2/3 COMpAAAS Tripartite: ART-CC, KP, and VA

2/3 COMPAAAS 三方：ART-CC、KP 和 VA

• 批准号: 10242196
• 负责人: Derek D Satre
• 金额: $ 57.31万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10242196
• 关键词: Address; Adult; Affect; Age; Aging; Alcohol abuse; Alcohol consumption; Alcohols; American; Anti-Retroviral Agents; Award; Biological Markers; Birth; California; Caring; Clinical; Cocaine; Cohort Studies; Collaborations; Country; Data; Data Set; Drug Interactions; Drug usage; Electronic Health Record; Europe; European; Gender; Goals; Grant; HIV; HIV Infections; HIV-1; HIV/HCV; Health; Healthcare Systems; Hepatitis C; Hospitalization; Individual; Infection; Intervention; 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; Preventive care; Preventive healthcare; Protocols documentation; RNA; Race; Reporting; Research; Risk; Sample Size; Sampling; Site; 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; alcohol use disorder; antiretroviral therapy; base; cohort; comorbidity; data cleaning; data exchange; data format; data sharing; drinking; frailty; improved outcome; innovation; member; men; men who have sex with men; mortality; phosphatidylethanol; prospective; smoking intervention; substance use; therapy design; therapy development; tobacco exposure

PROJECT SUMMARY/ABSTRACT HIV+ 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 expands the sample of uninfected comparators, a critically important group if we are to understand how alcohol differentially affects biomedical outcomes in HIV. KP will be able to identify demographically-matched uninfected comparators from their Northern California region. A new VA sample of veterans born in 1945-1965 (Birth Cohort) expands access to Hepatitis C infected (HCV+) and women comparators. The tripartite group will also participate in an HIV+ substudy (n=2250), The Medications, Alcohol, Substance Use in HIV Study (MASH), in which new data on potentially inappropriate medications (PIMS) and biomarkers for alcohol and substances (tobacco, marijuana, opioids, cocaine, and methamphetamine) will be collected. As the lead site for Aim 2, KP will examine the impact of alcohol and smoking on HIV outcomes, preventive care, and medical comorbidities. We anticipate that among HIV+ individuals, hazardous alcohol use, alcohol use disorders and smoking will negatively impact each of these outcomes; and that these effects will be amplified in HIV+ individuals compared with uninfected individuals. Initially, analyses will use electronic health record data including self-reported alcohol and substance use. 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. This application addresses key interactions between alcohol and tobacco use, antiretrovirals, and medications that may increase mortality, hospitalization, frailty, and adversely impact preventive health care. We anticipate findings may lead to innovative intervention development, such as combined alcohol, smoking and preventive care interventions.

项目概要/摘要 饮酒的 HIV 阳性成年人由于 HIV 感染、合并症（包括丙型肝炎）而生理上已经很脆弱。 在这种情况下，酒精的生物医学后果。 使用可以在适度使用的情况下发生，并且常常不被重视或被错误归因。 “艾滋病毒/艾滋病、酒精、衰老和多种物质的结果”(COMpAAAS) 得到 NIH/NIAAA 奖的支持 U24AA020794 在单个样本中研究这个问题，即退伍军人老龄化队列研究 (VACS)（约 50,000 HIV+ 美国退伍军人在人口统计上与约 100,000 名未感染的比较者相匹配）将直接使用 VACS。 酒精生物标志物（磷脂酰乙醇 [PEth] 和经过验证的生理虚弱指标（VACS 指数）。 这组三个应用程序，抗逆转录病毒治疗队列协作 (ART-CC) 和 Kaiser Permanente (KP) 团队作为 COMpAAAS 三方加入退伍军人医疗保健系统 (VA) 团队：ART-CC、 KP 和 VA。我们的长期目标是共同为酒精干预措施的设计和实施提供信息。 提议研究酒精和相关物质使用对艾滋病毒的生物医学影响，扩大 VACS 对北美和欧洲多个医疗保健系统的范围和普遍性 重要的是，COMpAAAS Tripartite 还显着增加了 HIV+ 受试者的样本量和多样性。 扩大了未感染的比较者的样本，如果我们要了解酒精如何影响，这是一个至关重要的群体 KP 将能够识别人口统计匹配的情况。 来自北加州地区的未受感染的对照者是 1945 年至 1965 年出生的退伍军人的新样本。 （出生队列）扩大了丙型肝炎感染者（HCV+）和女性对照者的接触范围。 还将参加 HIV+ 子研究 (n=2250)，HIV 研究中的药物、酒精和药物使用 （MASH），其中关于潜在不适当药物（PIMS）和酒精和酒精生物标志物的新数据 物质（烟草、大麻、阿片类药物、可卡因和甲基苯丙胺）将被收集作为主要地点。 对于目标 2，KP 将研究酒精和吸烟对艾滋病毒结果、预防保健和医疗的影响 我们预计，在艾滋病病毒感染者中，危险性饮酒、酒精使用障碍和 吸烟会对这些结果产生负面影响；并且这些影响在 HIV+ 中会被放大； 最初，分析将使用电子健康记录数据。 包括自我报告的酒精和药物使用分析将在最后一年重复进行纠正。 基于 MASH 结果的自我报告的酒精和药物使用偏差，全部与 RFA 一致。 赠款为所有目标提供数据，具有相同的目标和协议。该应用程序解决了关键问题。 饮酒和吸烟、抗逆转录病毒药物和可能增加死亡率的药物之间的相互作用， 我们预计调查结果可能会导致住院、虚弱和对预防性医疗保健产生不利影响。 创新干预措施的发展，例如结合酒精、吸烟和预防保健干预措施。

