Tailoring HIV Therapy for Alcohol-Using Populations

为饮酒人群量身定制艾滋病治疗

基本信息

批准号：
7279902
负责人：
RONALD S BRAITHWAITE
金额：
$ 15.3万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-09-01 至 2009-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7279902
关键词：
Adherence Affect African American Alcohol abuse Alcohol consumption Alcohol dependence Alcohols Algorithms Anti-Retroviral Agents Area Behavioral Biological CD4 Lymphocyte Count Caring Characteristics Class Clinical Clinical Data Clinical Investigator Clinical Research Clinical Trials Cohort Studies Comorbidity Computer Simulation Conflict (Psychology)Contracts Data Data Analyses Data Set Development Disadvantaged Disease Drug usage Equilibrium Failure Feedback Future Goals Guidelines HIV HIV Infections HIV Seropositivity HIV therapy Heterosexuals Highly Active Antiretroviral Therapy Immune system Justice Life Life Expectancy Link Master&apos s Degree Measurement Medical Mental Depression Mentors Mission Modeling Morbidity - disease rate Multi-Drug Resistance Mutation National Institute on Alcohol Abuse and Alcoholism Natural History Outcome Patients Pattern Pharmaceutical Preparations Population Principal Investigator RNA Rate Reading Regression Analysis Research Research Design Research Personnel Research Proposals Research Training Resistance Resources Risk Science Series Structure Supervision Survival Analysis Testing Theoretical model Time Training Programs Treatment Efficacy Treatment Protocols United States Department of Veterans Affairs Universities Viral Viral Load result alcohol effect alcohol use disorder career cohort design experience improved information gathering intravenous drug use mortality programs prospective repository simulation skills therapy adherence time interval

项目摘要

DESCRIPTION (provided by applicant): The overall goal of this proposal is to provide the resources and experiences that will allow the applicant to develop into a methodologically sophisticated, independent clinical investigator pursuing a research agenda directed at the effects of alcohol use and other comorbidity on the progression of HIV disease. This long term goal will be attained through the mentored completion of a study designed to improve tailoring of HIV treatment strategies to alcohol using populations. Using a large, ongoing prospective observational cohort (the Veterans Administration Cohort Study) the applicant will analyze the associations of alcohol use with short- and long-term efficacy of Highly-Active Anti-Retroviral Therapy (HAART). These associations will then be used in a computer simulation that will explore questions that clinical trials are not well suited to answer. The particular treatment questions that will be examined in this proposal are (1) how much life expectancy would be increased by treating hazardous or harmful patterns of alcohol consumption (2) what clinical parameters (CD4 and/or viral load) are the most appropriate thresholds for starting HAART, (3) what clinical parameters are the most appropriate thresholds for switching HAART upon regimen failure. The skills necessary to accomplish the above objectives and become an independent researcher will be accomplished through a series of classes, seminars, and mentored, structured reading and tutorials directed at specific areas of research related to the research proposal. The centerpiece of career development activities will be the K30 supported Clinical Research Training Program at the University of Pittsburgh which leads to a Masters Degree in Clinical Research. This program will be augmented through substantial time with internationally renowned experts and courses outside the Masters Degree program with specific applicability to important subject domains in the proposal, such as measurement of alcohol use and its consequences, measurement of adherence patterns and their correlates, survival analysis, regression analysis with time-dependent covariates, and algorithm design. My primary mentor, Mark S. Roberts, MD, MPP, an expert in medical decision sciences, together with my co-mentor, Amy Justice, the Principle Investigator of the Veterans Administration Cohort Study, will provide weekly feedback and supervision to help me accomplish these objectives.

描述（由申请人提供）：该提案的总体目标是提供资源和经验，以使申请人能够发展成一个具有方法论上的独立临床研究者，该研究人员追求针对酒精使用和其他合并症对HIV疾病进展的研究议程。这项长期目标将通过指导完成的研究来实现，该研究旨在改善使用人群对酒精的艾滋病毒治疗策略的剪裁。使用较大的前瞻性观察队列（退伍军人管理研究）申请人将分析酒精使用的关联与高活动性抗逆转录病毒疗法（HAART）的短期和长期疗效的关联。然后，这些关联将用于计算机模拟中，该计算机模拟将探讨临床试验不适合回答的问题。该提案中将检查的特定治疗问题是（1）通过治疗饮酒的危险或有害模式将增加多少预期寿命（2）哪些临床参数（CD4和/或病毒负荷）是开始HAART的最合适的阈值，（3）哪些临床参数是最合适的临床参数，是用于切换治疗障碍的最合适的截止点。实现上述目标并成为独立研究人员所需的技能将通过一系列的课程，研讨会以及针对与研究建议相关的特定研究领域的培训，结构化阅读和教程。职业发展活动的核心将是匹兹堡大学K30支持的临床研究培训计划，该计划导致临床研究硕士学位。该计划将通过大量时间进行大量时间，与硕士学位课程之外的国际知名专家和课程有关提案中的重要主题领域的特定能力，例如测量酒精使用及其后果，依从性模式及其相关性的测量，生存分析，回归分析，具有时间依赖于时间依赖于时间相关的协方差和藻类设计。我的主要导师Mark S. Roberts，医学博士MPP，MPP，医学决策科学专家，以及我的同事Amy Justice（退伍军人行政部门同伙研究的主要调查员），将提供每周的反馈和监督，以帮助我实现这些目标。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Linking cost sharing to value: an unrivaled yet unrealized public health opportunity.

将成本分摊与价值联系起来：无与伦比但尚未实现的公共卫生机会。

DOI：
10.7326/0003-4819-146-8-200704170-00011
发表时间：
2007
期刊：
Annals of internal medicine
影响因子：
39.2
作者：
Braithwaite,RScott;Rosen,AllisonB
通讯作者：
Rosen,AllisonB

Do Benefits of Earlier Antiretroviral Treatment Initiation Outweigh Harms for Individuals at Risk for Poor Adherence?

DOI：
10.1086/596768
发表时间：
2009-03-15
期刊：
CLINICAL INFECTIOUS DISEASES
影响因子：
11.8
作者：
Braithwaite, R. Scott;Roberts, Mark S.;Justice, Amy C.
通讯作者：
Justice, Amy C.

Evaluating interventions to improve antiretroviral adherence: how much of an effect is required for favorable value?

DOI：
10.1111/j.1524-4733.2010.00714.x
发表时间：
2010-08
期刊：
Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
影响因子：
0
作者：
Braithwaite RS;Fiellin DA;Nucifora K;Bryant K;Roberts M;Kim N;Justice AC
通讯作者：
Justice AC

Adjusting alcohol quantity for mean consumption and intoxication threshold improves prediction of nonadherence in HIV patients and HIV-negative controls.