3/3 COMpAAAS Tripartite: ART-CC, KP, and VA

3/3 COMpAAAS 三方：ART-CC、KP 和 VA

• 批准号: 10238904
• 负责人: Amy Caroline Justice
• 金额: $ 51.92万
• 依托单位: YALE UNIVERSITY
• 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/10238904
• 关键词: Address; Adult; Affect; Age; Aging; Alcohol abuse; Alcohol consumption; Alcohols; American; Anti-Retroviral Agents; Award; Biological Markers; Birth; Caring; Clinical; Cocaine; Cohort Studies; Collaborations; Country; Data; Data Set; Drug Interactions; Drug usage; Europe; European; Gender; Goals; HIV; HIV Infections; HIV-1; HIV/HCV; Health; Healthcare Systems; Hepatitis C; Hospitalization; Individual; Infection; Lead; Malignant Neoplasms; Marijuana; Measurement; 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; Preventive care; Protocols documentation; RNA; Race; Reporting; Research; Risk; Role; 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; comorbidity; data cleaning; data exchange; data format; data sharing; drinking; frailty; improved outcome; indexing; member; men; men who have sex with men; mortality; prospective; public health relevance; smoking intervention; substance use; therapy design; tobacco exposure

Abstract HIV infected adults who drink alcohol 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 at lower risk use and may be 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). 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 intervention design and implementation. Together we will study biomedical consequences of alcohol and associated substance use in HIV extending the scope and generalizability of VACS from a single national healthcare system to 12 systems across 10 North American and European countries, doubling the HIV+ sample and substantially increasing the diversity of subjects. Importantly, COMpAAAS Tripartite also extends the pool of uninfected comparators (more women, young patients, and HCV+) available for analyses, a critical step if we are to understand how alcohol differentially affects individual biomedical outcomes by HIV status by gender, age, and HCV status. Using propensity and related methods and variables tailored to each aim and hypothesis, we will closely match HIV+ subjects with uninfected comparators drawing from 3.7 million KP members (1.9 million women) and 5 million veterans born in 1945-1965 (Birth Cohort, includes 450,000 HCV+). ART-CC, KP, and VA will also participate in an HIV+ substudy (n=2250), The Medications, Alcohol, Substance use in HIV Study (MASH), involving new, prospective data on potentially inappropriate medications (PIMS) and direct biomarker measurements for alcohol and associated substances (tobacco, marijuana, opioids, cocaine, and methamphetamine). ART-CC, KP and VA have identical aims and protocols and contribute and share data. Aims compare HIV infected and uninfected individuals and address: 1) attributable risk from alcohol and tobacco for all cause and cause specific hospitalization and mortality; 2) the impact of alcohol and tobacco on primary and secondary preventative care; and 3) the role of alcohol and ART on drug interactions (potentially inappropriate medications) leading to adverse biomedical consequences. VA will coordinate sharing limited data sets based on the HIV Cohorts Data Exchange Protocol (HICDEP) a standardized format for data sharing. Standardized methods for data cleaning, imputation, and analyses will be employed.

抽象的 饮酒的艾滋病毒感染成年人由于艾滋病毒感染和合并症而生理上已经很虚弱 （包括丙型肝炎感染）、多重用药和相关物质使用。在这种背景下，生物医学 饮酒的后果可能会在较低风险的情况下发生，并且可能不被重视或被错误归因。这 支持“改善艾滋病毒/艾滋病、酒精、衰老和多种物质结果联盟”(COMpAAAS) NIH/NIAAA 授予 U24AA020794 奖项，用于在单一样本（退伍军人老龄化队列研究）中研究这个问题 （VACS）。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 Permanente (KP) 团队作为 COMpAAAS 三方加入退伍军人医疗保健系统 (VA) 团队：ART-CC、 KP 和 VA。我们的长期目标是为干预措施的设计和实施提供信息。我们将一起学习 酒精和相关物质使用对艾滋病毒的生物医学影响扩大了范围和 VACS 从单一国家医疗保健系统扩展到北美 10 个地区的 12 个系统的通用性 和欧洲国家，将 HIV+ 样本增加一倍，并大幅增加受试者的多样性。 重要的是，COMpAAAS Tripartite 还扩大了未感染比较者的范围（更多女性、年轻 患者和 HCV+）可用于分析，如果我们要了解酒精如何差异化，这是关键的一步 HIV 状况、性别、年龄和 HCV 状况影响个体生物医学结果。使用倾向和 针对每个目标和假设量身定制的相关方法和变量，我们将把 HIV+ 受试者与 未感染的比较对象来自 370 万 KP 成员（190 万女性）和 500 万出生的退伍军人 1945-1965 年（出生队列，包括 450,000 HCV+）。 ART-CC、KP 和 VA 也将参加 HIV+ 子研究 (n=2250)，艾滋病毒研究中的药物、酒精、物质使用 (MASH)，涉及新的、 潜在不适当药物 (PIMS) 的前瞻性数据和直接生物标志物测量 酒精和相关物质（烟草、大麻、阿片类药物、可卡因和甲基苯丙胺）。艺术CC， KP 和 VA 具有相同的目标和协议，并贡献和共享数据。目的比较 HIV 感染者和 未感染的个人并解决：1）各种原因造成的酒精和烟草的可归因风险 具体住院情况和死亡率； 2）烟酒对中小学的影响 预防性护理； 3) 酒精和抗逆转录病毒疗法对药物相互作用的作用（可能不恰当） 药物）导致不良的生物医学后果。 VA 将协调共享有限的数据集 HIV 队列数据交换协议 (HICDEP) 是一种数据共享的标准化格式。标准化 将采用数据清理、估算和分析方法。