项目成果

Influenza Vaccination Uptake and Associated Factors Among Adults With and Without Human Immunodeficiency Virus in a Large, Integrated Healthcare System.

大型综合医疗系统中感染和未感染人类免疫缺陷病毒的成年人的流感疫苗接种情况及相关因素。

• 发表时间: 2023-07-05
• 作者: Imp, Brandon M;Levine, Tory;Satre, Derek D;Skarbinski, Jacek;Luu, Mitchell N;Sterling, Stacy A;Silverberg, Michael J
• 通讯作者: Silverberg, Michael J

Cardiovascular Disease Risk Factor Control in People With and Without Human Immunodeficiency Virus.

感染和未感染人类免疫缺陷病毒的人的心血管疾病危险因素控制。

• 发表时间: 2024-01-16
• 作者: Silverberg, Michael J;Levine, Tory M;Lea, Alexandra N;Williams, Andrew E;Alexeeff, Stacey E;Bryant, Kendall;Cavassini, Matthias;Flamm, Jason A;Hare, C Bradley;Ingle, Suzanne M;Justice, Amy C;Lam, Jennifer O;Sterling, Stacy A;Horberg, Michael
• 通讯作者: Horberg, Michael

Health System-Based Unhealthy Alcohol Use Screening and Treatment Comparing Demographically Matched Participants With and Without HIV.

基于卫生系统的不健康饮酒筛查和治疗，比较人口统计匹配的感染艾滋病毒和未感染艾滋病毒的参与者。

• 发表时间: 2020-12
• 作者: Silverberg, Michael J;Levine;Hood, Nicole;Anderson, Alexandra N;Alexeeff, Stacey E;Lam, Jennifer O;Slome, Sally B;Flamm, Jason A;Hare, Charles Bradley;Ross, Thekla;Justice, Amy C;Sterne, Jonathan A C;Williams, Andrew E;Bryant, Kend
• 通讯作者: Bryant, Kend

Smoking and cessation treatment among persons with and without HIV in a U.S. integrated health system.

美国综合卫生系统中艾滋病毒感染者和未感染者的吸烟和戒烟治疗。

• 发表时间: 2020
• 影响因子: 4.2
• 作者: Lam, Jennifer O;Levine;Hood, Nicole;Alexeeff, Stacey E;Horberg, Michael A;Young;Sterling, Stacy A;Williams, Andrew;Weisner, Constance;Satre, Derek D;Silverberg, Michael J
• 通讯作者: Silverberg, Michael J

Beyond the HIV Care Continuum and Viral Suppression: Broadening the Scope of Quality Metrics for Total HIV Patient Care.

超越艾滋病毒护理连续体和病毒抑制：扩大艾滋病毒患者整体护理质量指标的范围。

• 发表时间: 2020-11
• 影响因子: 4.9
• 作者: Horberg, Michael A;Certa, Julia M;Rubenstein, Kevin B;Hurley, Leo B;Satre, Derek D;Kadlecik, Peter M;Silverberg, Michael J
• 通讯作者: Silverberg, Michael J