NUTRITIONAL STATUS OF HIV INFECTED INJECTION DRUG USERS

这项拟议的研究是一项关于艾滋病毒阳性和艾滋病毒阴性注射吸毒者(IDU)营养状况的研究(NIDA-DA10252)的竞争性更新。这项为期两年半的资助的第一年的结果表明，HIV阳性和HIV阴性的注射吸毒者的血清抗氧化维生素是相似的。然而，那些接受抗逆转录病毒联合疗法(ART)的HIV阳性参与者，包括一种蛋白酶抑制剂(PI)，与未服用PI的HIV阴性患者和HIV阳性患者相比，几种抗氧化维生素的平均血清水平显著更高。这种差异不能用饮食摄入量或补充剂使用的差异来解释。这些结果表明，在服用PI的患者中，通过血清抗氧化剂测量的氧化应激可能会减少；然而，这还需要进一步的研究。具体地说，我们想要研究不同抗逆转录病毒疗法的HIV阴性注射吸毒者和HIV阳性注射吸毒者之间的氧化应激和血清抗氧化剂水平之间的关系。我们还将研究氧化应激和血清抗氧化剂水平对艾滋病毒疾病进展的影响。此外，我们有机会确定一组更活跃的注射吸毒者的特征，其中许多人不接受抗逆转录病毒治疗，涉及氧化应激和抗氧化状态。拟议的更新将建立在现有研究(唐-Alive营养组)和正在进行的Alive研究的基础设施(NIDA-DA04334)的基础上。除了已经在唐(n=398)登记的受试者外，我们计划再招募52名HIV阳性的Alive参与者，将每个抗逆转录病毒治疗组的样本规模增加到50人；100名最近被招募到Alive研究的HIV阳性受试者，他们报告每周至少注射药物3次；以及30名HIV阴性的从未使用过药物的社区志愿者。研究参与者将接受饮食摄入访谈、身体成分测量和静脉穿刺术，以测量血清氧化应激和抗氧化剂。参与者将接受长达四年的艾滋病毒相关结果跟踪调查。这项观察性研究的结果可能有助于指导在PI时代设计更有效的抗氧化剂补充干预措施。

This proposed study is a competing renewal of a study on the nutritional status of HIV-positive and HIV-negative injection drug users (IDU) (NIDA-DA10252). Results from the first year of this 2.5 year grant indicate that serum antioxidant vitamins were similar between HIV-positive and HIV-negative IDUs. However, those HIV-positive participants on antiretroviral combination therapies (ART) including a protease inhibitor (PI) had significantly higher mean serum levels of several antioxidant vitamins compared to both HIV-negatives and HIV-positives not taking PI's. This difference was not explained by differences in dietary intake or supplement use. These results suggest that oxidative stress, as measured by serum antioxidants, may be reduced in patients taking PI's; however, this requires further investigation. Specifically, we would like to examine the associations between oxidative stress and serum antioxidant levels among HIV-negative IDUs and HIV-positive IDUs on various ART regimens. We will also examine the effect of oxidative stress and serum antioxidant levels on HIV disease progression. Furthermore, we have the opportunity to characterize a group of more active IDUs, many of whom are not on ART, with respect to oxidative stress and antioxidant status. The proposed renewal will build on the existing study (TANG - The ALIVE Nutrition Group) and the infrastructure of the ongoing ALIVE study (NIDA-DA04334). In addition to the subjects already enrolled in TANG (n=398), we plan to enroll 52 additional HIV-positive ALIVE participants to increase the sample size of each ARV therapy group to 50; 100 HIV-positive subjects who report injecting drugs at least 3 times a week, who have recently been recruited into the ALIVE study; and 30 HIV negative never-drug using volunteers from the community. Study participants will undergo dietary intake interviews, body composition measurements, and venipuncture for serum measures of oxidative stress and antioxidants. Participants will be followed for HIV-related outcomes for up to four years. The results from this observational study may help to guide the design of more effective interventions of antioxidant supplementation in the era of PI's.