1/3 Collaborative Research in HIV/AIDS, Alcohol, and Related Comorbidities (COMpAAAS) Tripartite: ART-CC, KP, and VA

1/3 HIV/AIDS、酒精和相关合并症的合作研究 (COMpAAAS) 三方：ART-CC、KP 和 VA

• 批准号: 9407827
• 负责人: Margaret May
• 金额: $ 45.68万
• 依托单位: UNIVERSITY OF BRISTOL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-20 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9407827
• 关键词: AIDS/HIV problem; Adult; Affect; Age; Aging; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; American; Award; Biological Markers; Birth; California; Caring; Clinical; Cocaine; Cohort Studies; Collaborations; Comorbidity; Country; Data; Data Set; Drug Interactions; Europe; European; Gender; Goals; Grant; HIV; HIV Infections; HIV-1; HIV/HCV; Health; Healthcare Systems; Hepatitis C; Hospitalization; Individual; Infection; 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; Population; Preventive care; Protocols documentation; RNA; Race; Reporting; Research; Risk; Sample Size; Sampling; 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; antiretroviral therapy; base; cohort; data exchange; data format; data sharing; drinking; frailty; improved outcome; indexing; member; men; men who have sex with men; mortality; phosphatidylethanol; prospective; public health relevance; smoking intervention; therapy design; tobacco exposure

Abstract word count: 424 HIV infected 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 extends uninfected comparators, a critically important group if we are to understand how alcohol may differentially effect biomedical outcomes in HIV. KP will be able to identify appropriate comparators from their Northern California region. A new VA sample of veterans born in 1945-1965 (Birth Cohort) substantially expands access to Hepatitis C infected (HCV+) and women comparators. The tripartite group will also participate in a HIV+ substudy (n=2250), The Medications, Alcohol, Substance Use in HIV Study (MASH), in which new data on potentially inappropriate medications (PIMS) and direct biomarkers for alcohol and associated substances (tobacco, marijuana, opioids, cocaine, and methamphetamine) will be prospectively collected. In initial years, analyses will be conducted using self-report of alcohol and substance use. Limited data sets and uniform methods for data cleaning, standardization, and imputation will be employed across teams. 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, and share data. The VA team will coordinate data sharing and analyses. Each collaborator will be responsible for conducting analyses for one aim. In this application, we will investigate the risk of mortality, hospitalization, and increased physiologic frailty measured by the VACS Index that is attributable to different levels of alcohol use and we will compare these outcomes in HIV-infected and uninfected populations.

摘要字数：424 饮酒的艾滋病毒感染成年人由于艾滋病毒感染、合并症（包括 丙型肝炎感染）、多重用药和相关药物的使用在这种情况下会产生生物医学后果。 适量饮酒可能会导致酒精滥用，但这种情况常常不被重视或被错误归因。 改善艾滋病毒/艾滋病、酒精、衰老和多种物质的结果”(COMpAAAS) 得到 NIH/NIAAA 的支持 授予 U24AA020794 在单个样本中研究这个问题，即退伍军人老龄化队列研究 (VACS) （约 50,000 名 HIV+ 美国退伍军人在人口统计上与约 100,000 名未感染的对照者相匹配）。 直接酒精生物标志物（磷脂酰乙醇 (PEth) 和经过验证的生理虚弱测量方法 (VACS) 在这三个应用程序中，抗逆转录病毒治疗队列协作 (ART-CC) 和 Kaiser。 Permanente (KP) 团队作为 COMpAAAS 三方加入退伍军人医疗保健系统 (VA) 团队：ART-CC、 KP 和 VA。我们的长期目标是共同为酒精干预措施的设计和实施提供信息。 提议研究酒精和相关物质使用对艾滋病毒的生物医学影响，延长 VACS 对北美和欧洲多个医疗保健系统的范围和普遍性 重要的是，COMpAAAS Tripartite 还显着增加了 HIV+ 受试者的样本量和多样性。 扩展了未感染的比较者，如果我们要了解酒精如何影响酒精，这是一个至关重要的群体 KP 将能够从其对 HIV 的生物医学结果产生不同的影响。 北加州地区 1945-1965 年出生的退伍军人的新样本（出生队列） 三方小组还将扩大丙型肝炎感染者（HCV+）和女性对照者的接触范围。 参加 HIV+ 子研究 (n=2250)，艾滋病毒研究中的药物、酒精、物质使用 (MASH)， 其中关于潜在不适当药物 (PIMS) 和酒精和酒精直接生物标志物的新数据 相关物质（烟草、大麻、阿片类药物、可卡因和甲基苯丙胺）将被前瞻性地 在最初几年，将使用有限的酒精和药物使用自我报告进行分析。 数据集和数据清理、标准化和插补的统一方法将在各个领域采用 团队将在最后一年重复分析，纠正自我报告的酒精和物质的偏差。 根据 MA​​SH 结果使用，与 RFA 一致，所有拨款都为所有目标提供相同的数据。 VA 团队将协调每个合作者的数据共享和分析。 将负责针对一个目标进行分析 在此应用程序中，我们将调查以下风险。 死亡率、住院治疗以及由 VACS 指数测量的生理虚弱程度增加，归因于 不同程度的饮酒，我们将比较艾滋病毒感染者和未感染者的这些结果。