Impact of Physical Activity Routines and Dietary Intake on the Longitudinal Symptom Experience of the people living with HIV (PROSPER-HIV)

项目摘要/摘要： 艾滋病毒携带者(PLHIV)经历了不成比例的高症状负担(例如，疲劳、失眠、 疼痛)，几乎没有治疗选择。这些症状经常出现，令人痛苦，经常同时出现，并有 对艾滋病病毒的健康和福祉造成重大后果，但我们几乎不知道如何 有效地缓解这些问题。对于症状，非药物治疗方案是非常可取的 在已经经历了多种并存疾病的高服药负担的PLHIV患者中的管理。我们的 研究小组此前曾报道，体力活动和更好的营养与较低的症状有关 艾滋病病毒的强度；但需要更清楚地了解体力活动和饮食的影响 确定这些方法如何减少这一人群中的症状困扰。在这些数据的基础上，这 该项目建议检查两种有前景的非药理学策略的效果，即体力活动 例行公事和饮食摄入，对人类免疫缺陷病毒(PLHIV)(天堂-HIV)的纵向症状体验。 天堂艾滋病毒研究是一项观察性的纵向研究，将利用实质性的 艾滋病研究中心(CFAR)综合临床系统(CNIC)网络的基础设施 检查850例艾滋病病毒感染者四年间的体力活动、饮食模式和症状负担。本研究 将发生在人口统计学上不同的四个艾滋病毒诊所[凯斯西储大学(俄亥俄州克利夫兰)， 阿拉巴马大学伯明翰分校(阿拉巴马州伯明翰)，华盛顿大学(华盛顿州西雅图) 和芬威健康研究所(波士顿，马萨诸塞州)]。天堂-艾滋病毒将克服 之前的研究通过1)登记了人口统计学和地理上不同的、以临床为基础的大样本 PLHIV，2)检查体力活动、饮食摄入量和症状负担随时间的关系， 3)使用预期的、黄金标准的体力活动(即三轴加速度法)和饮食 摄入量(即24小时饮食召回)。拟人化和身体健康因素将被评估为潜在的 体力活动和饮食摄入量对症状负担和强度的中介作用。当我们的目标是 完成后，我们将拥有准确、明确、高质量的数据来描述物理环境的影响 活动和饮食对PLHIV症状的影响。 这些数据可用于临床向艾滋病毒健康护理提供者提供有关体检的反馈 他们的病人的活动量和饮食摄入量。天堂-艾滋病毒研究还将有一个重要的科学 影响，并将告知该研究计划的下一阶段。这些发现将被用来开发一种 以个人为目标，以诊所为基础的干预措施，以改善体力活动和饮食摄入量，最终将 减少艾滋病病毒感染的症状。它们还将被用来检查生物和临床机制， 导致PLHIV所经历的普遍的坚持不懈的症状。因此，拟议的研究可能会 鼓励新的研究，这将对艾滋病病毒的健康和生活质量产生长期影响。

Project Summary/Abstract: People living with HIV (PLHIV) experience a disproportionately high symptom burden (e.g., fatigue, insomnia, pain) with few treatment options. These symptoms are frequent, distressing, often co-occur, and have significant consequences on the health and well-being of PLHIV, yet we know almost nothing about how to effectively mitigate them. Non-pharmacological treatment options are highly desirable for symptom management among PLHIV who already experience a high pill burden from multiple comorbid diseases. Our team previously reported that physical activity and better nutrition were associated with lower symptom intensity in PLHIV; but a clearer understanding of the effects of physical activity and diet is required to determine how these approaches can reduce symptom distress in this population. Building on these data, this project proposes to examine the effect of two promising non-pharmacological strategies, Physical Activity Routines And Dietary Intake, on the longitudinal Symptom Experience of PLHIV (PARADISE-HIV). The PARADISE-HIV study is an observational, longitudinal study that will utilize the substantial infrastructure of the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) to examine physical activity and dietary patterns and symptom burden of 850 PLHIV over four years. This study will occur in four demographically diverse HIV clinics [Case Western Reserve University (Cleveland, Ohio), University of Alabama at Birmingham (Birmingham, Alabama), University of Washington (Seattle, Washington) and Fenway Health Institute (Boston, Massachusetts)]. PARADISE-HIV will overcome the limitations of previous studies by 1) enrolling a large, demographically and geographically diverse, clinic-based sample of PLHIV, 2) examining the relationship between physical activity, dietary intake and symptom burden over time, and 3) using prospective, gold-standard measures of physical activity (i.e., triaxial accelerometry) and dietary intake (i.e., 24-hour diet recalls). Anthropomorphic and physical fitness factors will be assessed as potential mediators of physical activity and dietary intake on symptom burden and intensity. When our aims are accomplished we will have precise, definitive, high-quality data describing the impact of physical activity and diet on symptoms in PLHIV. These data can be used clinically to provide feedback to HIV health care providers on the physical activity and dietary intake of their patients. The PARADISE-HIV study will also have a significant scientific impact and will inform the next phase of this program of research. These findings will be used to develop an individually-targeted, clinic-based intervention to improve physical activity and dietary intake that will eventually reduce symptoms among PLHIV. They will also be used to examine biological and clinical mechanisms that lead to the prevalent unremitting symptoms experienced by PLHIV. Thus, the proposed study is likely to stimulate novel research that will have a long-term impact on the health and quality of life of PLHIV.