Hitting the Half-Way Mark with ADEPTT, St PETER, and 4-F
In this edition of the URBAN ARCH Newsletter, as a preview for our 2019 URBAN ARCH Annual Meeting, we will highlight study updates from our three cohorts that make up URBAN ARCH. These studies guide our HIV/alcohol research and allow for new work examining comorbidities such as frailty & falls, cardiovascular disease, and Tuberculosis (TB) that are common among people living with HIV (PLWH). A primary aim of these studies is to advance URBAN ARCH’s mission to conduct interdisciplinary research aimed at understanding how alcohol use impacts people living with HIV and to develop interventions to reduce alcohol use as well as alcohol and HIV-related consequences in this population.
Uganda ARCH: ADEPTT Trial
TB Preventative Therapy for HIV-Infected Alcohol Users in Uganda: An Evaluation of Safety, Tolerability and Adherence
Principal Investigator: Dr. Judith Hahn
Background and aims:
Tuberculosis (TB) is the leading cause of mortality in persons with HIV. Isoniazid (INH) preventive therapy (IPT) decreases all-cause mortality and active TB in persons with HIV by 30-50% above and beyond the benefits of antiretroviral therapy (ART) alone. Our first aim is to evaluate the safety and tolerability within each regimen and by level of alcohol use. Our second aim is to compare adherence by regimen; we hypothesize that adherence will be greater in the 3HR arm (3 months of daily INH plus rifampicin) compared to the 6H arm (6 months of daily INH).
Recruitment:
6 & 12 Month Follow-up Completion:
Baseline Characteristics:
Conference Abstracts and Presentations:
Metagenomic Analyses of the Gut-Microbial Dysbiosis among HIV Infected Heavy Drinkers (Barve). Oral Presentation, RSA 2019.
Russia ARCH: St PETER RCT
Targeting HIV-Comorbidities with Pharmacotherapy to Reduce Alcohol and Tobacco Use in HIV-Infected Russians
Principal Investigator: Dr. Jeffrey Samet, Dr. Matthew Freiberg, Dr. Hilary Tindle
Background and aims:
HIV-positive heavy drinking smokers are at high risk for coronary heart disease (CHD) and death. Our specific aims will compare effects of varenicline, cytisine, and nicotine replacement therapy (NRT) at 3 months on past month % heavy drinking days and alcohol craving, cigarettes per day and smoking abstinence (verified by carbon monoxide), inflammation (hsCRP, IL-6), CHD (Reynolds risk score), and mortality (VACS index) risk.
Recruitment:
6 & 12 Month Follow-up Completion:
Baseline Characteristics:
Conference Abstracts and Presentations:
Lodi S, Freiberg M, Gnatienko N, Blokhina E, Yaroslavtseva T, Krupitsky E, Samet J, Cheng D. Per-protocol analysis of the ZINC trial using causal interference methods. To be presented by Dr. Sara Lodi at the International Workshop on HIV and Hepatitis Observational Databases, 28th – 30th March, 2019, Athens, Greece.
Factors Associated with Elevated Transaminases in People Living with HIV on Anti-Retroviral Therapy in Uganda Who Drink and Do Not Drink Alcohol (Hahn). Oral Presentation, RSA 2019.
Boston ARCH: 4F Study
Alcohol and HIV-Associated Comorbidity and Complications: Frailty, Functional Impairment, Falls, and Fractures (The 4F Study)
Principal Investigator: Dr. Richard Saitz
Background and aims:
Up to a third of middle-aged people living with HIV infection (PLWH) experience falls each year. This study aims to 1) Test the associations between alcohol (and illicit drugs and polypharmacy) and falls (fractures secondarily); and 2) Test the associations between alcohol and acute healthcare utilization (emergency department use and hospitalization for falls and fractures).
Recruitment:
6 & 12 Month Follow-up Completion:
Baseline Characteristics:
Conference Abstracts and Presentations:
Polysubstance use patterns and HIV disease severity among those with substance use disorder: Latent class analysis (Bertholet et al.) Oral Presentation, CPDD 2019.
Substance use and quality of life in an urban cohort of people living with HIV and substance dependence (Rawlins-Pilgrim et al.) Oral Presentation, CPDD 2019.
Symposium accepted at Research Society on Alcoholism (RSA) 2019: “HIV, Alcohol and Comorbidity: From the Microbiome and Immunity to Clinical Outcomes.” Dr. Richard Saitz is organizing the symposium.
Falls In People Living with HIV Infection and Alcohol and Other Drug Use (Saitz). Oral Presentation, RSA 2019.