edu
Principal Investigator Name:
*
Primary Institution
*
Harvard University
Beth Israel Deaconess Medical Center
Boston Children's Hospital
Brigham and Women's Hospital
Dana Farber Cancer Institute
Immune Disease Institute
Lemuel Shattuck Hospital
Mass General Hospital
Fenway Health
Ragon Institute of MGH, MIT, Harvard
Other (please specify)
Other Institution(s) if applicable:
Study Contact Name:
*
Study Contact Phone:
Study Contact Email:
*
Best mechanism to request study data or specimens (for example, email study contact person directly or provide a link to a database or cohort website):
*
Short title of the research study
*
Description of Study Subjects:
*
Key Inclusion and/or Exclusion Criteria:
*
Study Locations (list countries, cities, regions, or institutions):
*
Subjects are
*
HIV+
HIV-
HIV+ and HIV-
HIV Co-infected
Other
Other
Enrollment Period (example, 1996-2010):
*
Enrollment Goal (example, 1000 participants):
*
Available Biological Specimens
*
B-cell lines
Blood, serum, or plasma
DNA
Peripheral Blood Mononuclear Cells
Tissues and Stool
Other
Other
Available Study Data (CD4 counts, viral loads, longitudinal data, etc.):
*
Applicable Keywords That Describe the Cohort
ART/ARV
Aging
Cancer
Chronic Disease
Elite Controllers
Multi-site Networks
Pediatrics
TB
Other
Other
Optional Additional Comments:
0/200 words