Impact of Alcohol Consumption on HIV/AIDS in Women

饮酒对女性艾滋病毒/艾滋病的影响

• 批准号: 6891037
• 负责人: WILLIAM Albert BLATTNER
• 金额: $ 11.14万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-05-01 至 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6891037
• 关键词: AIDS; AIDS therapy; HIV infections; alcoholic beverage consumption; alcoholism /alcohol abuse; antiAIDS agent; antiviral agents; clinical research; congenital infection; drug adverse effect; drug interactions; drug resistance; embryo /fetus disorder; embryo /fetus toxicology; epidemiology; female; human data; immunology; immunotoxicity; pathologic process; pediatric AIDS; perinatal; pregnancy; pregnancy infection; therapy compliance; vertical transmission; virus replication

DESCRIPTION (provided by applicant): Alcohol use influences the health status of individuals and may modify the natural history of infectious disease processes. Our goal is to elucidate the epidemiologic relationship between alcohol consumption and HIV/AIDS by utilizing existing HIV/AIDS data from the Women and Infants Transmission study (WITS), a population-based study of HIV-infected women and their infants. The specific hypothesis is that alcohol consumption accelerates the progression of HIV infection and affects pregnancy outcomes among HIV-infected women. We based the hypothesis on the observation that 1) alcohol intake increases in vitro and in vivo replication of HIV-1, 2) alcohol intake causes immunologic aberrations that share similarities to HIV-1 infection, and 3) alcohol use hinders medication adherence, which potentiates the emergence of drug-resistant HIV-I. Based on these observations, the focus of this proposal is to determine the consequences of alcohol consumption among HIV-infected women. The specific aims are to: 1. Examine the influence of alcohol consumption on clinical, virological, and immunological markers of HIV disease progression. We will develop propensity scores for alcohol consumption to give the likelihood of consumption and to adjust for the selective nature of alcohol use. Various types of alcohol consumption will be considered, including binge drinking, and frequent drinking. Both linear models and threshold models will be explored. 2. Determine the relationship between alcohol consumption and adherence to antiretroviral medications and consequently patient outcomes. The effect of alcohol use as a key determinant of adherence to antiretroviral therapies is not well defined since previous findings did not consider alcohol intake as a primary exposure of interest. We will develop an index for medication non-adherence based on the number of missed doses; and to discern the influence of various types of alcohol consumption on non-adherence to antiretroviral therapies. 3. Determine whether alcohol use and in-utero exposure to antiretroviral therapy are associated with adverse pregnancy outcomes and whether there is evidence of interaction between these two exposures and specific pregnancy outcomes. Interest in this aim is inspired by our recent finding indicating the association of cell-associated virus with perinatal transmission of HIV-1 despite the use of combination antiretroviral therapies. We will characterize patterns of maternal alcohol consumption during first, second, and third trimesters; and examine the join1 effects of maternal alcohol use and antiretroviral therapies on pregnancy outcomes including mother. to-child transmission of HIV.

描述（由申请人提供）：饮酒会影响个人的健康状况，并可能改变传染病过程的自然历史。我们的目标是通过利用妇女和婴儿传播研究（WITS）的现有HIV/AIDS数据来阐明饮酒与艾滋病毒/艾滋病之间的流行病学关系，这是一项基于人群的HIV感染妇女及其婴儿的研究。具体假设是，饮酒会加速HIV感染的进展，并影响感染HIV的妇女的妊娠结局。我们基于以下观察结果：1）酒精摄入增加了HIV-1的体外和体内复制，2）酒精摄入引起的免疫异常，与HIV-1感染具有相似性，3）酒精使用阻碍药物的依从性，从而增强了药物抗药性HIV-HIV-I-i的出现。基于这些观察结果，该提案的重点是确定艾滋病毒感染妇女饮酒的后果。具体目的是： 1。检查饮酒对HIV疾病进展的临床，病毒学和免疫学标志物的影响。我们将开发饮酒的倾向分数，以提供消费的可能性并调整饮酒的选择性。将考虑各种类型的饮酒，包括暴饮暴食和频繁饮酒。将探索线性模型和阈值模型。 2。确定饮酒和遵守抗逆转录病毒药物的关系，从而确定患者的预后。酒精使用作为依从性抗逆转录病毒疗法的关键决定因素的作用未被很好地定义，因为先前的发现并未将酒精摄入视为主要暴露量。我们将根据丢失剂量的数量为不遵守药物制定指数；并辨别各种类型饮酒对抗逆转录病毒疗法的不遵守的影响。 3.确定酒精使用和抗逆转录病毒疗法是否与不良妊娠结局有关，以及这两种暴露与特定妊娠结局之间相互作用的证据。对此目标的兴趣是我们最近的发现的启发，表明尽管使用了抗逆转录病毒疗法，但与细胞相关病毒与HIV-1的围产期传播的关联。我们将表征在第一，第二和第三个三物质中孕产妇饮酒的模式；并检查孕产妇饮酒和抗逆转录病毒疗法对包括母亲在内的妊娠结局的结合作用。艾滋病毒的孩子传播。