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

摘要 喝酒的感染艾滋病毒的成年人由于艾滋病毒感染，共病，生理上已经很虚弱 (包括丙型肝炎感染)、多药联用和相关物质使用。在这种情况下，生物医学 酒精使用的后果可能发生在风险较低的使用中，并且可能未被认识到或被错误地归类。这个 “改善艾滋病毒/艾滋病、酒精、老龄化和多种物质结果的联盟”(COMpAAAS)得到支持 由NIH/NIAAA颁发的U24AA020794奖以单一样本研究这一问题，退伍军人老龄化队列研究 (Vacs)。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干预设计和实施提供信息。我们将一起学习 在艾滋病毒中使用酒精和相关物质的生物医学后果扩大了范围和 将Vacs从一个国家医疗保健系统推广到10个北美的12个系统 和欧洲国家，将艾滋病毒样本增加一倍，并大幅增加研究对象的多样性。 重要的是，COMpAAAS三方还扩大了未感染的对照对象池(更多的女性，年轻的 患者和丙型肝炎病毒)可供分析，这是我们要了解酒精如何区分 通过性别、年龄和丙型肝炎病毒感染状况影响个体的生物医学结果。使用倾向性和 根据每个目标和假设量身定做相关方法和变量，我们将密切匹配艾滋病毒受试者 未受感染的对照人员来自370万金伯利进程成员(190万妇女)和500万出生的退伍军人 1945-1965年(出生队列，包括450,000丙型肝炎病毒)。ART-CC、KP和VA也将参与HIV 子研究(n=2250)，药物、酒精、物质在艾滋病毒中的使用研究(MASH)，涉及新的， 潜在不适当药物(PIMS)的预期数据和直接生物标记物测量 酒精及相关物质(烟草、大麻、类阿片、可卡因和甲基苯丙胺)。艺术-CC， 金伯利进程和退伍军人事务部有相同的目标和协议，并贡献和共享数据。目标是比较感染艾滋病毒和 未受感染的个人和地址：1)所有原因和原因的酒精和烟草的归因风险 具体住院时间和死亡率；2)烟酒对原发和继发疾病的影响 预防性护理；以及3)酒精和ART在药物相互作用中的作用(可能不适当 药物)导致不利的生物医学后果。VA将协调共享有限的数据集，基于 关于艾滋病毒群体数据交换协议(HICDEP)，这是一种数据共享的标准化格式。标准化 将使用数据清理、推算和分析的方法。

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.