Impaired Glucose Metabolism in HIV-Infected Drug Users

描述（由申请人提供）： 感染艾滋病毒的吸毒者可能与蛋白酶抑制剂（PI）治疗和合并感染丙型肝炎病毒（HCV）相关的葡萄糖耐量受损和2型糖尿病的风险增加。 为了解决这些问题，候选人提出了一项为期五年的前瞻性研究，研究对象为300名HIV感染者或有HIV感染风险的人，以检查HIV、PI治疗和HCV感染与糖耐量受损和2型糖尿病的关系。 通过将本研究嵌套在两项正在进行的纽约州布朗克斯吸毒者纵向研究中，候选人将受益于广泛的数据库和既定的研究基础设施以及一组经验丰富的独立调查人员的指导。 该项目的具体目标是：1。 确定HIV感染吸毒者中糖耐量受损和2型糖尿病的患病率及其相关因素，包括PI治疗、HCV感染、社会人口统计学、体重指数和糖尿病家族史。 2. 前瞻性确定HIV感染、PI治疗和HCV感染对糖耐量减低和2型糖尿病发病率的影响。 在每半年一次的研究访问中，参与者将接受标准化访谈，以评估社会人口统计学，病史和药物使用行为，测量身高，体重和腰/臀比，并进行CD 4+计数，HIV病毒载量，HCV抗体和HCV RNA水平的血液检测。 此外，还将获得空腹血脂谱和使用双能X线吸收测定法进行的身体成分分析。将每年进行口服葡萄糖耐量试验，以筛查葡萄糖耐量受损和糖尿病。 还将对临床疾病事件进行主动监测。 候选人的长期职业目标是成为吸毒者艾滋病毒流行病学的独立调查员。为了实现这一目标，她将与一个多学科的导师小组密切合作，这些导师具有与艾滋病毒，糖尿病，丙型肝炎和药物滥用相关的研究方面的专业知识。 她还将完成糖尿病相关临床研究，成瘾医学和负责任的研究行为的课程。

DESCRIPTION (provided by applicant): HIV-infected drug users may be at heightened risk for impaired glucose tolerance and type 2 diabetes mellitus in association with protease inhibitor (PI) therapy and co-infection with hepatitis C virus (HCV). To address these issues, the candidate proposes a five-year prospective study of 300 individuals with or at risk for HIV infection in order to examine the associations of HIV, PI therapy, and HCV infection with impaired glucose tolerance and type 2 diabetes. By nesting this study in two ongoing longitudinal studies of drug users in the Bronx, NY, the candidate will benefit from an extensive database and an established research infrastructure as well as the guidance of a group of experienced independent investigators. The specific aims of the project are: 1. To determine the prevalence of and factors associated with impaired glucose tolerance and type 2 diabetes in HIV-infected drug users, including PI therapy, HCV infection, sociodemographics, body mass index, and family history of diabetes. 2. To determine prospectively the impact of HIV infection, PI therapy, and HCV infection on the incidence of impaired glucose tolerance and type 2 diabetes. At semi-annual research visits, participants will undergo standardized interviews to assess sociodemographics, medical history, and drug use behavior, measurement of height, weight, and waist/hip ratio, and blood tests for CD4+ count, HIV viral load, HCV antibody, and HCV RNA level. In addition, fasting lipid profiles and body composition analysis using dual x-ray absorptiometry will be obtained. Oral glucose tolerance tests will be performed annually to screen for impaired glucose tolerance and diabetes. Active surveillance for clinical disease events will also be performed. The candidate's long term career goal is to become an independent investigator of HIV epidemiology in drug users. To achieve this goal, she will work closely with a multidisciplinary group of mentors with expertise in research related to HIV, diabetes, hepatitis C, and substance abuse. She will also complete coursework in the conduct of diabetes-related clinical research, addiction medicine, and the responsible conduct of research.