Impact of Physical Activity Routines and Dietary Intake on the Longitudinal Symptom Experience of the people living with HIV (PROSPER-HIV)

项目概要/摘要： 艾滋病毒感染者（PLHIV）经历了不成比例的高症状负担（例如，疲劳失眠 疼痛），治疗选择很少。这些症状是频繁的，令人痛苦的，经常共同发生，并有 对艾滋病毒感染者的健康和福祉产生重大影响，但我们几乎不知道如何 有效地减轻它们。非药物治疗方案是非常可取的症状 艾滋病毒感染者已经经历了多种共病的高药丸负担。我们 研究小组先前报告说，身体活动和更好的营养与较低的症状有关， 强度在PLHIV;但需要更清楚地了解身体活动和饮食的影响， 确定这些方法如何减少这一人群的症状困扰。基于这些数据， 一个项目建议检查两个有前途的非药物策略的效果，身体活动 药物和饮食摄入量，对艾滋病毒感染者的纵向症状经验（Paradise-HIV）。 Paradise-HIV研究是一项观察性纵向研究，将利用大量的 艾滋病研究中心综合临床系统网络（CNICS）的基础设施， 研究了四年来850名艾滋病毒感染者的身体活动和饮食模式以及症状负担。本研究 将发生在四个人口统计学上不同的HIV诊所[凯斯西储大学（克利夫兰，俄亥俄州）， 亚拉巴马大学伯明翰分校（伯明翰，亚拉巴马），华盛顿大学（西雅图，华盛顿） 和芬威健康研究所（波士顿，马萨诸塞州）]。天堂-艾滋病毒将克服的局限性， 以前的研究通过1）招募一个大的，人口统计学和地理上多样化的，基于临床的样本， PLHIV，2）随着时间的推移，检查身体活动、饮食摄入和症状负担之间的关系， 以及3）使用身体活动的前瞻性、黄金标准测量（即，三轴加速度计）和饮食 摄入量（即，24-小时饮食回忆）。拟人化和身体健康因素将被评估为潜在因素 身体活动和饮食摄入对症状负担和强度的介导。当我们的目标是 完成后，我们将有精确的，明确的，高质量的数据描述物理的影响， 活动和饮食对艾滋病病毒感染者症状的影响。 这些数据可以在临床上用于向艾滋病毒卫生保健提供者提供有关身体状况的反馈。 活动和饮食摄入量。Paradise-HIV研究也将对人类的健康产生重要的科学影响。 影响，并将告知这项研究计划的下一阶段。这些发现将用于开发一个 针对个人的，基于临床的干预，以改善体力活动和饮食摄入，最终将 减少艾滋病毒感染者的症状。它们还将用于检查生物和临床机制， 导致艾滋病毒感染者普遍出现的持续症状。因此，拟议的研究可能会 鼓励对艾滋病毒感染者的健康和生活质量产生长期影响的新研究。

Project Summary/Abstract: People living with HIV (PLHIV) experience a disproportionately high symptom burden (e.g., fatigue, insomnia, pain) with few treatment options. These symptoms are frequent, distressing, often co-occur, and have significant consequences on the health and well-being of PLHIV, yet we know almost nothing about how to effectively mitigate them. Non-pharmacological treatment options are highly desirable for symptom management among PLHIV who already experience a high pill burden from multiple comorbid diseases. Our team previously reported that physical activity and better nutrition were associated with lower symptom intensity in PLHIV; but a clearer understanding of the effects of physical activity and diet is required to determine how these approaches can reduce symptom distress in this population. Building on these data, this project proposes to examine the effect of two promising non-pharmacological strategies, Physical Activity Routines And Dietary Intake, on the longitudinal Symptom Experience of PLHIV (PARADISE-HIV). The PARADISE-HIV study is an observational, longitudinal study that will utilize the substantial infrastructure of the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) to examine physical activity and dietary patterns and symptom burden of 850 PLHIV over four years. This study will occur in four demographically diverse HIV clinics [Case Western Reserve University (Cleveland, Ohio), University of Alabama at Birmingham (Birmingham, Alabama), University of Washington (Seattle, Washington) and Fenway Health Institute (Boston, Massachusetts)]. PARADISE-HIV will overcome the limitations of previous studies by 1) enrolling a large, demographically and geographically diverse, clinic-based sample of PLHIV, 2) examining the relationship between physical activity, dietary intake and symptom burden over time, and 3) using prospective, gold-standard measures of physical activity (i.e., triaxial accelerometry) and dietary intake (i.e., 24-hour diet recalls). Anthropomorphic and physical fitness factors will be assessed as potential mediators of physical activity and dietary intake on symptom burden and intensity. When our aims are accomplished we will have precise, definitive, high-quality data describing the impact of physical activity and diet on symptoms in PLHIV. These data can be used clinically to provide feedback to HIV health care providers on the physical activity and dietary intake of their patients. The PARADISE-HIV study will also have a significant scientific impact and will inform the next phase of this program of research. These findings will be used to develop an individually-targeted, clinic-based intervention to improve physical activity and dietary intake that will eventually reduce symptoms among PLHIV. They will also be used to examine biological and clinical mechanisms that lead to the prevalent unremitting symptoms experienced by PLHIV. Thus, the proposed study is likely to stimulate novel research that will have a long-term impact on the health and quality of life of PLHIV.