Defining the threshold for alcohol-induced nonadherence in HIV+ patients

确定艾滋病毒患者因酒精导致的不依从的阈值

• 批准号: 7062670
• 负责人: RONALD S BRAITHWAITE
• 金额: $ 15.35万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-25 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7062670
• 关键词: AIDS; AIDS therapy; HIV infections; age difference; alcoholic beverage consumption; antiAIDS agent; behavioral /social science research tag; clinical research; comorbidity; hepatitis C; hepatotoxin; human data; human subject; longitudinal human study; substance abuse related behavior; therapy compliance; veterans

DESCRIPTION (provided by applicant): Poor adherence to antiretroviral medications is responsible for 80% of the clinical failures in HIV+ individuals, and alcohol consumption is the single most commonly identified behavioral risk factor for poor adherence. For this-reason, nonadherence to antriretroviral drugs is a harmful and highly prevalent consequence of alcohol consumption. Because HIV+ individuals experience this harmful consequence at daily alcohol consumption levels that are below comparable levels for HIV- individuals and are also below standard criteria for at-risk drinking, screening criteria may need to be adapted for HIV+ individuals. However, in order for alternative criteria to be evaluated, the threshold at which alcohol consumption impacts adherence in HIV+ individuals must be characterized in more detail. The specific aims of this proposal are to quantify the shift in the alcohol consumption threshold at which alcohol impairs the adherence of HIV+ individuals compared to HIV- individuals, and to determine if subgroups of HIV+ individuals with hepatotoxicity or frailty disproportionately contribute to this threshold shift. The broad objectives of this proposal have direct relevance to the mission of NIAAA, in particular to reduce the morbidity and mortality from alcohol consumption in a population that is very susceptible to its harms (individuals with HIV). LAY LANGUAGE: Antiretroviral therapies have saved the lives of millions of individuals with HIV, but they do not work for individuals who do not take them as directed. We know from previous research that alcohol consumption can lead to poor adherence with these medications, but we do not know how much alcohol is required for this to happen. We do know that less alcohol seems to be required for HIV+ individuals than HIV- individuals. This research will enable us to determine how much alcohol is required to reduce medication adherence among HIV+ individuals, so alcohol use guidelines can be tailored appropriately, and more lives may be saved.

描述（由申请人提供）：对抗逆转录病毒药物的依从性不足是HIV+个体中80％的临床失败，而饮酒是依从性较差的最常见的行为风险因素。对于这个季节，对胃逆转录病毒药物的不遵守是饮酒的有害且高度普遍的结果。由于艾滋病毒+个人在每日饮酒水平下经历这种有害的后果，而艾滋病毒个体的水平低于可比的水平，并且低于高危饮酒的标准标准，因此可能需要针对HIV+个体进行筛查标准。但是，为了评估替代标准，必须更详细地表征饮酒会影响艾滋病毒+个体依从性的阈值。该提案的具体目的是量化酒精消耗阈值的转移，在该阈值中，酒精与HIV+个体相比会损害HIV+个体的依从性，并确定HIV+肝毒性的亚组是否具有肝毒性或脆弱性不成比例地对这种阈值转移产生了贡献。该提案的广泛目标与NIAAA的使命是直接相关的，特别是为了减少饮酒的发病率和死亡率，而饮酒的人口非常容易受到危害（艾滋病毒患者）。 外行语言：抗逆转录病毒疗法挽救了数百万艾滋病毒的人的生命，但它们不适合不按照指示的人来工作。从先前的研究中我们知道，饮酒会导致这些药物的依从性不佳，但是我们不知道发生多少酒精需要多少酒精。我们确实知道，与艾滋病毒相比，艾滋病毒+个体似乎需要少的酒精。这项研究将使我们能够确定需要多少酒精来减少艾滋病毒+个人之间的药物依从性，因此可以适当地量身定制酒精使用指南，并可以挽救更多的生命。