Addressing Alcohol/HIV Consequences in Substance Dependence-Boston ARCH Cohort

解决酒精/艾滋病毒对物质依赖的影响 - 波士顿 ARCH 队列

• 批准号: 8967071
• 负责人: RICHARD SAITZ
• 金额: $ 8.7万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8967071
• 关键词: AIDS/HIV problem; Accounting; Address; Adult; Affect; Agonist; Alcohol consumption; Alcohols; Biometry; Bone Density; Boston; Buprenorphine; Caring; Chronic Disease; Clinical; Cohort Analysis; Cohort Studies; Collaborations; Complement; Consequences of HIV; Data; Dependence; Disease; Dose; Drug Addiction; Drug usage; Ethanol; Fracture; Future; Goals; HIV; HIV Infections; HIV risk; Health; Heavy Drinking; Heterogeneity; Heterosexuals; High Resolution Computed Tomography; Individual; Inflammatory; Injection of therapeutic agent; Intervention; Intervention Studies; Knowledge; Laboratories; Learning; Naloxone; Observational Study; Opiate Addiction; Opioid; Osteopenia; Participant; Patients; Persons; Pharmaceutical Preparations; Principal Investigator; Prospective Studies; Randomized; Research; Risk; Risk Factors; Russia; Sampling; Statistical Methods; Substance Addiction; Substance of Abuse; Supplementation; Testing; Uganda; Woman; Zinc; addiction; adverse outcome; alcohol and other drug; alcohol consequences; alcohol effect; alcohol intervention; alcohol misuse; alcohol research; alcohol risk; antiretroviral therapy; bone; bone health; bone loss; cohort; data management; design; double-blind placebo controlled trial; drinking; high risk drinking; improved; injection drug use; instrument; men; policy implication; prevent; prospective; response; sex

Unhealthy alcohol use is common among HIV-infected persons and it adversely affects health. Injection drug use accounts for 1 in 5 cases of HIV infection, thus opioid dependence is also common. More than one-third of those with HIV infection and other drug use drink too much alcohol. Research has focused on either alcohol or drug use in HIV-infected individuals, but much less is known about alcohol's health effects in HIV- infected people affected by multiple substances of abuse. This proposal is a component of the Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Consortium, whose goal is to examine the consequences of alcohol on HIV disease and to mitigate its harms. The objective of this proposal is to accurately characterize alcohol use and consequences in people with HIV infection affected by multiple substances, and to implement observational and intervention studies to understand and reduce alcohol's harm. The proposal has 3 specific aims: 1) To expand and continue an existing cohort to establish the longitudinal Boston ARCH Cohort of 250 HIV-infected men and women affected by multiple substances—a spectrum of alcohol use, and all with substance dependence or Injection drug use. 2) To treat both heavy drinking and opioid dependence with one medication. The Treating With Opioids For Ethanol Risks (TWOFER) trial will assess if high-dose buprenorphine (32mg) reduces heavy drinking compared to standard-dose (16mg) at 3 months in a randomized double-blind placebo-controlled trial among 100 HIV-infected adult Cohort participants with opioid dependence and heavy drinking. If efficacious, buprenorphine, a treatment for opioid dependence, could be easily disseminated as a treatment for unhealthy alcohol use in people with HIV infection and opioid dependence as only dose adjustment is required. 3) Because alcohol, opioid use, HIV infection and antlretroviral therapy may affect bone health and increase fracture risk, analysis of cohort data will determine the independent effect of alcohol consumption on changes in bone mineral density and microarchitecture (by high-resolution computed tomography) prospectively in all Cohort participants over 12-42 months. The Cohort will yield data on alcohol effects on bone, important information for defining risky drinking amounts in people with HIV infection and for advising them on alcohol-related risks. Thus, these studies will provide substantial new knowledge for mitigating alcohol consequences among HIV-infected adults affected by multiple substances. RELEVANCE (See instructions): HIV disease can be treated effectively, but drinking too much interferes with treatment and causes bone loss, especially among those who abuse other drugs. This research will study people with HIV infection to discover what amounts of alcohol increase risk of fractures, and to see whether a medication used for drug addiction can also reduce heavy drinking. Findings will be useful for advising people with HIV infection about drinking limits to prevent fractures and may identify a new treatment to reduce drinking and improve health. PROJECT/PERFORMANCE StTE(S) (if additional space is needed, use Project/Performance Project/Perfomiance Site Primary Location Organizational Name: Boston Medical Center DUNS: 00-549-2160 street 1: One Boston Medical Center Place street 2: City: Boston County: S u f f o l k Province: Country: U S A

