HIV-1 Infection in Methamphetamine Abusers: Endocrine Outcomes

描述（由申请人提供）：HIV-1感染与内分泌系统的不良后果相关。非法药物滥用是感染艾滋病毒-1的一个主要危险因素，也与内分泌异常有关。包括我们在内的几项研究报告了药物滥用HIV-1+个体的内分泌异常加剧。但这些调查是在可卡因和/或阿片类药物成瘾者中进行的，美国的药物滥用文化正在发生变化。甲基苯丙胺（冰毒）正在成为全国各地的首选毒品，在南佛罗里达，尤其是男男性接触者滥用冰毒的情况急剧上升。然而，关于甲基苯丙胺对HIV-1感染中内分泌的影响的研究很少。据推测，在HIV-1阳性的滥用冰毒的男男性行为者中，肾上腺活性会增加，甲状腺会亢进，胰岛素抵抗的发生率也会增加。为了检验这些假设，这项为期5年的申请计划调查三组共450名男性的肾上腺、甲状腺和胰岛素活性：HIV-1+冰毒滥用者（n=150）， HIV-1-冰毒滥用者（n=150）， HIV-1-非冰毒滥用者（n=150），分布在非洲裔美国人、白种人和西班牙裔美国人中。由于计划将重点放在男男性行为者身上，因此只有男性将被纳入研究。目的1：研究甲基苯丙胺滥用-HIV-1+男男性接触者、甲基苯丙胺滥用-HIV-1 -男男性接触者和HIV-1-无甲基苯丙胺对照者的肾上腺活性（ACTH和皮质醇水平）以及对地塞米松- crh联合刺激的反应。目的2：探讨甲基苯丙胺滥用-HIV-1+男男性行为者、甲基苯丙胺滥用-HIV-1 -男男性行为者和无甲基苯丙胺滥用者的甲状腺活性（TSH、T4和T3）和甲状腺抗体水平。目的3：探讨冰毒滥用- hiv -1阳性男男性行为者的胰岛素活性；滥用冰毒的HIV-1- MSM和HIV-1无冰毒对照参与者。这些内分泌紊乱可能给滥用冰毒的男男性行为者带来许多严重的医疗后果和后果的巨大负担，并进一步允许制定适当的干预措施。

DESCRIPTION (provided by applicant): HIV-1 Infection is associated with adverse outcomes in endocrine systems. Illicit drug abuse is a major risk factor for contracting HIV-1 infection and is also associated with abnormal endocrine outcomes. Several studies including ours have reported exacerbated endocrine abnormalities among drug abusing HIV-1+ individuals. But these investigations have been carried out among cocaine and/or opioids addicts, and the culture of drug abuse in the United States is changing. Methamphetamine (meth) is becoming a drug of choice all over the country and its abuse in South Florida particularly among MSM has skyrocketed. There is, however, a scarcity of investigations on the impact of methamphetamine on endocrines in HIV-1 infection. It is hypothesized that adrenal activity will be increased, there will be a hyper activity of thyroid as well as an increased incidence of insulin resistance, among HIV-1+ meth abusing MSM. In order to test these hypotheses, this 5 year application proposes to investigate cross sectionally adrenal, thyroid, and insulin activity in a total of 450 men in three groups: HIV-1+ meth abusers (n=150), HIV-1- meth abusers (n=150), HIV-1 - non-meth abusers (n=150) distributed among African Americans, Caucasians, and Hispanics. Because of the planned focus on MSM, only men will be included in the study. The following are aims: Aim 1: To investigate adrenal activity (ACTH and cortisol levels) as well as response to the combined dexamethasone-CRH challenge among meth abusing-HIV-1+ MSM, meth abusing HIV-1- MSM and HIV-1- meth-free control participants. Aim 2: To investigate thyroid activity (TSH, T4 and T3) as well as thyroid antibodies among meth abusing-HIV-1+ MSM, meth abusing HIV-1- MSM and HIV-1- meth-free control participants. Aim 3: To explore insulin activity among meth abusing-HIV-1+ MSM; meth abusing HIV-1- MSM and HIV-1- meth-free control participants. These endocrine disturbances may lead to enormous burden of a number of serious medical consequences and outcomes in meth abusing MSM and further allow developing suitable interventions. PUBLIC HEALTH RELEVANCE: Methamphetamine (meth) abuse particularly among MSM in South Florida has skyrocketed. Although endocrine outcomes in HIV-1 infection as well as drug abusers with HIV- 1 infection have been investigated, there is scarcity of information regarding such outcomes in HIV-1+ meth abusing MSM. This proposal investigates adrenal, thyroid and insulin activities in this population. It is proposed that adverse endocrine outcomes may result in an enormous medical burden.