Nutritional Status In HIV Hispanic Drug Abusers

描述(由申请人提供)：Bienestar研究是一项纵向队列研究，研究药物滥用对感染艾滋病毒的拉美裔人的营养状况和结局的影响。该队列由3个组组成：艾滋病毒+吸毒者、艾滋病毒+吸毒者和艾滋病毒+非吸毒者。努力的重点将是扩大和维持这一独特的群体。随着艾滋病毒成为一种慢性病，这一竞争性更新中涉及的新假设反映了当前的趋势。肝脏疾病是艾滋病毒患者越来越常见的并发症。虽然人们普遍认为，在艾滋病毒感染中，丙型肝炎病毒是导致肝脏疾病的主要原因，但研究表明，药物滥用本身也是丙型肝炎病毒携带者患肝病的危险因素。动物研究表明，可卡因可通过诱导氧化应激和组织损伤而导致肝脏毒性。美国东北部的拉美裔人比其他种族优先注射可卡因，因此可能面临更高的氧化应激和肝功能障碍的风险。血清抗氧化剂微量营养素水平低在吸毒者中很常见，进一步增加了氧化组织损伤的风险。这项研究建议检查感染艾滋病毒的西班牙裔药物滥用者的抗氧化状态、氧化应激和肝功能障碍。有4个具体目标：1)研究药物滥用类型(可卡因与海洛因)和滥用频率与血浆抗氧化能力和氧化应激之间的关系。他们特别感兴趣的是了解可卡因和海洛因在改变抗氧化能力和引起氧化应激方面的能力是否不同；2)检查药物滥用的类型和频率与肝功能障碍之间的联系。如果可卡因或海洛因对肝脏组织造成氧化应激，这可能会导致可检测到的肝功能变化；3)检查氧化损伤和肝功能障碍之间的联系。氧化应激和肝功能障碍之间的联系将意味着药物滥用通过涉及氧化应激的机制改变肝功能；以及4)检查艾滋病毒感染、丙型肝炎病毒感染和饮酒对具体目标1至3中描述的相关性的影响。这将确定药物滥用是否是肝功能障碍的独立风险因素，或者是否像酒精一样，是艾滋病毒和/或丙型肝炎感染者肝功能障碍的加速剂。拟议的研究将建立在Bienestar研究(NIDA DA 11598)和Bienestar-微量营养素研究(NIDA DA 14501)的基础上。

DESCRIPTION (provided by applicant): The BIENESTAR study is a longitudinal cohort study of the effect of drug abuse on nutritional status and outcomes among Hispanics with HIV infection. The cohort is comprised of 3 groups: HIV+ drug abusers, HIV- drug abusers, and HIV+ non-drug abusers. Efforts will focus on expanding and maintaining this unique cohort. New hypotheses addressed in this competitive renewal reflect current trends, as HIV becomes a chronic disease. Liver disease is an increasingly common complication in patients with HIV. While it is generally accepted that HCV is largely responsible for liver disease in HIV infection, studies suggest that drug abuse itself is a risk factor for liver disease among persons with HCV. Animal studies have shown that cocaine can cause liver toxicity by the induction of oxidative stress with tissue damage. Hispanics of the NE USA preferentially inject cocaine more than other races, and therefore may be at increased risk of oxidative stress and liver dysfunction. Low serum antioxidant micronutrient levels are common in drug abusers, further increasing the risk of oxidative tissue damage. This study proposes to examine antioxidant status, oxidative stress, and liver dysfunction in Hispanic drug abusers with HIV infection. There are 4 specific aims: 1) To examine the association between the type (cocaine versus heroin) and frequency of drug abuse with plasma antioxidant capacity and oxidative stress. The specific interest is to know if cocaine differs from heroin in its ability to alter antioxidant capacity and cause oxidative stress; 2) To examine the association between the type and frequency of drug abuse and liver dysfunction. If cocaine or heroin cause oxidative stress to hepatic tissues this may result in detectable alterations in liver function; 3) To examine the association between oxidative damage and liver dysfunction. An association between oxidative stress and liver dysfunction will imply that drug abuse alters liver function through a mechanism involving oxidative stress; and 4) To examine the influence of infection with HIV, infection with HCV, and alcohol consumption on the associations described in specific aims 1 to 3. This will determine if drug abuse is an independent risk factor for liver dysfunction or whether, like alcohol, it is an accelerator of liver dysfunction in persons with HIV and/or HCV infection. The proposed study will build on the infrastructure of the BIENESTAR study (NIDA DA 11598) and the BIENESTAR-micronutrient study (NIDA DA 14501).