Measurement of Alcohol Use Among HIV-Positives in Uganda

乌干达艾滋病毒阳性者饮酒情况的测量

• 批准号: 7119462
• 负责人: JUDITH ALISSA HAHN
• 金额: $ 17.2万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7119462
• 关键词: AIDS therapy; Africa; HIV infections; alcoholic beverage consumption; antiAIDS agent; biomarker; breath tests; clinical research; high performance liquid chromatography; human subject; interview; questionnaires; sample collection; therapy compliance

DESCRIPTION (provided by applicant): This is a revised proposal to validate novel biomarkers of alcohol use, and to use the validated biomarkers to examine the validity of new and standard self-reported measures of alcohol use, among persons infected with HIV in Uganda. Low cost and free HIV antiretroviral therapy (ART) has been increasing in sub-Saharan Africa. However, alcohol use is pervasive in Uganda and may threaten treatment outcome by impairing treatment adherence, increasing the risk of medication related hepatotoxicity, and reducing the bioavailability of ART, leading to sub-therapeutic medication levels and viral resistance. Measuring alcohol exposure in Uganda is problematic because (1) ubiquitous home-brews are served in non-standard drink volumes, (2) the alcohol concentration in these may vary widely, (3) the identification of alcohol related problems may be culturally dependent, and (4) persons receiving or hoping to receive ART that is in short supply may under- report their alcohol consumption. Several biomarkers of short-term and prolonged heavy alcohol use (ethyl glucuronide, ethyl sulfate, phosphatidyl ethanol, and fatty acid ethyl esters) have shown outstanding test characteristics in North America and Europe but have not been tested in Africa. In this study, 75 HIV- infected persons in Mbarara, Uganda, will be recruited from an existing NIH-funded cohort of HIV infected persons, and a high seroprevalence hospital-based HIV counseling and testing program. We will stratify by gender, ART status, and recent drinking, including equal numbers of abstainers, moderate drinkers, and heavy drinkers. We will first conduct baseline interviews using newly developed alcohol consumption and standard alcohol screening questionnaires and collect specimen samples. Next, we will validate the biomarkers using breathalyzer tests conducted at daily home visits, over a period of three weeks. Last, we will use biomarkers with high validity to examine the utility of the new and standard alcohol consumption surveys administered at baseline. PUBLIC HEALTH SUMMARY: Alcohol use is pervasive but difficult to measure in Uganda, as most drinks are home-brews, and served in non-standard drink sizes, with varying alcohol concentration. Alcohol use may impact HIV treatment adherence and HIV outcomes, therefore valid measurements of alcohol use are needed to assess HIV treatment success. This study will validate novel biomarkers and new and standard self-reported measures of alcohol use among HIV positives in Uganda.

描述（由申请人提供）：这是一项修订后的提案，旨在验证新型酒精使用生物标志物，并使用经过验证的生物标志物来检查乌干达艾滋病毒感染者中新的标准自我报告酒精使用措施的有效性。低成本、免费的艾滋病毒抗逆转录病毒治疗（ART）在撒哈拉以南非洲地区不断增加。然而，饮酒在乌干达很普遍，可能会损害治疗依从性，增加药物相关肝毒性的风险，并降低抗逆转录病毒治疗的生物利用度，从而导致治疗药物水平低于治疗水平和病毒耐药性，从而威胁治疗结果。在乌干达测量酒精暴露量是有问题的，因为（1）随处可见的自制啤酒以非标准的饮料量提供，（2）其中的酒精浓度可能差异很大，（3）酒精相关问题的识别可能取决于文化， (4) 接受或希望接受供应短缺的抗逆转录病毒疗法的人可能会少报其饮酒量。短期和长期大量饮酒的几种生物标志物（乙基葡萄糖醛酸、硫酸乙酯、磷脂酰乙醇和脂肪酸乙酯）已在北美和欧洲表现出出色的测试特性，但尚未在非洲进行测试。在这项研究中，将从乌干达姆巴拉拉的现有 NIH 资助的 HIV 感染者队列和基于医院的高血清流行率 HIV 咨询和检测项目中招募 75 名 HIV 感染者。我们将按性别、ART 状态和近期饮酒情况进行分层，包括相同数量的戒酒者、中度饮酒者和重度饮酒者。我们将首先使用新开发的饮酒量和标准酒精筛查问卷进行基线访谈并收集样本。接下来，我们将在三周的时间内使用每天家访时进行的呼气分析仪测试来验证生物标志物。最后，我们将使用具有高有效性的生物标志物来检查在基线上进行的新的和标准的酒精消费调查的效用。公共卫生摘要：在乌干达，饮酒很普遍，但难以测量，因为大多数饮料都是自制的，并且以非标准的饮料尺寸提供，酒精浓度各不相同。饮酒可能会影响艾滋病毒治疗的依从性和艾滋病毒治疗结果，因此需要有效测量酒精使用情况来评估艾滋病毒治疗的成功。这项研究将验证乌干达艾滋病毒阳性者饮酒的新型生物标志物和新的标准自我报告措施。