2/3 COMpAAAS Tripartite: ART-CC, KP, and VA

2/3 COMPAAAS 三方：ART-CC、KP 和 VA

• 批准号: 10242196
• 负责人: Derek D Satre
• 金额: $ 57.31万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10242196
• 关键词: Address; Adult; Affect; Age; Aging; Alcohol abuse; Alcohol consumption; Alcohols; American; Anti-Retroviral Agents; Award; Biological Markers; Birth; California; Caring; Clinical; Cocaine; Cohort Studies; Collaborations; Country; Data; Data Set; Drug Interactions; Drug usage; Electronic Health Record; Europe; European; Gender; Goals; Grant; HIV; HIV Infections; HIV-1; HIV/HCV; Health; Healthcare Systems; Hepatitis C; Hospitalization; Individual; Infection; Intervention; 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; Preventive care; Preventive healthcare; Protocols documentation; RNA; Race; Reporting; Research; Risk; Sample Size; Sampling; Site; 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; alcohol use disorder; antiretroviral therapy; base; cohort; comorbidity; data cleaning; data exchange; data format; data sharing; drinking; frailty; improved outcome; innovation; member; men; men who have sex with men; mortality; phosphatidylethanol; prospective; smoking intervention; substance use; therapy design; therapy development; tobacco exposure

PROJECT SUMMARY/ABSTRACT HIV+ 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 expands the sample of uninfected comparators, a critically important group if we are to understand how alcohol differentially affects biomedical outcomes in HIV. KP will be able to identify demographically-matched uninfected comparators from their Northern California region. A new VA sample of veterans born in 1945-1965 (Birth Cohort) expands access to Hepatitis C infected (HCV+) and women comparators. The tripartite group will also participate in an HIV+ substudy (n=2250), The Medications, Alcohol, Substance Use in HIV Study (MASH), in which new data on potentially inappropriate medications (PIMS) and biomarkers for alcohol and substances (tobacco, marijuana, opioids, cocaine, and methamphetamine) will be collected. As the lead site for Aim 2, KP will examine the impact of alcohol and smoking on HIV outcomes, preventive care, and medical comorbidities. We anticipate that among HIV+ individuals, hazardous alcohol use, alcohol use disorders and smoking will negatively impact each of these outcomes; and that these effects will be amplified in HIV+ individuals compared with uninfected individuals. Initially, analyses will use electronic health record data including self-reported alcohol and substance use. 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. This application addresses key interactions between alcohol and tobacco use, antiretrovirals, and medications that may increase mortality, hospitalization, frailty, and adversely impact preventive health care. We anticipate findings may lead to innovative intervention development, such as combined alcohol, smoking and preventive care interventions.

项目摘要/摘要 由于艾滋病毒感染、共病(包括丙型肝炎)，喝酒的成年人生理上已经很虚弱 感染)、多药联用和相关物质使用。在这种情况下，酒精的生物医学后果 使用可以发生在适度使用的情况下，并且经常不被赏识或被错误地归类。“改善财团” 艾滋病毒/艾滋病、酒精、衰老和多种物质的结果“(COMpAAAS)得到NIH/NIAAA奖的支持 U24AA020794要在单个样本中研究这一问题，退伍军人老龄化队列研究(Vacs)(~50,000艾滋病毒+ 美国退伍军人在人口统计上与约100,000名未感染的参照者匹配)。Vacs将聘请一名直属 酒精生物标记物(磷脂酰乙醇[PEH]和生理脆弱的有效量度(Vacs指数)。在……里面 这套三个应用程序，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 扩大未受感染的对照样本，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。KP将能够识别与人口统计相匹配的 来自他们北加州地区的未受感染的参照者。1945-1965年出生的退伍军人的新样本 (出生队列)扩大了获得丙型肝炎病毒感染者(丙型肝炎病毒+)和妇女参照者的机会。三方小组 还将参加HIV+子研究(n=2250)，即药物、酒精、物质使用在HIV中的研究 (MASH)，其中关于潜在不适当药物(PIMS)和酒精和生物标志物的新数据 将收集烟草、大麻、类阿片、可卡因和甲基苯丙胺等物质。作为销售线索站点 对于目标2，KP将研究酒精和吸烟对艾滋病毒结局、预防性护理和医疗的影响 合并症。我们预计在HIV+的个人中，危险的酒精使用，酒精使用障碍和 吸烟将对这些结果产生负面影响；这些影响在HIV+中将被放大 与未感染的个体进行比较。最初，分析将使用电子健康记录数据 包括自己报告的酒精和药物使用情况。分析将在最后一年重复进行，以修正 根据MASH结果，自我报告的酒精和物质使用方面的偏差。与RFA一致，所有 赠款贡献了所有目标的数据，具有相同的目标和协议。此应用程序解决了关键字 酒精和烟草使用、抗逆转录病毒药物和可能增加死亡率的药物之间的相互作用， 住院，虚弱，并对预防性卫生保健产生不利影响。我们预计调查结果可能会导致 创新干预发展，如酒精、吸烟和预防保健联合干预。

项目成果

Cardiovascular Disease Risk Factor Control in People With and Without Human Immunodeficiency Virus.

感染和未感染人类免疫缺陷病毒的人的心血管疾病危险因素控制。

• DOI: 10.1093/cid/ciad728
• 发表时间: 2024
• 期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
• 作者: Silverberg,MichaelJ;Levine,ToryM;Lea,AlexandraN;Williams,AndrewE;Alexeeff,StaceyE;Bryant,Kendall;Cavassini,Matthias;Flamm,JasonA;Hare,CBradley;Ingle,SuzanneM;Justice,AmyC;Lam,JenniferO;Sterling,StacyA;Horberg,Michael
• 通讯作者: Horberg,Michael

Health System-Based Unhealthy Alcohol Use Screening and Treatment Comparing Demographically Matched Participants With and Without HIV.

• DOI: 10.1111/acer.14481
• 发表时间: 2020-12
• 期刊: Alcoholism, clinical and experimental research
• 作者: Silverberg MJ;Levine-Hall T;Hood N;Anderson AN;Alexeeff SE;Lam JO;Slome SB;Flamm JA;Hare CB;Ross T;Justice AC;Sterne JAC;Williams AE;Bryant KJ;Weisner CM;Horberg MA;Sterling SA;Satre DD
• 通讯作者: Satre DD