Prospective Evaluation of Antiviral Therapy and Cardiac Health

抗病毒治疗与心脏健康的前瞻性评估

• 批准号: 7691228
• 负责人: Judith S. Currier
• 金额: $ 85.92万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-25 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7691228
• 关键词: AIDS clinical trial group; Affect; Anti-Retroviral Agents; Antiviral Therapy; Arterial Injury; Atazanavir; Atherosclerosis; Body Composition; Cardiac; Cardiovascular Diseases; Cardiovascular system; Chronic; Clinical; Collaborations; Communicable Diseases; Comparative Study; Endocrinologist; Evaluation; Functional disorder; Goals; HIV; HIV-1; Health; Image; Immune; Immunologist; Individual; Inflammation; Inflammatory; Insulin; Insulin Resistance; Integrase Inhibitors; Investigation; Lead; Life; Lipids; Lipoproteins; Long-Term Effects; Measures; Mediating; Metabolic; National Institute of Allergy and Infectious Disease; Obesity; Patients; Principal Investigator; Protease Inhibitor; Public Health; Randomized Clinical Trials; Research; Research Personnel; Research Proposals; Risk Factors; Ritonavir; Scientist; Specialist; Thick; Time; Treatment Efficacy; Treatment Protocols; Vasodilation; Virus Diseases; Visceral; abstracting; antiretroviral therapy; brachial artery; cardiovascular disorder risk; cost; glucose metabolism; immune function; improved; intima media; multidisciplinary; non-nucleoside reverse transcriptase inhibitors; prospective; treatment strategy; volunteer

DESCRIPTION (provided by applicant): The overall goal of this research proposal is to prospectively examine the impact of three modern antiretroviral therapy (ART) treatment strategies on the progression of atherosclerosis in treatment-na¿ve individuals with human immunodeficiency virus (HIV) infection. The studies proposed will examine and quantify the contributions of ART, cardiovascular disease (CVD) risk factors, immune activation and inflammation on arterial injury and atherosclerosis progression in HIV-infected individuals. The co-principal investigators are an infectious disease specialist and a cardiologist with expertise in the investigation of CVD risk in patients with HIV. They have assembled a multidisciplinary team of investigators that includes two experts in the treatment of HIV, two cardiologists with expertise in atherosclerosis imaging and lipids, an endocrinologist, and an immunologist, and a cardiovascular basic scientist, who, in collaboration with the National Institute of Allergy and Infectious Diseases AIDS Clinical Trials Group AIDS Clinical Trials Group, will conduct a prospective substudy of A5257, "A Comparative Study of Three Compact, Non-Nucleoside Reverse Transcriptase Inhibitor Sparing Antiretroviral Regimens for the Treatment Naive HIV-1 Infected Volunteers." A5257 is a prospective, randomized clinical trial (RCT) of ART efficacy. Embedding analyses of structural and functional markers of arterial injury and their determinants in a prospective, randomized clinical trial within the ACTG is an efficient and cost-effective approach to understanding the contributions of traditional and HIV-related factors to atherosclerosis progression in individuals with HIV. The proposal includes the following clinical and mechanistic aims: AIM 1 (Clinical): To examine the effects of three contemporary initial ART treatment strategies on atherosclerosis progression over three years. AIM 2 (Mechanistic and clinical): To examine the magnitude and time course of the effects of three contemporary initial ART treatment strategies on endothelial function during the first year of therapy. AIM 3 (Mechanistic): To examine the effects of ART-related metabolic changes on endothelial function and atherosclerosis progression. AIM 4 (Mechanistic): To examine the effects of ART-related changes in immune function and inflammation on endothelial function and atherosclerosis progression. There are estimated to be 33 million people worldwide who are living with HIV infection. Treatment for HIV infection has improved dramatically over the past twenty years, however there is growing concern that HIV treatments and chronic HIV infection might increase the risk of cardiovascular disease in people living with HIV. The proposed research will help identify the factors that increase the risk of cardiovascular disease in HIV patients and determine the optimal treatment strategies to reduce long-term cardiovascular disease risk in the setting of HIV infection. (End of Abstract)

描述（由申请人提供）： 本研究提案的总体目标是前瞻性研究三种现代抗逆转录病毒疗法 (ART) 治疗策略对治疗中动脉粥样硬化进展的影响拟议的研究将检查和量化 ART、心血管疾病 (CVD) 危险因素、免疫激活和炎症对 HIV 感染者的动脉损伤和动脉粥样硬化进展的影响。他们组建了一个多学科研究小组，其中包括两名艾滋病治疗专家和两名具有专业知识的心脏病专家。动脉粥样硬化成像和血脂领域的内分泌学家、免疫学家和心血管基础科学家将与国家过敏和传染病研究所艾滋病临床试验组合作，对 A5257 进行前瞻性亚组研究，“一项比较研究三种紧凑型非核苷逆转录酶抑制剂可节省抗逆转录病毒治疗方案，用于治疗初始 HIV-1 A5257 是一项关于 ART 疗效的前瞻性、随机临床试验 (RCT)。在 ACTG 内的前瞻性、随机临床试验中嵌入分析动脉损伤的结构和功能标志物及其决定因素是一种有效且具有成本效益的方法了解传统因素和 HIV 相关因素对 HIV 感染者动脉粥样硬化进展的影响 该提案包括以下临床和机制目标： AIM 1（临床）：检查三个当代初始因素的影响。三年内 ART 治疗策略对动脉粥样硬化进展的影响 AIM 2（机制和临床）：研究治疗第一年期间三种当代初始 ART 治疗策略对内皮功能的影响程度和时间过程。 ：检查 ART 相关代谢变化对内皮功能和动脉粥样硬化进展的影响 AIM 4（机制）：检查 ART 相关变化对免疫功能和炎症的影响。过去二十年来，全球有 3300 万人感染艾滋病毒，但人们越来越担心艾滋病毒治疗和慢性艾滋病毒感染可能会增加。拟议的研究将有助于确定增加艾滋病毒患者心血管疾病风险的因素，并确定降低艾滋病毒感染者长期心血管疾病风险的最佳治疗策略。 （摘要完）