The International URBAN Alcohol Research Collaboration on HIV/AIDS (ARCH) Center

摘要 全球四分之一的人口感染了结核分枝杆菌， 发展活动性结核病和死亡，特别是艾滋病毒感染者。酒精使用 越来越多的人认识到，结核病是结核病流行的驱动因素，可能是减轻艾滋病毒/结核病的重要手段 发病率和死亡率。结核病预防性治疗（TPT）是预防结核病进展的重要方法。 潜伏性结核感染到活动性结核病。然而，TPT不能预防新的或重复的结核感染，因此， 饮酒的艾滋病毒携带者感染结核病的风险可能仍然增加，即使在接受TPT治疗后。重 饮酒在艾滋病毒感染者中很常见。虽然活动性结核病的风险增加， 归因于酒精相关的免疫抑制导致潜伏性结核病再激活，酒精使用在 获得新的或重复的TB感染和TPT后进展为活动性TB疾病尚未广泛 检查，包括艾滋病毒携带者。那些完成结核病治疗的人有广泛的结核病后发病率， 死亡率几乎高出四倍重度饮酒和艾滋病毒在促进肺部疾病中的作用 结核病治疗后的情况尚不清楚。国际乌干达俄罗斯波士顿酒精网络的中心目标 酒精研究合作艾滋病毒/艾滋病（URBAN艾滋病）中心是研究酒精使用的作用， 新的结核病的获得，TPT后活动性结核病的发生，以及感染者中的结核病后肺部疾病。 这一新的知识将使未来的干预措施的发展，可以减少酒精对结核病的影响， 艾滋病毒/艾滋病感染者的相关发病率和死亡率。该中心将由4个组成部分（行政 核心，生物统计和数据管理[BDM]核心，乌干达项目，俄罗斯项目），将工作 协同实现以下主要目标：1）检查酒精使用在驾驶中的作用 乌干达艾滋病病毒携带者TPT后获得新的结核感染和活动性结核病的发生 （乌干达项目）。这一新知识将为潜在的新干预措施提供信息，以降低结核病感染风险 和活动性疾病; 2）确定酒精使用和肺部疾病治疗后的关系， 艾滋病毒携带者和艾滋病患者中的活动性结核病，并定性评估调整酒精和吸烟干预措施的因素 在PLWH（俄罗斯项目）的结核病治疗环境中; 3）进行高质量的数据管理， 艾滋病毒/酒精研究的统计分析（BDM核心）; 4）促进多学科国际合作 促进创新和严格的艾滋病毒/酒精研究（行政核心）;以及5）提供持续培训 并指导将初级和中级职业研究人员培养成艾滋病毒/酒精研究的未来领导者 （行政核心）。国际城市规划中心的结构将确保有效的 行政和科学整合广泛的活动，旨在协同发展该领域 艾滋病毒/酒精/结核病的预防和治疗。

ABSTRACT One quarter of the global population is infected with the bacillus Mycobacterium tuberculosis and is at risk of developing active tuberculosis (TB) disease and death, especially persons living with HIV (PLWH). Alcohol use is increasingly being recognized as a driver of the TB epidemic, and may be a vital means to mitigate HIV/TB morbidity and mortality. TB preventive therapy (TPT) is an important approach in preventing the progression of latent TB infection to active TB disease. However, TPT does not prevent new or repeat TB infection, thus PLWH who drink alcohol may remain at increased risk for TB acquisition, even after receipt of TPT. Heavy alcohol use is common among persons living with HIV (PLWH). While the increased risk for active TB is attributed to alcohol-related immunosuppression leading to latent TB re-activation, the role of alcohol use in acquiring new or repeat TB infection and progression to active TB disease after TPT has not been extensively examined, including among PLWH. Those who complete TB treatment have extensive post-TB morbidity and almost a 4-fold higher risk of mortality. The role of both heavy alcohol use and HIV in promoting lung disease after TB treatment is not clear. The central goal of the International Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Center is to examine the role of alcohol use on new TB acquisition, occurrence of active TB disease after TPT, and post-TB lung disease among PLWH. This new knowledge will enable future development of interventions that can reduce alcohol’s impact on TB- related morbidity and mortality among PLWH. The Center will be comprised of 4 components (Administrative Core, Biostatistics and Data Management [BDM] Core, Uganda Project, Russia Project) that will work synergistically to accomplish the following primary objectives: 1) Examine the role of alcohol use in driving the acquisition of new TB infection and the occurrence of active TB disease after TPT in PLWH in Uganda (Uganda Project). This new knowledge will inform potential new interventions to reduce risk of TB acquisition and active disease; 2) Determine the relationship between alcohol use and lung disease after treatment for active TB disease among PLWH and qualitatively evaluate factors to tailor alcohol and smoking interventions in the setting of TB treatment in PLWH (Russia Project); 3) Conduct high quality data management and statistical analyses for HIV/alcohol research (BDM Core); 4) Foster multidisciplinary international collaborations to promote innovative and rigorous HIV/alcohol research (Administrative Core); and 5) Provide ongoing training and mentoring to develop junior and mid-career investigators into future leaders in HIV/alcohol research (Administrative Core). The structure of the International URBAN ARCH Center will ensure effective administrative and scientific integration of a broad range of activities designed to synergistically grow the field of HIV/alcohol/TB prevention and treatment.