The Role of Alcohol Use in Lung Disease After Treatment for Active TB Disease Among Persons Living with HIV

艾滋病毒感染者治疗活动性结核病后饮酒对肺部疾病的影响

基本信息

批准号：
10303987
负责人：
Kaku So-Armah
金额：
$ 46万
依托单位：
BOSTON MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-10 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10303987
关键词：
AIDS/HIV problem Address Aftercare Alcohol abuse Alcohol consumption Alcohols Anatomy Behavioral Biological Markers Biometry Boston Bronchiectasis COVID-19 Calendar Carbon Monoxide Cause of Death Cities Collaborations Data Diagnosis Diffuse Disease Disease Outcome Disease Progression Effectiveness of Interventions Epidemiology Ethanol toxicity Foundations Future Goals HIV HIV/TB Health Health Personnel Heavy Drinking High Prevalence Immune System Diseases Immunologics Immunology Infectious Agent Inpatients International Intervention Interview Knowledge Link Lung Lung CAT Scan Lung diseases Lung infections Malnutrition Measures Methods Observational Study Outcome Perception Persons Pharmacists Physiological Physiology Pneumonia Predisposition Pulmonary Function Test/Forced Expiratory Volume 1 Pulmonary Tuberculosis Pulmonary function tests Pulmonology Readiness Research Respiratory Signs and Symptoms Risk Risk Factors Role Russia Severity of illness Smoking Testing Time TimeLine Toxic effect Translating Tuberculosis Uganda Vital capacity Walking Woman Work X-Ray Computed Tomography active method alcohol effect alcohol intervention alcohol research alcohol use disorder base behavioral pharmacology co-infection exercise capacity functional outcomes hazardous drinking improved interest lung injury men modifiable risk phosphatidylethanol primary outcome secondary outcome smoking intervention smoking prevalence substance use tuberculosis treatment

项目摘要

ABSTRACT Tuberculosis (TB) is the leading cause of death from a single infectious agent and the leading cause of death in people living with HIV (PLWH). An estimated 8.5 million people with TB are cured every year but many do not return to full health. Up to half of those completing treatment for pulmonary TB have post-TB lung disease, a disabling under-diagnosed group of lung deficits. Lung deficits at TB treatment completion are the strongest predictors of post-TB lung disease severity up to a year later. Alcohol and HIV are associated with lung immune dysfunction and alcohol use is associated with delayed TB diagnosis, increasing the risk of lung injury during active TB disease. However, it is not known whether alcohol use is associated with post-TB lung disease in PLWH. We hypothesize that hazardous drinking increases susceptibility to and worsens post-TB lung disease in PLWH. Our objective is to investigate hazardous drinking (Alcohol Use Disorders Identification Test [AUDIT] ≥8) as a modifiable risk factor for post-TB lung disease in PLWH. To achieve this, we propose a 2-year observational study of 200 PLWH completing inpatient pulmonary TB treatment in St. Petersburg, Russia. We will evaluate the following post-TB lung disease outcomes: functional exercise capacity (primary outcome assessed by 6-minute walk distance), lung physiology (pulmonary function tests), anatomy (CT scan), and lung infections. The primary exposure is past-year hazardous drinking. Secondary alcohol measures will include 30-day Timeline Followback (calendar-based method of alcohol use recall) and phosphatidylethanol (PEth; a biomarker of recent alcohol use). Our expertise spans alcohol use, HIV, TB, pulmonology, epidemiology, and biostatistics. Our primary aim (Aim 1a) is to determine the relationship between past-year hazardous drinking and post-TB lung disease. In Aim 1b we assess the association of past-month heavy drinking and post-TB lung disease progression over time. In Aim 1c we explore whether smoking modifies the association of past-month heavy drinking and post-TB lung disease progression over time. Heavy drinking in Aims 1b and 1c is defined by Timeline Followback as ≥7 drinks/week (women) or ≥14 drinks/week (men) or PEth>200 ng/mL. In Aim 2, we will qualitatively evaluate factors that can improve tailoring of pharmaco- behavioral alcohol and smoking interventions in PLWH receiving TB treatment. We will conduct in-depth interviews with 24 PLWH during or after inpatient TB treatment and 12 TB healthcare providers. IMPACT: We will determine the association of alcohol use and post-TB lung disease in PLWH. Our quantitative and qualitative data will lay the foundation for future work to tailor alcohol and smoking interventions to improve long-term health in HIV/TB co-infection.

抽象的结核病 (TB) 是单一传染源导致死亡的主要原因，也是导致死亡的主要原因据估计，每年有 850 万结核病患者得到治愈，但其中许多人确实治愈了。完成肺结核治疗的人中，多达一半患有结核后肺病，结核病治疗结束时肺缺陷的致残性、未诊断性最为严重。结核病后一年内肺部疾病严重程度的预测因子与肺部相关。免疫功能障碍和饮酒与结核病诊断延迟有关，增加肺损伤的风险然而，目前尚不清楚饮酒是否与结核病后肺部相关。我们勇敢地承认，有害饮酒会增加结核病的易感性并使其病情恶化。我们的目标是调查感染者的肺部疾病（酒精使用障碍识别）。测试 [AUDIT] ≥8) 作为 PLWH 结核病后肺部疾病的可改变危险因素。对圣彼得堡 200 名完成住院肺结核治疗的感染者进行的为期 2 年的观察性研究，俄罗斯。我们将评估以下结核病后肺部疾病的结果：功能锻炼能力（主要）通过 6 分钟步行距离评估结果）、肺生理学（肺功能测试）、解剖学（CT 扫描）、主要暴露是过去一年的危险饮酒。包括 30 天时间线追踪（基于日历的酒精使用召回方法）和磷脂酰乙醇（PEth；近期饮酒的生物标志物）我们的专业知识涵盖饮酒、艾滋病毒、结核病、肺病学、我们的主要目标（目标 1a）是确定过去一年之间的关系。在目标 1b 中，我们评估了危险饮酒与结核病后肺部疾病的关联。在目标 1c 中，我们探讨了吸烟是否会改变饮酒和结核病后肺部疾病的进展。过去一个月的大量饮酒与结核病后肺部疾病随时间的进展之间的关系。时间线追踪将目标 1b 和 1c 定义为每周 ≥7 次饮酒（女性）或 ≥14 次饮酒/每周（男性）或 PEth>200 ng/mL 在目标 2 中，我们将定性评估可以改进药物定制的因素。我们将深入开展对接受结核病治疗的感染者的饮酒和吸烟行为干预。在住院结核病治疗期间或治疗后采访了 24 名感染者和 12 名结核病医疗保健提供者。将确定 PLWH 中饮酒与结核病后肺部疾病的关系。定性数据将为未来制定酒精和吸烟干预措施以改善 HIV/TB 合并感染的长期健康。