不健康的饮酒在艾滋病毒感染者中很常见，这会对健康产生不利影响。注射药品 使用阿片类药物占艾滋病毒感染病例的五分之一，因此阿片类药物依赖也很常见。超过三分之一 感染艾滋病毒和使用其他药物的人饮酒过多。研究重点集中在 艾滋病毒感染者酗酒或吸毒，但人们对酒精对艾滋病毒健康的影响知之甚少。 受到多种滥用药物影响的感染者。该提案是乌干达提案的一部分 俄罗斯波士顿酒精网络艾滋病毒/艾滋病酒精研究合作 (URBAN ARCH) 该联盟的目标是检查酒精对艾滋病毒的影响并减轻其影响 危害。该提案的目的是准确描述人们的饮酒情况及其后果 受多种物质影响的艾滋病毒感染者，并实施观察和干预研究 了解并减少酒精的危害。该提案有 3 个具体目标： 1) 扩大并继续 现有队列建立由 250 名 HIV 感染男性和女性组成的纵向波士顿 ARCH 队列 受到多种物质的影响——一系列饮酒，并且所有物质依赖或注射 药物使用。 2) 用一种药物治疗酗酒和阿片类药物依赖。治疗方法 阿片类药物对抗乙醇风险 (TWOFER) 试验将评估高剂量丁丙诺啡 (32 毫克) 是否可以减少重度酒精中毒 在一项随机双盲安慰剂对照试验中，与 3 个月时的标准剂量（16 毫克）饮酒相比 一项针对 100 名患有阿片类药物依赖和酗酒的 HIV 感染成人队列参与者的试验。如果 有效的丁丙诺啡是一种治疗阿片类药物依赖的药物，可以作为一种治疗方法轻松传播 对于艾滋病毒感染者和阿片类药物依赖者的不健康饮酒，唯一的剂量调整是 必需的。 3) 因为酒精、阿片类药物的使用、艾滋病毒感染和抗逆转录病毒治疗可能会影响骨骼健康和 增加骨折风险，队列数据分析将确定饮酒的独立影响 骨矿物质密度和微结构的变化（通过高分辨率计算机断层扫描） 前瞻性地在 12-42 个月内对所有队列参与者进行研究。该队列将产生有关酒精影响的数据 骨，定义艾滋病毒感染者危险饮酒量和提供建议的重要信息 他们了解与酒精相关的风险。因此，这些研究将为缓解 酒精对受多种物质影响的艾滋病毒感染者的影响。 相关性（参见说明）： 艾滋病毒疾病可以有效治疗，但饮酒过多会干扰治疗并导致骨质流失， 尤其是那些滥用其他药物的人。这项研究将研究艾滋病毒感染者 发现多少酒精会增加骨折的风险，并查看药物是否用于药物 成瘾也可以减少酗酒。研究结果将有助于向艾滋病毒感染者提供相关建议 限制饮酒以防止骨折，并可能找到一种新的治疗方法来减少饮酒和改善健康。 项目/绩效 StTE(S)（如果需要额外空间，请使用项目/绩效 项目/绩效地点 主要位置 组织名称：波士顿医疗中心 邓白氏：00-549-2160 街道 1：波士顿医疗中心一号广场 街道 2： 城市： 波士顿 县： 萨福克 省份： 国家： 美国