Psychobiological Processes and Health in HIV/AIDS

艾滋病毒/艾滋病的心理生物学过程和健康

• 批准号: 7087888
• 负责人: GAIL H IRONSON
• 金额: $ 51.99万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-04 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7087888
• 关键词: HIV infections; behavioral /social science research tag; clinical research; coping; cortisol; cytotoxic T lymphocyte; human subject; longitudinal human study; natural killer cells; outcomes research; pathologic process; patient care personnel relations; patient oriented research; psychobiology; psychometrics; social psychology; stress; therapy compliance; virus load

DESCRIPTION (provided by applicant): Despite the recent advances in the treatment for HIV/AIDS there remains a significant amount of variability in disease course that may be accounted for by psychosocial and psychobiological processes. This grant requests funding to determine the impact of both psychosocial (stress, coping and related variables) and biological factors (cortisol, Cytotoxic T lymphocytes, and NK#) on disease progression and mortality in HIV/AIDS. The study includes an HIV positive sample that has been followed for 3.5 years: This proposal would add new subjects comparable to the existing cohort and new biological measures and extend follow-up for 5 to 8 years total. At entry our subjects' CD4 counts were between 150 and 500, and they had never had serious AIDS symptoms (Category C). Particular strengths of the study that give this cohort the ability to contribute new information above other cohorts studied to date include (1) Our sample has diverse groups (28% women; 36% African American; 30% Hispanic). (2) The entire study has been conducted during the time protease inhibitors have been available, which makes issues such as adherence of paramount importance. Antiretroviral levels and genotyping will be added to ensure accuracy of adherence measures and to measure the development of resistance. (3) We have been able to quantify some relatively unexplored variables such as the doctor-patient relationship, spirituality, and emotional processing. (4) We are one of the first studies to be able to predict viral load. (5) We include several biological measures that could be investigated as both predictors and as mediators of disease progression. While we have strong cross sectional and longitudinal data showing that psychosocial variables are related to CD4 and viral load changes (controlling for relevant variables), the current long-term longitudinal design should allow us to relate these psychosocial variables to the development of serious AIDS symptoms and mortality. These analyses confirm that we have identified appropriate variables for expanding explorations of psychobiological links. Major strengths of the proposed study are that it will allow us to: (a) predict critical disease end points (e.g. Category C symptoms) and mortality; and (b) relate important psychosocial variables (e.g. stress, depression coping, adherence, doctor-patient relationship) to biological processes and disease endpoints.

描述（由申请人提供）：尽管最近在艾滋病毒/艾滋病的治疗方面取得了进展，但疾病过程中仍然存在显着的变异性，这可能是由心理社会和心理生物学过程造成的。该赠款要求提供资金来确定社会心理（压力、应对和相关变量）和生物因素（皮质醇、细胞毒性 T 淋巴细胞和 NK#）对 HIV/AIDS 疾病进展和死亡率的影响。该研究包括一个已跟踪 3.5 年的 HIV 阳性样本：该提案将增加与现有队列相当的新受试者和新的生物措施，并将随访时间延长 5 至 8 年。入组时，我们受试者的 CD4 计数在 150 到 500 之间，并且他们从未出现过严重的艾滋病症状（C 类）。该研究的特殊优势使该群体能够比迄今为止研究的其他群体贡献新信息的能力包括（1）我们的样本具有多元化的群体（28％为女性；36％为非洲裔美国人；30％为西班牙裔）。 (2) 整个研究是在蛋白酶抑制剂问世期间进行的，这使得依从性等问题变得至关重要。将添加抗逆转录病毒水平和基因分型，以确保依从性测量的准确性并测量耐药性的发展。 （3）我们已经能够量化一些相对未探索的变量，例如医患关系、灵性和情绪处理。 (4) 我们是最早能够预测病毒载量的研究之一。 (5) 我们纳入了几种生物学指标，可以将其作为疾病进展的预测因素和中介因素进行研究。虽然我们有强有力的横截面和纵向数据表明心理社会变量与 CD4 和病毒载量变化相关（控制相关变量），但目前的长期纵向设计应该允许我们将这些心理社会变量与严重艾滋病症状和死亡率的发展联系起来。这些分析证实我们已经确定了适当的变量来扩大心理生物学联系的探索。拟议研究的主要优点是它将使我们能够： (a) 预测关键疾病终点（例如 C 类症状）和死亡率； (b) 将重要的心理社会变量（例如压力、抑郁应对、依从性、医患关系）与生物过程和疾病终点联系起来。