The International Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Center

摘要 全球四分之一的人口感染了结核分枝杆菌，并面临着 罹患活动性结核病和死亡，特别是艾滋病毒携带者。饮酒 越来越多地被认为是结核病流行的驱动力，可能是减轻艾滋病毒/结核病的重要手段 发病率和死亡率。结核病预防治疗(TPT)是预防结核病进展的重要途径。 从潜伏性结核病感染到活动性结核病。然而，TPT不能预防新的或重复的结核病感染，因此 即使在接受TPT后，饮酒的PLWH可能仍有更高的结核病感染风险。重的 酒精在艾滋病毒携带者(PLWH)中很常见。虽然活动性结核病的风险增加是 由于酒精相关的免疫抑制导致潜在的TB重新激活，酒精使用在 获得新的或重复的结核病感染并在TPT后进展为活动性结核病尚未得到广泛的 经审查，包括在PLWH中。那些完成结核病治疗的人有广泛的结核病后发病率和 死亡风险几乎高出4倍。酗酒和艾滋病毒在促进肺部疾病中的作用 结核病后的治疗情况尚不清楚。国际乌干达-俄罗斯-波士顿酒精网络的中心目标 为酒精研究合作艾滋病毒/艾滋病(城市ARCH)中心是为了研究酒精使用的作用 新发结核病、TPT后活动性肺结核的发生情况以及PLWH中结核病后肺部疾病的发生情况。 这一新知识将使未来能够开发出能够减少酒精对结核病影响的干预措施。 PLWH的相关发病率和死亡率。该中心将由4个组成部分组成(管理 核心、生物统计和数据管理[BDM]核心、乌干达项目、俄罗斯项目)将会奏效 协同完成以下主要目标：1)检查酒精使用在驾驶中的作用 乌干达妇幼保健院TPT后新结核感染和活动性肺结核的发生 (乌干达项目)。这一新知识将为潜在的新干预措施提供信息，以降低结核病感染的风险 和活动性疾病；2)确定治疗后饮酒与肺部疾病的关系 长春市人群活动性肺结核患病情况及吸烟和饮酒干预因素的定性评价 在PLWH结核病治疗的背景下(俄罗斯项目)；3)进行高质量的数据管理和 艾滋病毒/酒精研究的统计分析(BDM核心)；4)促进多学科国际合作 促进创新和严格的艾滋病毒/酒精研究(行政核心)；以及5)提供持续的培训 并指导将初级和职业生涯中期的研究人员培养成艾滋病毒/酒精研究的未来领导者 (管理核心)。国际城市拱形中心的结构将确保有效 将旨在协同发展该领域的一系列活动进行行政和科学整合 预防和治疗艾滋病毒/酒精/结核病。

ABSTRACT One quarter of the global population is infected with the bacillus Mycobacterium tuberculosis and is at risk of developing active tuberculosis (TB) disease and death, especially persons living with HIV (PLWH). Alcohol use is increasingly being recognized as a driver of the TB epidemic, and may be a vital means to mitigate HIV/TB morbidity and mortality. TB preventive therapy (TPT) is an important approach in preventing the progression of latent TB infection to active TB disease. However, TPT does not prevent new or repeat TB infection, thus PLWH who drink alcohol may remain at increased risk for TB acquisition, even after receipt of TPT. Heavy alcohol use is common among persons living with HIV (PLWH). While the increased risk for active TB is attributed to alcohol-related immunosuppression leading to latent TB re-activation, the role of alcohol use in acquiring new or repeat TB infection and progression to active TB disease after TPT has not been extensively examined, including among PLWH. Those who complete TB treatment have extensive post-TB morbidity and almost a 4-fold higher risk of mortality. The role of both heavy alcohol use and HIV in promoting lung disease after TB treatment is not clear. The central goal of the International Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Center is to examine the role of alcohol use on new TB acquisition, occurrence of active TB disease after TPT, and post-TB lung disease among PLWH. This new knowledge will enable future development of interventions that can reduce alcohol’s impact on TB- related morbidity and mortality among PLWH. The Center will be comprised of 4 components (Administrative Core, Biostatistics and Data Management [BDM] Core, Uganda Project, Russia Project) that will work synergistically to accomplish the following primary objectives: 1) Examine the role of alcohol use in driving the acquisition of new TB infection and the occurrence of active TB disease after TPT in PLWH in Uganda (Uganda Project). This new knowledge will inform potential new interventions to reduce risk of TB acquisition and active disease; 2) Determine the relationship between alcohol use and lung disease after treatment for active TB disease among PLWH and qualitatively evaluate factors to tailor alcohol and smoking interventions in the setting of TB treatment in PLWH (Russia Project); 3) Conduct high quality data management and statistical analyses for HIV/alcohol research (BDM Core); 4) Foster multidisciplinary international collaborations to promote innovative and rigorous HIV/alcohol research (Administrative Core); and 5) Provide ongoing training and mentoring to develop junior and mid-career investigators into future leaders in HIV/alcohol research (Administrative Core). The structure of the International URBAN ARCH Center will ensure effective administrative and scientific integration of a broad range of activities designed to synergistically grow the field of HIV/alcohol/TB prevention and treatment.