The International Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Center

国际乌干达俄罗斯波士顿酒精网络艾滋病毒/艾滋病酒精研究合作 (URBAN ARCH) 中心

• 批准号: 10303983
• 负责人: JEFFREY H. SAMET
• 金额: $ 144.51万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 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/10303983
• 关键词: AIDS/HIV problem; Accounting; Address; Aftercare; Alcohol consumption; Alcohols; Automobile Driving; Bacillus; Biometry; Boston; Cause of Death; Cessation of life; Clinical; Collaborations; Complex; Data; Data Management Resources; Disease; Ensure; Epidemic; Fostering; Future; Goals; HIV; HIV/TB; Health; Heavy Drinking; Immunosuppression; Impairment; Individual; Infectious Agent; International; Intervention; Knowledge; Lung; Lung diseases; Malignant neoplasm of lung; Measures; Mentors; Morbidity - disease rate; Mycobacterium tuberculosis; NIH Office of AIDS Research; Outcome; Persons; Population; Predisposition; Prevention; Preventive therapy; Pulmonary Tuberculosis; Recording of previous events; Research; Research Personnel; Research Project Grants; Rifampin; Risk; Role; Russia; Statistical Data Interpretation; Structure; Testing; Training; Tuberculosis; Uganda; Work; active method; acute coronary syndrome; alcohol intervention; alcohol research; career; co-infection; cohort; comorbidity; data management; design; experience; high risk; improved; innovation; isoniazid; mortality; mortality risk; multidisciplinary; prevent; rifapentine; smoking intervention; therapy development; tuberculosis treatment

ABSTRACT One quarter of the global population is infected with the bacillus Mycobacterium tuberculosis and is at risk of developing active tuberculosis (TB) disease and death, especially persons living with HIV (PLWH). Alcohol use is increasingly being recognized as a driver of the TB epidemic, and may be a vital means to mitigate HIV/TB morbidity and mortality. TB preventive therapy (TPT) is an important approach in preventing the progression of latent TB infection to active TB disease. However, TPT does not prevent new or repeat TB infection, thus PLWH who drink alcohol may remain at increased risk for TB acquisition, even after receipt of TPT. Heavy alcohol use is common among persons living with HIV (PLWH). While the increased risk for active TB is attributed to alcohol-related immunosuppression leading to latent TB re-activation, the role of alcohol use in acquiring new or repeat TB infection and progression to active TB disease after TPT has not been extensively examined, including among PLWH. Those who complete TB treatment have extensive post-TB morbidity and almost a 4-fold higher risk of mortality. The role of both heavy alcohol use and HIV in promoting lung disease after TB treatment is not clear. The central goal of the International Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Center is to examine the role of alcohol use on new TB acquisition, occurrence of active TB disease after TPT, and post-TB lung disease among PLWH. This new knowledge will enable future development of interventions that can reduce alcohol’s impact on TB- related morbidity and mortality among PLWH. The Center will be comprised of 4 components (Administrative Core, Biostatistics and Data Management [BDM] Core, Uganda Project, Russia Project) that will work synergistically to accomplish the following primary objectives: 1) Examine the role of alcohol use in driving the acquisition of new TB infection and the occurrence of active TB disease after TPT in PLWH in Uganda (Uganda Project). This new knowledge will inform potential new interventions to reduce risk of TB acquisition and active disease; 2) Determine the relationship between alcohol use and lung disease after treatment for active TB disease among PLWH and qualitatively evaluate factors to tailor alcohol and smoking interventions in the setting of TB treatment in PLWH (Russia Project); 3) Conduct high quality data management and statistical analyses for HIV/alcohol research (BDM Core); 4) Foster multidisciplinary international collaborations to promote innovative and rigorous HIV/alcohol research (Administrative Core); and 5) Provide ongoing training and mentoring to develop junior and mid-career investigators into future leaders in HIV/alcohol research (Administrative Core). The structure of the International URBAN ARCH Center will ensure effective administrative and scientific integration of a broad range of activities designed to synergistically grow the field of HIV/alcohol/TB prevention and treatment.

抽象的 全球四分之一的人口感染了结核分枝杆菌，并面临感染的风险 罹患活动性结核病 (TB) 并导致死亡，尤其是艾滋病毒感染者 (PLWH)。 越来越多地被认为是结核病流行的驱动因素，并且可能是减轻艾滋病毒/结核病的重要手段 结核病预防治疗（TPT）是预防结核病进展的重要方法。 潜伏性结核感染到活动性结核病 然而，TPT 不能预防新的或重复的结核感染。 即使在接受重型 TPT 治疗后，饮酒的感染者感染结核病的风险仍可能增加。 饮酒在艾滋病毒感染者（PLWH）中很常见，而活动性结核病的风险增加。 归因于酒精相关的免疫抑制导致潜伏结核病重新激活，饮酒在 TPT 后发生新的或重复的结核感染并进展为活动性结核病的情况并不常见 进行了检查，包括完成结核病治疗的感染者和结核病感染者。 酗酒和艾滋病毒在促进肺部疾病方面的作用几乎增加了四倍。 国际乌干达俄罗斯波士顿酒精网络的中心目标尚不清楚。 艾滋病毒/艾滋病酒精研究合作 (URBAN ARCH) 中心将研究酒精使用的作用 PLWH 中新发结核病、TPT 后活动性结核病的发生以及结核病后肺部疾病。 这一新知识将使未来能够减少酒精对结核病影响的干预措施的开发成为可能。 该中心将由 4 个部分组成（行政部门）。 核心、生物统计和数据管理 [BDM] 核心、乌干达项目、俄罗斯项目）将发挥作用 协同实现以下主要目标： 1) 检查饮酒在驾驶中的作用 乌干达 PLWH 中新发结核感染的获得和 TPT 后活动性结核病的发生 （乌干达项目）。这一新知识将为潜在的新干预措施提供信息，以降低结核病感染的风险。 和活动性疾病；2) 确定治疗后饮酒与肺部疾病之间的关系 PLWH 中的活动性结核病并定性评估因素以调整酒精和吸烟干预措施 PLWH 的结核病治疗（俄罗斯项目）； 3) 进行高质量的数据管理和 HIV/酒精研究的统计分析（BDM 核心）；4) 促进多学科国际合作 促进创新和严格的艾滋病毒/酒精研究（管理核心）；以及 5) 提供持续培训； 并提供指导，将初级和中期职业调查员培养成为艾滋病毒/酒精研究的未来领导者 （行政核心）。国际URBAN ARCH中心的结构将确保有效。 旨在协同发展该领域的广泛活动的行政和科学整合 艾滋病毒/酒精/结核病的预防和治疗。