1/3 Collaborative Research in HIV/AIDS, Alcohol, and Related Comorbidities (COMpAAAS) Tripartite: ART-CC, KP, and VA

1/3 HIV/AIDS、酒精和相关合并症的合作研究 (COMpAAAS) 三方：ART-CC、KP 和 VA

• 批准号: 9407827
• 负责人: Margaret May
• 金额: $ 45.68万
• 依托单位: UNIVERSITY OF BRISTOL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-20 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9407827
• 关键词: AIDS/HIV problem; Adult; Affect; Age; Aging; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; American; Award; Biological Markers; Birth; California; Caring; Clinical; Cocaine; Cohort Studies; Collaborations; Comorbidity; Country; Data; Data Set; Drug Interactions; Europe; European; Gender; Goals; Grant; HIV; HIV Infections; HIV-1; HIV/HCV; Health; Healthcare Systems; Hepatitis C; Hospitalization; Individual; Infection; Lead; Malignant Neoplasms; Marijuana; Measurement; Measures; Mediating; Medical; Mental Depression; Methamphetamine; Methods; National Institute on Alcohol Abuse and Alcoholism; North America; Opioid; Outcome; Patient Self-Report; Patients; Pharmaceutical Preparations; Physiological; Polypharmacy; Population; Preventive care; Protocols documentation; RNA; Race; Reporting; Research; Risk; Sample Size; Sampling; Smoking; Standardization; System; Tobacco; Tobacco use; United States National Institutes of Health; Update; Veterans; Woman; alcohol consequences; alcohol exposure; alcohol intervention; alcohol measurement; alcohol risk; antiretroviral therapy; base; cohort; data exchange; data format; data sharing; drinking; frailty; improved outcome; indexing; member; men; men who have sex with men; mortality; phosphatidylethanol; prospective; public health relevance; smoking intervention; therapy design; tobacco exposure

Abstract word count: 424 HIV infected adults who drink are already physiologically frail due to HIV infection, comorbidity (including hepatitis C infection), polypharmacy and associated substance use. In this setting, biomedical consequences of alcohol use can occur with moderate use and are often unappreciated or misattributed. The “Consortium to improve OutcoMes in HIV/Aids, Alcohol, Aging & multi-Substance” (COMpAAAS) is supported by NIH/NIAAA award U24AA020794 to study this issue in a single sample, the Veterans Aging Cohort Study (VACS) (~50,000 HIV+ US veterans demographically matched to ~100,000 uninfected comparators). VACS will employ a direct alcohol biomarker (Phosphatidyl-ethanol (PEth) and a validated measure of physiologic frailty (VACS Index). In this set of three applications, the Antiretroviral Therapy Cohort Collaboration (ART-CC) and Kaiser Permanente (KP) teams join the Veterans Healthcare System (VA) team as COMpAAAS Tripartite: ART-CC, KP, and VA. Our long term goal is to inform alcohol intervention design and implementation. Together we propose to study biomedical consequences of alcohol and associated substance use in HIV extending the scope and generalizability of VACS to multiple healthcare systems in North America and Europe and substantially increasing sample size and diversity of HIV+ subjects. Importantly, COMpAAAS Tripartite also extends uninfected comparators, a critically important group if we are to understand how alcohol may differentially effect biomedical outcomes in HIV. KP will be able to identify appropriate comparators from their Northern California region. A new VA sample of veterans born in 1945-1965 (Birth Cohort) substantially expands access to Hepatitis C infected (HCV+) and women comparators. The tripartite group will also participate in a HIV+ substudy (n=2250), The Medications, Alcohol, Substance Use in HIV Study (MASH), in which new data on potentially inappropriate medications (PIMS) and direct biomarkers for alcohol and associated substances (tobacco, marijuana, opioids, cocaine, and methamphetamine) will be prospectively collected. In initial years, analyses will be conducted using self-report of alcohol and substance use. Limited data sets and uniform methods for data cleaning, standardization, and imputation will be employed across teams. Analyses will be repeated in the final year correcting for biases in self-reported alcohol and substance use based upon MASH results. Consistent with the RFA, all grants contribute data for all aims, have identical aims and protocols, and share data. The VA team will coordinate data sharing and analyses. Each collaborator will be responsible for conducting analyses for one aim. In this application, we will investigate the risk of mortality, hospitalization, and increased physiologic frailty measured by the VACS Index that is attributable to different levels of alcohol use and we will compare these outcomes in HIV-infected and uninfected populations.

摘要字数：424 饮酒的艾滋病毒感染成年人由于艾滋病毒感染已经在生理上虚弱， 丙型肝炎感染）、多种药物和相关物质使用。在这种情况下，生物医学后果 适度饮酒也会导致酒精滥用，而且往往不被重视或被错误归因。"财团， 改善艾滋病毒/艾滋病、酒精、衰老和多种物质结果"（COMpAAAS）由NIH/NIAAA支持 授予U24AA020794在单一样本中研究这个问题，退伍军人老龄化队列研究（VACS） （约50，000名HIV+美国退伍军人在人口统计学上与约100，000名未感染的对照者相匹配）。VACS将采用 直接的酒精生物标志物（磷脂酰乙醇（PEth））和经验证的生理虚弱指标（VACS 索引）。在这三个应用程序中，抗逆转录病毒治疗队列协作（ART-CC）和Kaiser 永久（KP）团队加入退伍军人医疗保健系统（VA）团队作为COMpAAAS三方：ART-CC， kp和vp。我们的长期目标是为酒精干预的设计和实施提供信息。我们一起 建议研究酒精和相关物质使用对艾滋病毒的生物医学后果， VACS在北美和欧洲多个医疗保健系统的范围和可推广性， 大大增加了样本量和HIV+受试者的多样性。重要的是，COMpAAAS三方还 扩展未感染的比较者，如果我们要了解酒精如何 对艾滋病毒的生物医学结果有不同的影响。金伯利进程将能够从其 北方加州地区。一个新的退伍军人样本出生于1945年至1965年（出生队列）， 扩大丙型肝炎感染者（HCV+）和女性对照者的可及性。三方小组还将 参与HIV+子研究（n = 2250），HIV研究中的药物、酒精、物质使用（MASH）， 其中关于潜在不适当药物（PIMS）和酒精直接生物标志物的新数据， 相关物质（烟草，大麻，阿片类药物，可卡因和甲基苯丙胺）将被前瞻性地 收集。在最初几年，将使用酒精和物质使用的自我报告进行分析。有限 数据集和数据清理、标准化和插补的统一方法将在 团队分析将在最后一年重复进行，以纠正自我报告的酒精和物质偏见 根据MASH结果使用。与RFA一致，所有赠款都为所有目标提供数据， 目标和协议，并共享数据。VA团队将协调数据共享和分析。每个协作者 将负责为一个目的进行分析。在本申请中，我们将调查以下风险： 死亡率、住院率和由VACS指数测量的生理虚弱增加， 不同程度的酒精使用，我们将在艾滋病毒感染和未感染人群中比较这些结果。