Nutritional Status In HIV Hispanic Drug Abusers

描述（由申请人提供）：BIENESTAR研究是一项药物滥用对西班牙裔HIV感染患者营养状况和预后影响的纵向队列研究。该队列由3组组成：HIV+药物滥用者、HIV-药物滥用者和HIV+非药物滥用者。努力的重点将是扩大和维持这一独特的群体。在这种竞争性更新中提出的新假设反映了当前的趋势，因为艾滋病毒已成为一种慢性病。肝脏疾病是艾滋病毒感染者中越来越常见的并发症。虽然人们普遍认为丙型肝炎病毒在很大程度上导致了艾滋病毒感染中的肝脏疾病，但研究表明，药物滥用本身也是丙型肝炎病毒感染者患肝脏疾病的一个危险因素。动物研究表明，可卡因可通过诱导氧化应激和组织损伤而引起肝毒性。美国东北部的西班牙裔人比其他种族更倾向于注射可卡因，因此可能会增加氧化应激和肝功能障碍的风险。低血清抗氧化微量营养素水平在药物滥用者中很常见，进一步增加了氧化性组织损伤的风险。本研究旨在检测西班牙裔药物滥用者伴HIV感染的抗氧化状态、氧化应激和肝功能障碍。有4个具体目的：1)检查药物滥用类型（可卡因与海洛因）和频率与血浆抗氧化能力和氧化应激之间的关系。具体的兴趣是了解可卡因是否在改变抗氧化能力和引起氧化应激的能力方面与海洛因不同；2)探讨药物滥用类型和频率与肝功能障碍的关系。如果可卡因或海洛因引起肝组织氧化应激，这可能导致肝功能可检测到的改变；3)探讨氧化损伤与肝功能障碍的关系。氧化应激和肝功能障碍之间的关联意味着药物滥用通过涉及氧化应激的机制改变肝功能；4)检验HIV感染、HCV感染和饮酒对具体目的1至3中所述关联的影响。这将确定药物滥用是肝功能障碍的独立危险因素，还是像酒精一样，是艾滋病毒和/或丙型肝炎病毒感染者肝功能障碍的加速因素。拟议的研究将建立在BIENESTAR研究（NIDA DA 11598）和BIENESTAR微量营养素研究（NIDA DA 14501）的基础上。

DESCRIPTION (provided by applicant): The BIENESTAR study is a longitudinal cohort study of the effect of drug abuse on nutritional status and outcomes among Hispanics with HIV infection. The cohort is comprised of 3 groups: HIV+ drug abusers, HIV- drug abusers, and HIV+ non-drug abusers. Efforts will focus on expanding and maintaining this unique cohort. New hypotheses addressed in this competitive renewal reflect current trends, as HIV becomes a chronic disease. Liver disease is an increasingly common complication in patients with HIV. While it is generally accepted that HCV is largely responsible for liver disease in HIV infection, studies suggest that drug abuse itself is a risk factor for liver disease among persons with HCV. Animal studies have shown that cocaine can cause liver toxicity by the induction of oxidative stress with tissue damage. Hispanics of the NE USA preferentially inject cocaine more than other races, and therefore may be at increased risk of oxidative stress and liver dysfunction. Low serum antioxidant micronutrient levels are common in drug abusers, further increasing the risk of oxidative tissue damage. This study proposes to examine antioxidant status, oxidative stress, and liver dysfunction in Hispanic drug abusers with HIV infection. There are 4 specific aims: 1) To examine the association between the type (cocaine versus heroin) and frequency of drug abuse with plasma antioxidant capacity and oxidative stress. The specific interest is to know if cocaine differs from heroin in its ability to alter antioxidant capacity and cause oxidative stress; 2) To examine the association between the type and frequency of drug abuse and liver dysfunction. If cocaine or heroin cause oxidative stress to hepatic tissues this may result in detectable alterations in liver function; 3) To examine the association between oxidative damage and liver dysfunction. An association between oxidative stress and liver dysfunction will imply that drug abuse alters liver function through a mechanism involving oxidative stress; and 4) To examine the influence of infection with HIV, infection with HCV, and alcohol consumption on the associations described in specific aims 1 to 3. This will determine if drug abuse is an independent risk factor for liver dysfunction or whether, like alcohol, it is an accelerator of liver dysfunction in persons with HIV and/or HCV infection. The proposed study will build on the infrastructure of the BIENESTAR study (NIDA DA 11598) and the BIENESTAR-micronutrient study (NIDA DA 14501).