The International URBAN Alcohol Research Collaboration on HIV/AIDS (ARCH) Center

国际城市酒精艾滋病毒/艾滋病研究合作中心 (ARCH)

• 批准号: 10845873
• 负责人: JEFFREY H. SAMET
• 金额: $ 37.73万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10845873
• 关键词: Acceleration; Accounting; Address; Aftercare; Alcohol consumption; Alcohols; Automobile Driving; Bacillus; Biometry; Boston; Cause of Death; Cessation of life; Clinical; Collaborations; Complex; Data; Data Management Resources; Disease; Ensure; Epidemic; Fostering; Future; Goals; HIV; HIV/AIDS; HIV/TB; Heavy Drinking; Immunosuppression; Impairment; Individual; Infectious Agent; International; Intervention; Knowledge; Lung; Lung diseases; Malignant neoplasm of lung; Measures; Mentors; Morbidity - disease rate; Mycobacterium tuberculosis; NIH Office of AIDS Research; Outcome; Persons; Population; Predisposition; Prevention; Preventive therapy; Productivity; Pulmonary Tuberculosis; Recording of previous events; Research; Research Personnel; Research Project Grants; Rifampin; Risk; Risk Reduction; Role; Russia; Statistical Data Interpretation; Structure; Testing; Training; Tuberculosis; Uganda; Work; active method; acute coronary syndrome; alcohol intervention; alcohol research; career; co-infection; cohort; comorbidity; data management; design; experience; high risk; improved; innovation; isoniazid; lung health; mortality; mortality risk; multidisciplinary; prevent; rifapentine; smoking intervention; therapy development; tuberculosis treatment

ABSTRACT One quarter of the global population is infected with the bacillus Mycobacterium tuberculosis and is at risk of developing active tuberculosis (TB) disease and death, especially persons living with HIV (PLWH). Alcohol use is increasingly being recognized as a driver of the TB epidemic, and may be a vital means to mitigate HIV/TB morbidity and mortality. TB preventive therapy (TPT) is an important approach in preventing the progression of latent TB infection to active TB disease. However, TPT does not prevent new or repeat TB infection, thus PLWH who drink alcohol may remain at increased risk for TB acquisition, even after receipt of TPT. Heavy alcohol use is common among persons living with HIV (PLWH). While the increased risk for active TB is attributed to alcohol-related immunosuppression leading to latent TB re-activation, the role of alcohol use in acquiring new or repeat TB infection and progression to active TB disease after TPT has not been extensively examined, including among PLWH. Those who complete TB treatment have extensive post-TB morbidity and almost a 4-fold higher risk of mortality. The role of both heavy alcohol use and HIV in promoting lung disease after TB treatment is not clear. The central goal of the International Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Center is to examine the role of alcohol use on new TB acquisition, occurrence of active TB disease after TPT, and post-TB lung disease among PLWH. This new knowledge will enable future development of interventions that can reduce alcohol’s impact on TB- related morbidity and mortality among PLWH. The Center will be comprised of 4 components (Administrative Core, Biostatistics and Data Management [BDM] Core, Uganda Project, Russia Project) that will work synergistically to accomplish the following primary objectives: 1) Examine the role of alcohol use in driving the acquisition of new TB infection and the occurrence of active TB disease after TPT in PLWH in Uganda (Uganda Project). This new knowledge will inform potential new interventions to reduce risk of TB acquisition and active disease; 2) Determine the relationship between alcohol use and lung disease after treatment for active TB disease among PLWH and qualitatively evaluate factors to tailor alcohol and smoking interventions in the setting of TB treatment in PLWH (Russia Project); 3) Conduct high quality data management and statistical analyses for HIV/alcohol research (BDM Core); 4) Foster multidisciplinary international collaborations to promote innovative and rigorous HIV/alcohol research (Administrative Core); and 5) Provide ongoing training and mentoring to develop junior and mid-career investigators into future leaders in HIV/alcohol research (Administrative Core). The structure of the International URBAN ARCH Center will ensure effective administrative and scientific integration of a broad range of activities designed to synergistically grow the field of HIV/alcohol/TB prevention and treatment.

抽象的 全球人口中有四分之一感染了结核菌杆菌的感染 发展活跃的结核病（TB）疾病和死亡，尤其是艾滋病毒（PLWH）的患者。饮酒 越来越多地被认为是结核病流行的驱动力，可能是减轻HIV/TB的重要手段 发病率和死亡率。 TB预防疗法（TPT）是防止进展的重要方法 潜在的结核病感染活性结核病。但是，TPT不会阻止新的或重复的结核病感染，因此 即使在收到TPT后，饮用酒精的PLWH也可能仍处于增加结核病风险。重的 饮酒在艾滋病毒（PLWH）的患者中很常见。而主动结核病风险的增加是 归因于酒精相关的免疫抑制导致潜在的结核病重新激活，酒精使用的作用 尚未广泛地获得新的或重复的结核病感染，并在TPT之后发展为主动TB疾病 检查了，包括PLWH。那些完成结核病治疗的人具有广泛的结核病后发病率和 死亡率的风险几乎高4倍。大量饮酒和艾滋病毒在促进肺部疾病中的作用 结核病治疗后尚不清楚。国际乌干达俄罗斯波士顿酒精网络的核心目标 用于艾滋病毒/艾滋病（Urban Arch）中心的酒精研究合作是检查酒精使用的作用 关于新的结核病获取，TPT后发生活性结核病的发生以及PLWH中结核病后肺部疾病。 这些新知识将使未来的干预措施发展，从而减少酒精对结核病的影响 PLWH之间的相关发病率和死亡率。该中心将完成4个组件（管理 核心，生物统计学和数据管理[BDM]核心，乌干达项目，俄罗斯项目）将有效 协同实现以下主要目标：1）检查酒精使用在驾驶中的作用 在乌干达的PLWH中获得新的结核病感染和TPT后发生活性结核病的发生 （乌干达项目）。这些新知识将为潜在的新干预措施提供信息，以减少收购结核病的风险 和活性疾病； 2）确定治疗后酒精使用与肺部疾病之间的关系 PLWH中的活性结核病和定性评估的因素来量身定制酒精和吸烟干预措施 在PLWH（俄罗斯项目）中的结核病治疗环境中； 3）进行高质量的数据管理和 HIV/酒精研究的统计分析（BDM Core）； 4）培养多学科国际合作 促进创新和严格的艾滋病毒/酒精研究（行政核心）； 5）提供持续的培训 并为艾滋病毒/酒精研究的未来领导者发展少年和中级研究人员的心理 （行政核心）。国际城市拱门中心的结构将确保有效 旨在协同发展领域的各种活动的行政和科学融合 艾滋病毒/酒精/结核病预防和治疗。