NUTRITIONAL STATUS OF HIV INFECTED INJECTION DRUG USERS

这项拟议的研究是对hiv阳性和hiv阴性注射吸毒者（IDU）营养状况研究（NIDA-DA10252）的竞争性更新。这项为期2.5年的资助第一年的结果表明，在hiv阳性和hiv阴性的IDUs中，血清抗氧化维生素相似。然而，那些接受包括蛋白酶抑制剂（PI）在内的抗逆转录病毒联合疗法（ART）的hiv阳性参与者，其血清中几种抗氧化维生素的平均水平明显高于未接受PI的hiv阴性和hiv阳性参与者。这种差异不能用饮食摄入或补充剂使用的差异来解释。这些结果表明，通过血清抗氧化剂测量，服用PI的患者可能会降低氧化应激；然而，这需要进一步的调查。具体来说，我们想要检查不同ART治疗方案中hiv阴性注射吸毒者和hiv阳性注射吸毒者的氧化应激和血清抗氧化水平之间的关系。我们还将研究氧化应激和血清抗氧化剂水平对HIV疾病进展的影响。此外，我们有机会描述一组更活跃的注射吸毒者，其中许多人没有接受抗逆转录病毒治疗，就氧化应激和抗氧化状态而言。拟议的更新将建立在现有研究（TANG - The ALIVE Nutrition Group）和正在进行的ALIVE研究（NIDA-DA04334）的基础上。除了已经入组TANG的受试者（n=398），我们计划再入组52名hiv阳性的ALIVE参与者，将每个ARV治疗组的样本量增加到50人；100名hiv阳性受试者，报告每周至少注射药物3次，最近被招募到ALIVE研究中；以及30名来自社区的HIV阴性从不吸毒的志愿者。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检测血清氧化应激和抗氧化剂。研究人员将对参与者进行长达四年的艾滋病相关结果跟踪调查。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.