Cohort Studies on HIV/AIDS and Substance Abuse in Miami

迈阿密艾滋病毒/艾滋病和药物滥用队列研究

• 批准号: 9144756
• 负责人: Marianna K Baum
• 金额: $ 107.78万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9144756
• 关键词: AIDS/HIV problem; Adult; African American; Alcohols; Animal Experiments; Animals; Area; Behavioral; Biological Markers; Cause of Death; Cessation of life; Cirrhosis; Clinical; Cocaine; Cocaine Abuse; Cocaine Users; Cohort Studies; Comorbidity; Data; Databases; Devices; Diagnostic; Disease; Disease Outcome; Drug abuse; Etiology; FDA approved; Florida; Funding; Future; Genetic Markers; Goals; HIV; HIV Infections; HIV/HCV; Health; Health Services Accessibility; Hepatitis C; Hepatitis C co-infection; Heterosexuals; Hispanics; Human; Immunity; Immunosuppression; In Vitro; Intervention; Laboratories; Liver Fibrosis; Liver diseases; Magnetic Resonance Elastography; Malnutrition; Metabolic; Mono-S; Morbidity - disease rate; Nature; Outcome; Oxidative Stress; Participant; Pathogenesis; Pattern; Persons; Pharmaceutical Preparations; Pharmacotherapy; Population; Populations at Risk; Primary carcinoma of the liver cells; Prognostic Factor; Program Development; Program Evaluation; Quality of life; Recording of previous events; Recruitment Activity; Research; Research Design; Resources; Risk Factors; Role; Signal Transduction; Specimen; Stimulus; Substance abuse problem; Treatment Failure; United States; United States National Institutes of Health; Virus; Virus Diseases; Woman; antiretroviral therapy; chronic liver disease; co-infection; cocaine use; cohort; cytokine; disparities in morbidity; drug of abuse; effective intervention; effective therapy; evidence base; fibrogenesis; follow-up; health care availability; health disparity; improved; insight; interest; liver development; mortality; noninvasive diagnosis; novel; prevent; programs; prospective; public health relevance; repository; retention rate; time interval; transmission process; treatment effect; uptake; AIDS/HIV problem; Adult; African American; Alcohols; Animal Experiments; Animals; Area; Behavioral; Biological Markers; Cause of Death; Cessation of life; Cirrhosis; Clinical; Cocaine; Cocaine Abuse; Cocaine Users; Cohort Studies; Comorbidity; Data; Databases; Devices; Diagnostic; Disease; Disease Outcome; Drug abuse; Etiology; FDA approved; Florida; Funding; Future; Genetic Markers; Goals; HIV; HIV Infections; HIV/HCV; Health; Health Services Accessibility; Hepatitis C; Hepatitis C co-infection; Heterosexuals; Hispanics; Human; Immunity; Immunosuppression; In Vitro; Intervention; Laboratories; Liver Fibrosis; Liver diseases; Magnetic Resonance Elastography; Malnutrition; Metabolic; Mono-S; Morbidity - disease rate; Nature; Outcome; Oxidative Stress; Participant; Pathogenesis; Pattern; Persons; Pharmaceutical Preparations; Pharmacotherapy; Population; Populations at Risk; Primary carcinoma of the liver cells; Prognostic Factor; Program Development; Program Evaluation; Quality of life; Recording of previous events; Recruitment Activity; Research; Research Design; Resources; Risk Factors; Role; Signal Transduction; Specimen; Stimulus; Substance abuse problem; Treatment Failure; United States; United States National Institutes of Health; Virus; Virus Diseases; Woman; antiretroviral therapy; chronic liver disease; co-infection; cocaine use; cohort; cytokine; disparities in morbidity; drug of abuse; effective intervention; effective therapy; evidence base; fibrogenesis; follow-up; health care availability; health disparity; improved; insight; interest; liver development; mortality; noninvasive diagnosis; novel; prevent; programs; prospective; public health relevance; repository; retention rate; time interval; transmission process; treatment effect; uptake

