2/3 COMpAAAS Tripartite: ART-CC, KP, and VA

2/3 COMpAAAS 三方：ART-CC、KP 和 VA

• 批准号: 9408427
• 负责人: Derek D Satre
• 金额: $ 60.76万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9408427
• 关键词: Address; Adult; Affect; Age; Aging; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; American; Anti-Retroviral Agents; Award; Biological Markers; Birth; California; Caring; Clinical; Cocaine; Cohort Studies; Collaborations; Comorbidity; Country; Data; Data Set; Drug Interactions; Drug usage; Electronic Health Record; Europe; European; Gender; Goals; Grant; HIV; HIV Infections; HIV-1; HIV/HCV; Health; Healthcare Systems; Hepatitis C; Hospitalization; Individual; Infection; Intervention; Lead; Malignant Neoplasms; Marijuana; Measurement; Measures; Mediating; Medical; Mental Depression; Methamphetamine; Methods; National Institute on Alcohol Abuse and Alcoholism; North America; Opioid; Outcome; Patient Self-Report; Patients; Pharmaceutical Preparations; Physiological; Polypharmacy; Preventive care; Preventive healthcare; Protocols documentation; RNA; Race; Reporting; Research; Risk; Sample Size; Sampling; Site; Smoking; Standardization; System; Tobacco; Tobacco use; United States National Institutes of Health; Update; Veterans; Woman; alcohol consequences; alcohol exposure; alcohol intervention; alcohol measurement; alcohol risk; alcohol use disorder; antiretroviral therapy; base; cohort; data exchange; data format; data sharing; drinking; frailty; improved outcome; indexing; innovation; member; men; men who have sex with men; mortality; phosphatidylethanol; prospective; smoking intervention; therapy design; therapy development; tobacco exposure

PROJECT SUMMARY/ABSTRACT HIV+ adults who drink are already physiologically frail due to HIV infection, comorbidity (including hepatitis C infection), polypharmacy and associated substance use. In this setting, biomedical consequences of alcohol use can occur with moderate use and are often unappreciated or misattributed. The “Consortium to improve OutcoMes in HIV/Aids, Alcohol, Aging & multi-Substance” (COMpAAAS) is supported by NIH/NIAAA award U24AA020794 to study this issue in a single sample, the Veterans Aging Cohort Study (VACS) (~50,000 HIV+ US veterans demographically matched to ~100,000 uninfected comparators). VACS will employ a direct alcohol biomarker (Phosphatidyl-ethanol [PEth] and a validated measure of physiologic frailty (VACS Index). In this set of three applications, the Antiretroviral Therapy Cohort Collaboration (ART-CC) and Kaiser Permanente (KP) teams join the Veterans Healthcare System (VA) team as COMpAAAS Tripartite: ART-CC, KP, and VA. Our long term goal is to inform alcohol intervention design and implementation. Together we propose to study biomedical consequences of alcohol and associated substance use in HIV, extending the scope and generalizability of VACS to multiple healthcare systems in North America and Europe and substantially increasing sample size and diversity of HIV+ subjects. Importantly, COMpAAAS Tripartite also expands the sample of uninfected comparators, a critically important group if we are to understand how alcohol differentially affects biomedical outcomes in HIV. KP will be able to identify demographically-matched uninfected comparators from their Northern California region. A new VA sample of veterans born in 1945-1965 (Birth Cohort) expands access to Hepatitis C infected (HCV+) and women comparators. The tripartite group will also participate in an HIV+ substudy (n=2250), The Medications, Alcohol, Substance Use in HIV Study (MASH), in which new data on potentially inappropriate medications (PIMS) and biomarkers for alcohol and substances (tobacco, marijuana, opioids, cocaine, and methamphetamine) will be collected. As the lead site for Aim 2, KP will examine the impact of alcohol and smoking on HIV outcomes, preventive care, and medical comorbidities. We anticipate that among HIV+ individuals, hazardous alcohol use, alcohol use disorders and smoking will negatively impact each of these outcomes; and that these effects will be amplified in HIV+ individuals compared with uninfected individuals. Initially, analyses will use electronic health record data including self-reported alcohol and substance use. Analyses will be repeated in the final year correcting for biases in self-reported alcohol and substance use based upon MASH results. Consistent with the RFA, all grants contribute data for all aims, have identical aims and protocols. This application addresses key interactions between alcohol and tobacco use, antiretrovirals, and medications that may increase mortality, hospitalization, frailty, and adversely impact preventive health care. We anticipate findings may lead to innovative intervention development, such as combined alcohol, smoking and preventive care interventions.

项目摘要/摘要 由于艾滋病毒感染，合并症（包括乙型肝炎），饮酒的艾滋病毒+成年人已经身体虚弱 感染），多药和相关物质的使用。在这种情况下，酒精的生物医学后果 使用中等用途可能会发生使用，并且通常不会被批准或误入。 “改善的财团 NIH/NIAAA奖的支持 U24AA020794要在单个样本中研究此问题，退伍军人老化队列研究（VACS）（〜50,000 HIV+ 美国退伍军人在人口统计学上与约100,000个未感染的比较器匹配）。 VACS将采用直接 酒精生物标志物（磷脂酰乙醇[Peth]和经过验证的生理脆弱量（VACS指数）。 这套三种应用，抗逆转录病毒疗法队列协作（ART-CC）和Kaiser Permanente（KP）团队以Compaaas Tripartite的身份加入退伍军人医疗保健系统（VA）团队：Art-CC， KP和VA。我们的长期目标是告知酒精干预设计和实施。我们在一起 研究艾滋病毒中酒精和相关物质使用的生物医学后果的提议，扩展了 VAC对北美和欧洲多个医疗系统的范围和概括性以及 大大增加了艾滋病毒+受试者的样本量和多样性。重要的是，Compaaas Tripartite也 扩展未感染比较器的样本，如果我们要了解酒精，这是一个至关重要的群体 差异影响HIV中的生物医学结果。 KP将能够识别人口统计学匹配的 来自北加州地区的未感染比较者。 1945 - 1965年出生的退伍军人的新VA样本 （出生队列）扩大了对丙型肝炎感染（HCV+）和女性比较剂的访问。三方小组 还将参与HIV+蛋白（n = 2250），药物，酒精，艾滋病毒研究中的使用 （MASH），其中有关不适当药物（PIMS）的新数据以及酒精和生物标志物 将收集物质（烟草，大麻，阿片类药物，可卡因和甲基苯丙胺）。作为领先地点 对于AIM 2，KP将检查酒精和吸烟对HIV结果，预防保健和医疗的影响 合并症。我们预计在艾滋病毒+个人中，危险的饮酒，酒精使用障碍和 吸烟会对这些结果中的每一个产生负面影响；这些影响将是HIV+的放大器 与未感染的个体相比。最初，分析将使用电子健康记录数据 包括自我报告的酒精和使用物质。分析将在最后一年重复纠正 基于土豆泥的结果，自我报告的酒精和药物使用的偏见。与RFA一致 赠款为所有目标提供了数据，具有相同的目标和协议。此应用程序地址为密钥 酒精和烟草使用，抗逆转录病毒和可能增加死亡率的药物之间的相互作用， 住院，脆弱和不利影响预防性医疗保健。我们预计发现可能会导致 创新的干预开发，例如酒精，吸烟和预防性护理干预措施。