Khat Chewing: Its Association with HIV Status and CD4 T Cells

描述（由申请人提供）：埃塞俄比亚有一个爆炸性的艾滋病毒/艾滋病流行病，估计患病率为3.5%。最近有证据表明，当地种植和广泛使用的一种毒品-阿拉伯茶与性活动和无保护的性行为有关。此外，阿茶的使用可能与艾滋病毒阴性者的CD 4 T细胞增加有关。拟议的研究将是一个横断面调查，在三个自愿测试中心设在埃塞俄比亚的阿迪斯。本研究的主要研究目的是（1）通过定性方法描述埃塞俄比亚成年自愿咨询和检测（VCT）客户中阿茶的使用模式，（2）检查埃塞俄比亚成年VCT客户中阿茶使用与艾滋病毒状况之间的关联，以及（3）检查经常使用阿茶与艾滋病毒阴性个体中CD 4 T细胞之间的关联，在控制烟草使用之后。在拟议研究的头几个月，将进行深入访谈和焦点小组讨论，以指导问卷的编制和解决第一个研究问题。随后将利用自愿咨询和检测中心，通过与18-44岁的同意受试者进行面对面访谈进行调查。还将采集尿液和血液样本，以分别测量阿拉伯茶暴露量和CD 4 T细胞数量。在埃塞俄比亚，艾滋病毒感染人口排名第五，重要的是要知道咀嚼阿拉伯茶的习惯与疾病的传播有何联系。阿拉伯茶的使用很普遍（流行率为30-50%），它深深植根于埃塞俄比亚的社会和文化传统。这项研究的信息可以帮助艾滋病毒/艾滋病政策制定者和方案解决习惯性使用阿拉伯茶的问题，作为预防流行病传播的干预措施的一部分。这种调查的结果也将提高我们的理解如何卡塔叶可能发挥作用，在确定CD 4 T细胞计数在艾滋病毒阴性的个人。 项目叙述：更好地了解阿茶使用与艾滋病毒感染状况之间的关系，有助于艾滋病毒/艾滋病政策制定者和方案解决阿茶使用问题，以防止这一流行病的传播。此外，CD 4 T细胞已被用作感染HIV的个体的免疫状态的量度。在感染艾滋病毒的患者中观察到的许多免疫紊乱与感染过程中CD 4 T细胞计数和百分比的下降有关;如果在艾滋病毒阳性个体中，嚼阿拉伯茶者与非嚼阿拉伯茶者具有不同的CD 4 T细胞特征，则他们可能需要不同的管理指南来预防机会性感染或抗逆转录病毒治疗。

DESCRIPTION (provided by applicant): Ethiopia has an explosive HIV/AIDS epidemic with an estimated prevalence of 3.5%. There has been recent evidence that khat (Catha edulis), a locally grown and widely used drug, is associated with sexual activity and unprotected sex. In addition, khat use may be associated with an increase in CD4 T cells in HIV negative individuals. The proposed research will be a cross-sectional survey in three voluntary testing centers located in Addis Ababa, Ethiopia. The main research aims for this study are (1) to describe the pattern of khat use among adult Voluntary Counseling and Testing (VCT) clients in Ethiopia, through qualitative methods, (2) to examine the association between khat use and HIV status among adult VCT clients in Ethiopia, and (3) to examine the association between frequent khat use and CD 4 T cells in HIV negative individuals, after controlling for tobacco use. In depth interviews and focus groups will be conducted in the first few months of the proposed study to guide the development of a questionnaire and address the first research question. This will be followed by survey implemented through face-to-face interviews with consenting subjects aged 18-44, utilizing the VCT centers. Urine and blood samples will also be collected to measure khat exposure and quantity CD4 T cells respectively. In Ethiopia, which has the 5th largest HIV infected population, it will be important to know how khat chewing habit is linked to the spread of the disease. The use of khat is widespread (30-50% prevalence) and it has deep roots in the social and cultural tradition of Ethiopia. Information from this study can aid HIV/AIDS policy makers and programs to address the habitual use of khat as part of intervention efforts in preventing the spread of the epidemic. The outcome of such an investigation will also enhance our understanding of how khat may play a role in determining CD4 T cell count in HIV negative individuals. Project Narrative: A better understanding of the association between khat use and HIV status can aid HIV/AIDS policy makers and programs to address khat use in preventing the spread of the epidemic. In addition, CD4 T cells have been used as a measure of immune status in individuals infected with HIV. Many of the immunological disturbances observed among patients infected with HIV are related to the decline in CD4 T cell counts and percentage during the course of infection; if among HIV positive individuals, khat chewers have a different CD 4 T cell profile than non- chewers, they may require different management guidelines for chemoprophylaxis of opportunistic infections or antiretroviral therapy.