 DESCRIPTION (provided by applicant): Liver disease is a major cause of death in HIV infected persons in the United States. While advances in antiretroviral therapy have significantly reduced HIV-related mortality, co-infection with hepatitis C virus (HCV), is widespread and accelerates progression of liver fibrosis to cirrhosis and liver carcinoma. In addition, substance abuse accelerates HIV disease, and may facilitate progression of liver fibrosis. The primary goal of this proposal is to continue to follow the existing Miami Adult Studies on HIV (MASH) cohort, its specimen repository and database, and expand it from the current 881 to 1,500 study participants. The purpose is to generate collaborative studies to investigate the impact of cocaine, by far the most prevalent drug of abuse in South Florida, on HIV infection, HIV/HCV co-infection, and on long-term morbidity with a focus on liver disease in this population with disparities in access to care. HIV and HCV un-infected cocaine users and non-users will also be recruited to allow determination of the impact of cocaine use alone, as well as the interaction of cocaine use with HIV, HCV, and HIV/HCV co-infection. As new and more effective treatments and access to care for HIV, HCV and drug abuse become available, maintaining a well- characterized cohort, specimen repository and database will create a strong resource platform for current and future collaborative research. Observing the uptake of new HCV treatments and potential new cocaine cessation programs in this at-risk population with health disparities will provide data on barriers and facilitators to effective treatments to prevent long-term morbidity and mortality. We have followed the MASH cohort of 881 participants for up to 12 years with excellent retention rates, and have created a specimen repository and a database. The MASH cohort in Miami is unique because it will be a mostly Hispanic cohort with a large number of African Americans, women, non-injector drug users, with predominantly heterosexual HIV- transmission etiology. We propose to (1) compare the progression of liver fibrosis over four years among cocaine users and non-users in HIV+/HCV-, HIV+/HCV+, HIV-/HCV+, and HIV-/HCV-, using a novel non- invasive diagnostic device, the Magnetic Resonance Elastography (MRE). We also propose to (2) compare the pattern over four years of biomarkers and identify genetic markers associated with the mechanisms of liver fibrosis among cocaine users and non-users. Understanding the role of cocaine use in the context of HIV and HIV/HCV co-infections and lack of lasting effects of treatments for cocaine use cessation are crucial in order to gain insights into the pathogenesis and disease outcomes, and to provide the basis for identifying antifibrotic therapies such as oxidative stress, which are amenable to intervention. These studies will be critical for program development, appropriate interventions, and for improving health in this population.

 描述（由适用提供）：肝病是美国感染艾滋病毒感染者的主要死亡原因。尽管抗逆转录病毒疗法的进展显着降低了与HIV相关的死亡率，但与丙型肝炎病毒（HCV）的共感染却广泛，并加速了肝纤维化对肝硬化和肝癌的进展。此外，药物滥用会加速艾滋病毒疾病，并可能促进肝纤维化的进展。该提案的主要目的是继续遵循现有的迈阿密成人研究（MASH）队列，其标本存储库和数据库，并将其从目前的881个扩展到1,500名研究参与者。目的是进行协作研究，以调查可卡因，迄今为止南佛罗里达州最普遍的虐待药物，对艾滋病毒感染，艾滋病毒/HCV共同感染以及长期发病率，重点关注该人群中具有护理方面分布的人群的肝病。还将招募HIV和HCV未感染的可卡因用户和非使用者，以确定可卡因使用的影响，以及可卡因使用与HIV，HCV和HIV/HCV共同感染的相互作用。随着新的，更有效的治疗方法以及获得艾滋病毒的护理，HCV和药物滥用的可用，维护特征良好的队列，标本存储库和数据库将为当前和将来的协作研究创建一个强大的资源平台。观察到具有健康差异的这种高危人群中新的HCV治疗和潜在的新可卡因戒烟计划的吸收，将提供有关障碍和促进因子的数据，以防止长期发病率和死亡率。我们遵循了881名参与者的MASH队列，最多12年，保留率很高，并创建了一个标本存储库和一个数据库。迈阿密的MASH队列是独一无二的，因为它将主要是西班牙裔人群，其中大量非洲裔美国人，妇女，非注射药物使用者，主要是异性恋HIV传播病因。我们建议（1）使用新型的非抗诊断设备，磁共振弹性（ME）（ME），比较了可卡因使用者和非用户在HIV+/HCV-，HIV+/HCV+，HIV-/HCV+和HIV-/HCV-中比较四年来肝纤维化的进展。我们还建议（2）比较四年来生物标志物的模式，并确定与可卡因使用者和非用户之间肝纤维化机制相关的遗传标记。了解可卡因在HIV和HIV/HCV共同感染中的作用以及对可卡因使用戒烟的持久影响缺乏持久影响至关重要，以便深入了解发病机理和疾病结果，并为识别诸如氧化应激（例如氧化应激）介入的抗纤维疗法提供基础。这些研究对于计划制定，适当的干预措施以及改善该人群的健康至关重要。