Russia ARCH Cohort
Matthew Freiberg, MD, MSc, Co-Investigator
Evgeny Krupitsky, MD, PhD, DMSci, Co-Investigator & PI of Russian Subcontract
Dmitry Lioznov, MD, PhD, Co-Investigator
Elena Blokhina, MD, PhD, Co-Investigator
Edwin Zvartau, MD, PhD, DMSci, Co-Investigator & Russian Project Director
Natalia Gnatienko, MPH
Data from this study are available from our URBAN ARCH Repository.
Tatiana Yaroslavsteva – Russian Project Coordinator
Heavy alcohol consumption in an HIV-infected person may accelerate HIV disease progression and end organ disease with one leading explanatory pathway being via enhanced microbial translocation and inflammation/altered coagulation. Heavy alcohol consumption and HIV infection are both causes of microbial translocation, the process by which bacterial products leak across the gastrointestinal membrane with resultant destructive immune activation. Among HIV-infected people, high levels of microbial translocation (as measured by soluble CD14) and inflammation/altered coagulation (as measured by D- dimer) are each associated with an increased risk of death. Of importance, among HIV-infected persons, heavy drinking is also significantly associated with higher levels of D-dimer in cross-sectional studies. Of note, initiation of antiretroviral therapy (ART) is associated with a reduction in D-dimer levels. Yet the following is not known: is there a longitudinal relationship between alcohol consumption and these biomarkers independent of ART? Answering this question requires a setting with prevalent HIV infection, heavy alcohol use and limited current ART use. As Russia has a relatively young, expanding HIV epidemic, a growing HIV treatment infrastructure and enormous per capita alcohol consumption, St. Petersburg is a setting where this research is possible. Thus, as part of the Uganda, Russia, Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Consortium, we seek to create the Russia ARCH cohort from participants of a recently completed NIAAA-funded randomized controlled trial (RCT) of HIV-infected Russian heavy drinkers and perform an assessment of the longitudinal association between alcohol consumption and biomarkers of microbial translocation (sCD14) and inflammation/altered coagulation (D-dimer).This study will clarify the association between alcohol and key biomarkers overtime in HIV-infected heavy drinkers.