Addressing Alcohol/HIV Consequences in Substance Dependence-Boston ARCH Cohort

解决酒精/艾滋病毒对物质依赖的影响 - 波士顿 ARCH 队列

基本信息

批准号：
8967071
负责人：
RICHARD SAITZ
金额：
$ 8.7万
依托单位：
BOSTON MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-12-01 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8967071
关键词：
AIDS/HIV problem Accounting Address Adult Affect Agonist Alcohol consumption Alcohols Biometry Bone Density Boston Buprenorphine Caring Chronic Disease Clinical Cohort Analysis Cohort Studies Collaborations Complement Consequences of HIV Data Dependence Disease Dose Drug Addiction Drug usage Ethanol Fracture Future Goals HIV HIV Infections HIV risk Health Heavy Drinking Heterogeneity Heterosexuals High Resolution Computed Tomography Individual Inflammatory Injection of therapeutic agent Intervention Intervention Studies Knowledge Laboratories Learning Naloxone Observational Study Opiate Addiction Opioid Osteopenia Participant Patients Persons Pharmaceutical Preparations Principal Investigator Prospective Studies Randomized Research Risk Risk Factors Russia Sampling Statistical Methods Substance Addiction Substance of Abuse Supplementation Testing Uganda Woman Zinc addiction adverse outcome alcohol and other drug alcohol consequences alcohol effect alcohol intervention alcohol misuse alcohol research alcohol risk antiretroviral therapy bone bone health bone loss cohort data management design double-blind placebo controlled trial drinking high risk drinking improved injection drug use instrument men policy implication prevent prospective response sex

项目摘要

Unhealthy alcohol use is common among HIV-infected persons and it adversely affects health. Injection drug use accounts for 1 in 5 cases of HIV infection, thus opioid dependence is also common. More than one-third of those with HIV infection and other drug use drink too much alcohol. Research has focused on either alcohol or drug use in HIV-infected individuals, but much less is known about alcohol's health effects in HIV- infected people affected by multiple substances of abuse. This proposal is a component of the Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Consortium, whose goal is to examine the consequences of alcohol on HIV disease and to mitigate its harms. The objective of this proposal is to accurately characterize alcohol use and consequences in people with HIV infection affected by multiple substances, and to implement observational and intervention studies to understand and reduce alcohol's harm. The proposal has 3 specific aims: 1) To expand and continue an existing cohort to establish the longitudinal Boston ARCH Cohort of 250 HIV-infected men and women affected by multiple substances—a spectrum of alcohol use, and all with substance dependence or Injection drug use. 2) To treat both heavy drinking and opioid dependence with one medication. The Treating With Opioids For Ethanol Risks (TWOFER) trial will assess if high-dose buprenorphine (32mg) reduces heavy drinking compared to standard-dose (16mg) at 3 months in a randomized double-blind placebo-controlled trial among 100 HIV-infected adult Cohort participants with opioid dependence and heavy drinking. If efficacious, buprenorphine, a treatment for opioid dependence, could be easily disseminated as a treatment for unhealthy alcohol use in people with HIV infection and opioid dependence as only dose adjustment is required. 3) Because alcohol, opioid use, HIV infection and antlretroviral therapy may affect bone health and increase fracture risk, analysis of cohort data will determine the independent effect of alcohol consumption on changes in bone mineral density and microarchitecture (by high-resolution computed tomography) prospectively in all Cohort participants over 12-42 months. The Cohort will yield data on alcohol effects on bone, important information for defining risky drinking amounts in people with HIV infection and for advising them on alcohol-related risks. Thus, these studies will provide substantial new knowledge for mitigating alcohol consequences among HIV-infected adults affected by multiple substances. RELEVANCE (See instructions): HIV disease can be treated effectively, but drinking too much interferes with treatment and causes bone loss, especially among those who abuse other drugs. This research will study people with HIV infection to discover what amounts of alcohol increase risk of fractures, and to see whether a medication used for drug addiction can also reduce heavy drinking. Findings will be useful for advising people with HIV infection about drinking limits to prevent fractures and may identify a new treatment to reduce drinking and improve health. PROJECT/PERFORMANCE StTE(S) (if additional space is needed, use Project/Performance Project/Perfomiance Site Primary Location Organizational Name: Boston Medical Center DUNS: 00-549-2160 street 1: One Boston Medical Center Place street 2: City: Boston County: S u f f o l k Province: Country: U S A

在感染HIV的人中，不健康的饮酒很常见，并且会对健康产生不利影响。注射药物使用艾滋病毒感染的5例中有1例，因此阿片类药物的依赖也很常见。超过三分之一在艾滋病毒感染和其他药物使用的人中，酒精过多。研究重点是艾滋病毒感染者中的酒精或吸毒，但对艾滋病毒中酒精的健康影响知之甚少。受到多种虐待物质影响的感染者。该提议是乌干达的组成部分俄罗斯波士顿酒精网络艾滋病毒/艾滋病研究合作（Urban Arch）财团的目标是检查酒精对艾滋病毒疾病的后果并减轻其危害。该提案的目的是准确表征饮酒和对人的后果艾滋病毒感染受多种物质影响，并实施观察和干预研究了解和减少酒精的伤害。该提案具有3个具体目标：1）扩展并继续现有的队列建立250名HIV的男性和女性的纵向波士顿拱门队列受多种物质的影响 - 饮酒范围，并且都具有物质依赖性或注射吸毒。 2）用一种药物治疗大量饮酒和阿片类药物依赖性。与治疗乙醇风险的阿片类药物（TWOFER）试验将评估高剂量丁丙诺啡（32mg）是否会减少重量与标准剂量（16mg）相比，在3个月时在一个随机的双盲安慰剂对照中喝酒在100名HIV感染的成人队列参与者中，具有阿片类药物依赖性和大量饮酒的试验。如果有效的，丁丙诺啡是阿片类药物依赖性的治疗方法，可以轻松地传播为治疗对于艾滋病毒感染和阿片类药物依赖性患者的不健康饮酒，因为只有剂量调整是必需的。 3）因为酒精，阿片类药物的使用，艾滋病毒感染和垂体病毒疗法可能会影响骨骼健康和增加断裂风险，对队列数据的分析将确定饮酒的独立效果关于骨矿物质密度和微体系结构的变化（通过高分辨率计算机断层扫描）在12-42个月的所有队列参与者中前景。该队列将产生有关酒精影响的数据骨头，定义艾滋病毒感染患者的危险饮酒量的重要信息和建议他们面临与酒精有关的风险。这是这些研究将为缓解的大量新知识受多种物质影响的HIV感染的成年人的酒精后果。相关性（请参阅说明）：艾滋病毒疾病可以有效治疗，但是对治疗的干扰过多并导致骨质流失，特别是在滥用其他药物的人中。这项研究将研究感染艾滋病毒的人发现多少酒精会增加裂缝的风险，并查看是否用于药物的药物成瘾也可以减少大量饮酒。调查结果对感染艾滋病毒感染的咨询患者很有用饮酒限制以防止骨折，并可能确定一种新的治疗方法，以减少饮酒并改善健康状况。项目/性能STTE（如果需要额外的空间，请使用项目/性能项目/完善网站主要位置组织名称：波士顿医疗中心 Duns：00-549-2160 街1：波士顿医疗中心地点街2：城市：波士顿县：S U F F O L K 省：国家：