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: 10244904
• 负责人: Jonathan Sterne
• 金额: $ 42.76万
• 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 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10244904
• 关键词: AIDS/HIV problem; Adult; Affect; Age; Aging; Alcohol abuse; Alcohol consumption; Alcohols; American; Award; Biological Markers; Birth; California; Caring; Clinical; Cocaine; Cohort Studies; Collaborations; Country; Data; Data Analyses; 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; comorbidity; data cleaning; data exchange; data format; data sharing; drinking; frailty; improved outcome; member; men; men who have sex with men; mortality; mortality risk; phosphatidylethanol; prospective; public health relevance; smoking intervention; substance use; 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.

抽象字数：424 艾滋病毒感染的成年人由于艾滋病毒感染，合并症（包括 丙型肝炎感染），多药和相关药物使用。在这种情况下，生物医学后果 中度使用可能会发生饮酒，并且常常被未批准或误入。 “财团” NIH/NIAAA支持艾滋病毒/艾滋病，酒精，衰老和多余的艾滋病的结果”（compaaaS） 授予U24AA020794在单个样本中研究此问题，即退伍军人老年同伴研究（VACS） （约50,000名HIV+美国退伍军人在人口统计学上与约100,000个未感染的比较器匹配）。 VACS将雇用 直接酒精生物标志物（磷脂酰乙醇（Peth）和经过验证的生理脆弱测量（VACS） 指数）。在这组三种应用中，抗逆转录病毒疗法队列协作（ART-CC）和Kaiser Permanente（KP）团队以Compaaas Tripartite的身份加入退伍军人医疗保健系统（VA）团队：Art-CC， KP和VA。我们的长期目标是告知酒精干预设计和实施。我们在一起 研究艾滋病毒中酒精和相关物质使用的生物医学后果的提议扩展了 VAC对北美和欧洲多个医疗系统的范围和概括性以及 大大增加了艾滋病毒+受试者的样本量和多样性。重要的是，Compaaas Tripartite也 扩展未感染的比较器，如果我们要了解酒精如何 艾滋病毒中有效的生物医学结果。 KP将能够从他们的 北加州地区。 1945 - 1965年出生的退伍军人的新的VA样本（出生队列） 扩展对乙型肝炎感染（HCV+）和女性比较剂的访问。三方小组也将 参加HIV+ ordudy（n = 2250），艾滋病毒研究中的药物，酒精，药物使用（MASH）， 其中有关不当药物（PIM）和酒精和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）将是前瞻性的 集。在最初的几年中，将使用酒精和使用物质的自我报告进行分析。有限的 数据集和统一方法的数据清洁，标准化和归类的方法将成为员工 团队。在最后一年将重复分析，以纠正自我报告的酒精和主题的偏见 根据土豆泥结果使用。与RFA一致，所有赠款都为所有目标提供了数据，都具有相同的 目标和协议，并共享数据。 VA团队将协调数据共享和分析。每个合作者 将负责进行一个目标的分析。在此应用程序中，我们将调查 VACS指数衡量的死亡率，住院和增加的生理脆弱性 饮酒水平的不同，我们将比较感染HIV和未感染的人群中的这些结果。

项目成果

Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings.

欧洲高收入地区接受抗逆转录病毒治疗者超额死亡率趋势和模式的参数估计。

• DOI: 10.1097/qad.0000000000002387
• 发表时间: 2019
• 期刊: AIDS (London, England)
• 作者: Trickey,Adam;vanSighem,Ard;Stover,John;Abgrall,Sophie;Grabar,Sophie;Bonnet,Fabrice;Berenguer,Juan;Wyen,Christoph;Casabona,Jordi;d'ArminioMonforte,Antonella;Cavassini,Matthias;DelAmo,Julia;Zangerle,Robert;Gill,MJohn;Obel,Ni
• 通讯作者: Obel,Ni