In 1998, we were awarded an RO-1 (DA11602) from NIDA to conduct a longitudinal study in HIV-infected persons who have a history of illicit drug use (DU). The major aims of that study were to develop a longitudinal cohort of HIV-infected patients in medical care in order to characterize utilization of the new highly active antiretroviral drug therapies (HAART), and assess the effect of these therapies on HIV disease progression in DUs. We established a comprehensive longitudinal clinic-based cohort of over 4600 HIV infected persons; half of who have a history of DU. Our research suggests that DUs have not received the same level of benefit from HAART as non-DUs. Prior to HAART, there was little difference between DUs and non-DUs in HIV progression. Our research has shown that active DU is a barrier to receiving and adhering to HAART, and achieving effective viral and immunologic improvement on HAART. We hypothesize that the early differences that have emerged between DUs and non-DUs will substantially widen over the next 5 years as HIV resistance to current drugs increases, toxicity limits the use of therapy, and viral hepatitis along with other medical consequences of DU further increase the burden of morbidity. Because of HAART, HIV is now a chronic illness, and DUs have numerous barriers to stable, chronic disease management. We are optimally situated to assess the core factors that impede successful HIV management as the HAART era matures over the next 5 years, and are submitting a new proposal for a competitive continuing RO-I. We propose the following aims, consistent with our overarching goal of improving the outcomes of HIV infection in DUs: 1) Evaluate virologic, immunologic and clinical HIV disease progression for up to 10 years, 2) Assess the impact of viral hepatitis coinfection, 3) Assess other medical consequences of DU including bacterial infection and STDs, 4) Assess adverse effects of HIV therapy. We offer a productive resource to address our aims that is unique in scope and size, cost-efficient in conducting research, highly relevant to the HIV epidemic as it effects DUs, and fully operational from our prior R01. ? ?
| Grover, Surbhi; Desir, Fidel; Jing, Yuezhou et al. (2018) Reduced Cancer Survival Among Adults With HIV and AIDS-Defining Illnesses Despite No Difference in Cancer Stage at Diagnosis. J Acquir Immune Defic Syndr 79:421-429 |
| Yanik, Elizabeth L; Hernández-Ramírez, Raúl U; Qin, Li et al. (2018) Brief Report: Cutaneous Melanoma Risk Among People With HIV in the United States and Canada. J Acquir Immune Defic Syndr 78:499-504 |
| Altekruse, Sean F; Shiels, Meredith S; Modur, Sharada P et al. (2018) Cancer burden attributable to cigarette smoking among HIV-infected people in North America. AIDS 32:513-521 |
| AIDS-defining Cancer Project Working Group of IeDEA, COHERE in EuroCoord (2018) Non-Hodgkin lymphoma risk in adults living with HIV across five continents. AIDS 32:2777-2786 |
| Elion, Richard A; Althoff, Keri N; Zhang, Jinbing et al. (2018) Recent Abacavir Use Increases Risk of Type 1 and Type 2 Myocardial Infarctions Among Adults With HIV. J Acquir Immune Defic Syndr 78:62-72 |
| Gonsalves, Gregg S; Paltiel, A David; Cleary, Paul D et al. (2017) A Flow-Based Model of the HIV Care Continuum in the United States. J Acquir Immune Defic Syndr 75:548-553 |
| Muzaale, A D; Althoff, K N; Sperati, C J et al. (2017) Risk of End-Stage Renal Disease in HIV-Positive Potential Live Kidney Donors. Am J Transplant 17:1823-1832 |
| Anderegg, Nanina; Johnson, Leigh F; Zaniewski, Elizabeth et al. (2017) All-cause mortality in HIV-positive adults starting combination antiretroviral therapy: correcting for loss to follow-up. AIDS 31 Suppl 1:S31-S40 |
| Fritz, Cristin Q; Blevins, Meridith; Lindegren, Mary Lou et al. (2017) Comprehensiveness of HIV care provided at global HIV treatment sites in the IeDEA consortium: 2009 and 2014. J Int AIDS Soc 20:20933 |
| Drozd, Daniel R; Kitahata, Mari M; Althoff, Keri N et al. (2017) Increased Risk of Myocardial Infarction in HIV-Infected Individuals in North America Compared With the General Population. J Acquir Immune Defic Syndr 75:568-576 |
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