Alcohol and HIV Treatment and Clinical Progression

酒精和艾滋病毒治疗及临床进展

• 批准号: 7687606
• 负责人: RICHARD Douglas MOORE
• 金额: $ 29.52万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7687606
• 关键词: AIDS/HIV problem; Address; Adherence; Adverse effects; Adverse event; Affect; Alcohol abuse; Alcohol consumption; Alcohols; Anti-Retroviral Agents; Body Size; Cardiovascular Diseases; Cardiovascular system; Caring; Cause of Death; Cessation of life; Chronic; Chronic Disease; Clinical; Clinical Treatment; Collection; Complex; Computer Assisted; Consequences of HIV; Consumption; Data; Data Analyses; Data Set; Data Sources; Development; Diabetes Mellitus; Disease; Disease Management; Disease Progression; Drug usage; Endocrine; Ethanol Metabolism; Event; Gender; Goals; HIV; HIV Infections; HIV therapy; HIV-1; Health; Human; Illicit Drugs; Immune; Immune system; Immunocompromised Host; Immunologics; Infection; Inflammation; Interview; Kidney; Kidney Failure; Knowledge; Life; Liver; Longevity; Measures; Metabolism; National Institute on Alcohol Abuse and Alcoholism; Natural History; Opportunistic Infections; Outcome; Pancreatitis; Paper; Patient Self-Report; Patients; Peripheral Nervous System Diseases; Persons; Play; Population; Questionnaires; RNA; Recovery; Reporting; Research; Risk; Role; Services; Shapes; Source; Terminal Disease; Time; Toxic effect; Treatment Protocols; Treatment outcome; Viral; Viral Load result; Viral hepatitis; Woman; antiretroviral therapy; body system; cohort; design; disorder risk; drinking; hazardous drinking; interest; public health relevance; resistance mutation; response

DESCRIPTION (provided by applicant): In the U.S., modern antiretroviral (ARV) therapy has transformed HIV infection from a terminal illness to a chronic infection with a potentially normal life span. With long life-spans, alcohol use has a greater opportunity to play an important role in the progression of HIV disease through effects on utilization of antiretroviral (ARV) therapy, immune recovery and the development of AIDS-related and non-AIDS related clinical events. Hazardous alcohol use is associated with a wide range of adverse health effects. In HIV-infection, we have shown that hazardous drinking (NIAAA definition) is associated independently with diminished utilization of ARVs, and poorer HIV viral load suppression and immune recovery. Since hazardous alcohol use interferes with effective ARV treatment, it is therefore likely that it will be associated with more rapid HIV disease progression. However, because HIV infection is characterized by chronic inflammation and immunocompromise, co-infections such as viral hepatitis, and possibly an increased risk of non-AIDS related clinical events (e.g. cardiovascular, renal, liver, endocrine), even lower levels of alcohol use that are not generally considered hazardous may have an adverse impact on patients with HIV-infection. Therefore, we propose to determine the relationship of alcohol use more broadly on HIV treatment and clinical disease progression. Our research will use the Johns Hopkins HIV Clinical Cohort, a longitudinal clinical cohort of patients who receive primary HIV/AIDS care on the Johns Hopkins HIV/AIDS Services. The Cohort was established in 1991, and has provided a rich source of data for over 160 papers that have examined the natural history, treatment and outcomes of HIV infection in patients in care. We assess specific levels of alcohol consumption using more than one validated consumption questionnaire, as well as drinking-related problems every 6 months with an audio computer-assisted self-interview (A-CASI). We propose to address the following specific aims: 1) Evaluate the relationship between alcohol consumption and response to HIV treatment (virologic and immunologic response, development of HIV resistance mutations, development of opportunistic infections, and survival), 2) Evaluate the relationship between alcohol use and development of toxicity from antiretroviral therapy. Alcohol use at levels generally considered non-hazardous may be a significant under- recognized barrier to the effective long-term management and outcomes of HIV infection. Our research can yield valuable results to better understand the relationship between alcohol use and HIV/AIDS. PUBLIC HEALTH RELEVANCE: Modern HIV therapy is allowing people with HIV infection to live longer lives. Because of this, alcohol drinking may have a greater opportunity to cause adverse consequences. Our study is designed to measure alcohol use in a population of HIV- infected patients in care, and to determine levels of alcohol use that increase the risk of bad outcomes.

描述（由申请人提供）：在美国，现代抗逆转录病毒（ARV）疗法已将艾滋病毒感染从末期疾病转变为具有潜在正常寿命的慢性感染。借助长期寿命，通过对抗逆转录病毒（ARV）治疗，免疫恢复以及与艾滋病相关和非AID相关的临床事件的发展，饮酒有更大的机会在HIV疾病进展中发挥重要作用。危险的饮酒与多种不利的健康影响有关。在HIV感染中，我们表明危险饮酒（NIAAA定义）与ARV的利用率降低以及HIV病毒负荷抑制和免疫恢复独立相关。由于有害酒精的使用会干扰有效的ARV治疗，因此它可能与更快的HIV疾病进展有关。但是，由于HIV感染的特征是慢性炎症和免疫弹药，因此诸如病毒肝炎等共同感染，可能增加与非AID相关临床事件的风险增加（例如心血管，肾脏，肝脏，肝脏，内分泌），甚至较低的酒精使用水平也不危险地危害HIV-HIV可能会对患者产生不利影响。因此，我们建议在HIV治疗和临床疾病进展方面更广泛地确定酒精使用的关系。我们的研究将使用Johns Hopkins HIV临床队列，这是一个纵向临床临床队列的患者，这些患者在Johns Hopkins HIV/AIDS服务上接受初级艾滋病毒/艾滋病护理。该队列成立于1991年，为160多种论文提供了丰富的数据来源，这些数据已经检查了护理患者的HIV感染的自然病史，治疗和结果。我们使用多个经过验证的消费调查表评估特定水平的饮酒水平，以及每6个月与饮酒有关的问题，并使用音频计算机辅助的自我面试（A-CASI）来评估饮酒水平。我们建议解决以下特定目的：1）评估酒精消耗与对HIV治疗的反应之间的关系（病毒学和免疫学反应，HIV耐药性突变的发展，机会感染的发展以及生存），2）评估抗逆转录病毒治疗毒性的酒精使用与毒性发展之间的关系。通常认为非危害的水平的酒精使用可能是有效的长期治疗和HIV感染结果的重大公认的障碍。我们的研究可以产生宝贵的结果，以更好地了解酒精使用与艾滋病毒/艾滋病之间的关系。 公共卫生相关性：现代艾滋病毒疗法使艾滋病毒感染的人能够过更长的寿命。因此，饮酒可能会有更大的机会造成不利后果。我们的研究旨在衡量在护理中受HIV感染的患者人群中的饮酒，并确定饮酒水平，从而增加了不良预后的风险。