HIV-infected drug users may be at heightened risk for impaired glucose tolerance and type 2 diabetes mellitus in association with protease inhibitor (PI) therapy and co-infection with hepatitis C virus (HCV). To address these issues, the candidate proposes a five-year prospective study of 300 individuals with or at risk for HIV infection in order to examine the associations of HIV, PI therapy, and HCV infection with impaired glucose tolerance and type 2 diabetes. By nesting this study in two ongoing longitudinal studies of drug users in the Bronx, NY, the candidate will benefit from an extensive database and an established research infrastructure as well as the guidance of a group of experienced independent investigators.
The specific aims of the project are: 1. To determine the prevalence of and factors associated with impaired glucose tolerance and type 2 diabetes in HIV-infected drug users, including PI therapy, HCV infection, sociodemographics, body mass index, and family history of diabetes. 2. To determine prospectively the impact of HIV infection, PI therapy, and HCV infection on the incidence of impaired glucose tolerance and type 2 diabetes. At semi-annual research visits, participants will undergo standardized interviews to assess sociodemographics, medical history, and drug use behavior, measurement of height, weight, and waist/hip ratio, and blood tests for CD4+ count, HIV viral load, HCV antibody, and HCV RNA level. In addition, fasting lipid profiles and body composition analysis using dual x-ray absorptiometry will be obtained. Oral glucose tolerance tests will be performed annually to screen for impaired glucose tolerance and diabetes. Active surveillance for clinical disease events will also be performed. The candidate's long term career goal is to become an independent investigator of HIV epidemiology in drug users. To achieve this goal, she will work closely with a multidisciplinary group of mentors with expertise in research related to HIV, diabetes, hepatitis C, and substance abuse. She will also complete coursework in the conduct of diabetes-related clinical research, addiction medicine, and the responsible conduct of research.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA015003-02
Application #
6703642
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Khalsa, Jagjitsingh H
Project Start
2003-02-01
Project End
2008-01-31
Budget Start
2004-02-01
Budget End
2005-01-31
Support Year
2
Fiscal Year
2004
Total Cost
$136,400
Indirect Cost
Name
Montefiore Medical Center (Bronx, NY)
Department
Type
DUNS #
041581026
City
New York
State
NY
Country
United States
Zip Code
10467
Polsky, Sarit; Floris-Moore, Michelle; Schoenbaum, Ellie E et al. (2011) Incident hyperglycaemia among older adults with or at-risk for HIV infection. Antivir Ther 16:181-8
Howard, Andrea A; Hoover, Donald R; Anastos, Kathryn et al. (2010) The effects of opiate use and hepatitis C virus infection on risk of diabetes mellitus in the Women's Interagency HIV Study. J Acquir Immune Defic Syndr 54:152-9
Howard, Andrea A; Lo, Yungtai; Floris-Moore, Michelle et al. (2007) Hepatitis C virus infection is associated with insulin resistance among older adults with or at risk of HIV infection. AIDS 21:633-41
Floris-Moore, Michelle; Howard, Andrea A; Lo, Yungtai et al. (2007) Hepatitis C infection is associated with lower lipids and high-sensitivity C-reactive protein in HIV-infected men. AIDS Patient Care STDS 21:479-91
Howard, A A; Floris-Moore, M; Lo, Y et al. (2006) Abnormal glucose metabolism among older men with or at risk of HIV infection. HIV Med 7:389-96
Howard, Andrea A; Floris-Moore, Michelle; Arnsten, Julia H et al. (2005) Disorders of glucose metabolism among HIV-infected women. Clin Infect Dis 40:1492-9