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 受艾滋病毒感染的成年人饮酒后，由于艾滋病毒感染、共病(包括 丙型肝炎病毒感染)、多药联用和相关物质使用。在这种情况下，生物医学后果 适量饮酒可能会发生酒精使用的情况，而且往往不被赏识或被错误归类。该“财团将 改善艾滋病毒/艾滋病、酒精、衰老和多种物质的结果“(COMpAAAS)由NIH/NIAAA支持 授予U24AA020794以单一样本研究这一问题，即退伍军人老龄化队列研究(Vacs) (大约50,000名艾滋病毒+美国退伍军人与大约100,000名未感染的对照人员在人口统计学上相匹配)。Vacs将聘用 直接酒精生物标记物(磷脂酰乙醇(PEH)和生理脆弱程度的有效测量(VAS) 索引)。在这组三个应用中，抗逆转录病毒治疗队列协作(ART-CC)和Kaiser 永久(KP)团队作为COMpAAAS三方加入退伍军人医疗系统(VA)团队：ART-CC， Kp和VA。我们的长期目标是为酒精干预的设计和实施提供信息。我们在一起 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，扩大 Vacs的范围和推广到北美和欧洲的多种医疗保健系统以及 大幅增加样本规模和艾滋病毒阳性受试者的多样性。重要的是，COMpAAAS三方还 扩大未感染的比较者，如果我们要了解酒精如何 对艾滋病毒的生物医学结果产生不同的影响。金伯利进程将能够从他们的 加利福尼亚州北部地区。出生于1945-1965年的退伍军人的新样本(出生队列) 扩大对感染丙型肝炎病毒(丙型肝炎病毒+)和妇女对照的访问。三方小组还将 参加艾滋病毒+分研究(n=2250)，药物，酒精，艾滋病毒物质使用研究(MASH)， 其中关于潜在不适当药物(PIMS)和酒精和酒精的直接生物标志物的新数据 相关物质(烟草、大麻、类阿片、可卡因和甲基苯丙胺)将有望 收好了。在最初几年，将使用酒精和物质使用情况的自我报告进行分析。有限 将在以下方面使用数据集和统一的数据清理、标准化和归责方法 团队。分析将在最后一年重复，以纠正自我报告的酒精和物质的偏差 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，具有相同的 目标和协议，并共享数据。退伍军人事务部团队将协调数据共享和分析。每位协作者 将负责为一个目标进行分析。在此应用程序中，我们将调查 死亡率、住院率和由VAS指数衡量的生理性脆弱程度增加，可归因于 不同程度的酒精使用，我们将比较艾滋病毒感染人群和未感染人群的结果。