The impact of alcohol consumption on TB treatment outcomes
The impact of alcohol consumption on TB treatment outcomes
批准号:
9103779
负责人:
Karen R Jacobson
金额:
$69.84万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2016
资助国家:
美国
项目状态:
已结题
起止时间:
2016-04-08 至 2021-03-31
关键词:
AIDS/HIV problemAcuteAddressAdherenceAdverse drug effectAffectAftercareAlcohol abuseAlcohol consumptionAlcoholismAlcoholsAnimal ModelAreaArea Under CurveBehaviorBehavioralBiologicalBiological MarkersBiologyBlood specimenBostonBrazilCar PhoneCause of DeathCessation of lifeChestChinaChronicCommunicable DiseasesCommunitiesCommunity WorkersComplexCountryDataDeltastabDiseaseDoseDrug KineticsDrug toxicityEpidemicEthambutolFarming environmentFemaleHIVHealthHigh PrevalenceIncidenceIndiaIndividualInfectionIngestionInterventionInterviewerInvestigationLeadLengthLiver DysfunctionLongitudinal StudiesMeasuresMedical ResearchMedical centerMetabolismMonitorObservational StudyOrganOutcomeOutcome MeasurePathway interactionsPatientsPatternPersonsPharmaceutical PreparationsPharmacodynamicsPopulationPrevalenceProspective StudiesProvincePulmonary TuberculosisPyrazinamideQuestionnairesRecruitment ActivityRegimenRelapseReportingResearch PersonnelRetrospective StudiesRifampinRiskRuralSouth AfricaSouth AfricanSputumSterilizationSystemTechnologyTimeToxic effectTrainingTreatment FailureTreatment outcomeTuberculosisUnited StatesUniversitiesWineabsorptionalcohol misuseattributable mortalitybasebinge drinkingchronic alcohol ingestioncohortfarm workerimprovedinnovationinterdisciplinary approachisoniazidmedical schoolsmedication compliancemortalitynovelphosphatidylethanolprospectivepublic health relevancetreatment adherencetreatment durationtreatment responsetuberculosis drugstuberculosis treatment
中文摘要
英文摘要
DESCRIPTION (provided by applicant): After HIV/AIDS, tuberculosis (TB) remains the second leading cause of death due to an infectious disease globally. Retrospective studies from many countries, including South Africa, have consistently reported that in addition to having a higher burden of TB disease, patients with problem alcohol use have worse TB treatment outcomes, including delayed culture conversion and higher rates of treatment failure, relapse, and death, compared to patients who do not consume alcohol. An estimated 10% of TB deaths are attributable to problematic alcohol use globally. Although one causal pathway to worse TB outcomes is through poor treatment adherence, observational studies and animals models suggest that the relationship between alcohol use and TB treatment outcomes persists after adjustment for suboptimal adherence. One potential biological mechanism is through alcohol's impact on the pharmacokinetics (PK) and pharmacodynamics (PD) of TB drugs. Problem alcohol use may lead to poorer absorption and/or accelerated metabolism of TB drugs, thereby increasing the risk of suboptimal sterilization. There is an urgent need to identify modifiable factors that contribute to poor TB treatment response, and understanding drivers of poor treatment response, both at the individual and population level, is essential for TB control. Investigators at Boston Medical Center (BMC), Boston University School of Medicine (BUSM), the South African Medical Research Council (MRC), and the University of Cape Town (UCT) propose to conduct the first prospective study to attempt to clarify the causal mechanisms underlying the deleterious effects of problem alcohol use on TB treatment outcomes. We plan to recruit 438 culture positive, pulmonary TB patients in Worcester, South Africa, an area highly endemic for both TB and problem alcohol use. The specific aims of this study are: 1) examine the associations between problem alcohol use and TB treatment outcomes, and (ii) demonstrate that these associations persist independent of adherence to TB treatment, and 2) to evaluate the effect of problematic alcohol use on the PK/PD of TB drugs. Our multidisciplinary approach will provide the best evidence to date addressing the complex interactions between TB and alcoholism and inform management strategies for countries facing these two epidemics.
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会议论文
Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL)
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批准号:10674749
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项目类别:
-
资助金额:$92.68万
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财政年份:2019
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负责人:Karen R Jacobson
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依托单位:
Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL)
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批准号:10212938
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项目类别:
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资助金额:$62.82万
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财政年份:2019
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负责人:Karen R Jacobson
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依托单位:
Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL)
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批准号:10458601
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项目类别:
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资助金额:$62.59万
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财政年份:2019
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负责人:Karen R Jacobson
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依托单位:
The impact of alcohol consumption on TB treatment outcomes
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批准号:9901424
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项目类别:
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资助金额:$67.3万
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财政年份:2016
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负责人:Karen R Jacobson
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依托单位:
Geospatial clustering and molecular and social epidemiology of drug resistant TB
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批准号:8664054
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项目类别:
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资助金额:$8.85万
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财政年份:2013
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负责人:Karen R Jacobson
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依托单位:
Geospatial clustering and molecular and social epidemiology of drug resistant TB
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批准号:8681578
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项目类别:
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资助金额:$14.34万
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财政年份:2013
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负责人:Karen R Jacobson
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依托单位:
Geospatial clustering and molecular and social epidemiology of drug resistant TB
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批准号:8334634
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项目类别:
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资助金额:$5.41万
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财政年份:2011
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负责人:Karen R Jacobson
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依托单位:
Geospatial clustering and molecular and social epidemiology of drug resistant TB
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批准号:8234217
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项目类别:
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资助金额:$14.26万
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财政年份:2011
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负责人:Karen R Jacobson
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依托单位:
SWG1: HIV/TB Scientific Working Group
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批准号:10454400
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项目类别:
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资助金额:$5.09万
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财政年份:1998
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负责人:Karen R Jacobson
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依托单位:
SWG1: HIV/TB Scientific Working Group
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批准号:10197768
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项目类别:
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资助金额:$3.71万
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财政年份:1998
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负责人:Karen R Jacobson
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依托单位:
海外基金