The relationship of smoking and unhealthy alcohol use to HIV care retention and viral suppression: findings from a multi-site cohort study.

Objectives: Tobacco smoking and alcohol use may negatively influence HIV care, but associations have not been examined across cohorts.

Design: Multisite international collaboration of cohort studies.

Methods: People with HIV (PWH) were included from 11 cohorts; 5 North American and 6 Western European.

Comparison of 2 electronic health record data extraction methods for laboratory tests used in the Veterans Aging Cohort Study Index.

Objective: To compare Observational Medical Outcomes Partnership (OMOP) Logical Observation Identifiers Names and Codes (LOINC) and Veterans Aging Cohort Study (VACS) methods for extracting laboratory chemistry data from Veterans Health Administration (VA) electronic health records (EHR).

Materials And Methods: Laboratory chemistry test results for 16 laboratory tests commonly assess in Veterans in VACS HIV ( = 143 830) followed in the VA 2015-2019 were extracted from the EHR and compared using 2 different data extraction approaches.

Results: The LOINC approach captured laboratory results from all 130 VA stations for all 16 labs.

Cannabis Use Disorder Among People With and Without HIV.

Objectives: In the United States, adults aged 65 and older are the fastest-growing age group using cannabis. People living with HIV (PLWH) are an aging population with prevalent cannabis use exceeding the general population. We examined cannabis use disorder (CUD) diagnoses from 2000 to 2022, by age, race/ethnicity, sex, comorbidity, and HIV status.

Multi-ancestry genome-wide association study of topiramate's effects on heavy alcohol use.

Background: Topiramate reduces alcohol consumption in individuals who drink heavily. Candidate gene studies aimed at identifying genetic variants that predict topiramate's effects on drinking have yielded inconsistent findings. To identify genetic variation associated with treatment response, we conducted a genome-wide association study (GWAS) among participants in the Million Veteran Program (MVP) who initiated topiramate treatment.

Domain Shift Analysis in Chest Radiographs Classification in a Veterans Healthcare Administration Population.

This study aims to assess the impact of domain shift on chest X-ray classification accuracy and to analyze the influence of ground truth label quality and demographic factors such as age group, sex, and study year. We used a DenseNet121 model pre-trained MIMIC-CXR dataset for deep learning-based multi-label classification using ground truth labels from radiology reports extracted using the CheXpert and CheXbert Labeler. We compared the performance of the 14 chest X-ray labels on the MIMIC-CXR and Veterans Healthcare Administration chest X-ray dataset (VA-CXR).

Glucagon-like peptide-1 receptor agonists, but not dipeptidyl peptidase-4 inhibitors, reduce alcohol intake.

BACKGROUNDDespite growing preclinical evidence that glucagon-like peptide1 receptor agonists (GLP-1RAs) could be repurposed to treat alcohol use disorder (AUD), clinical evidence is scarce. Additionally, the potential impact of dipeptidyl peptidase-4 inhibitors (DPP-4Is) on alcohol intake is largely unknown.METHODSWe conducted a large cohort study using 2008-2023 electronic health records data from the U.

The Association of Anemia on Non-AIDS-Defining Cancer and Subsequent Survival Among People With HIV After Antiretroviral Initiation.

Background: The association of anemia as a predictive and prognostic indicator of non-AIDS-defining cancer (NADC) among people with HIV (PWH) remains unknown. We evaluated the presence of anemia and its severity as a predictor of NADC and 5-year all-cause survival after an NADC diagnosis among PWH who had initiated antiretroviral therapy.

Setting: North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

Cannabis Use and Self-Reported Bothersome Symptoms in People with HIV.

Objective: While cannabis use is common among people with HIV (PWH), there have been few studies examining the association of use with health outcomes among PWH. We aimed to evaluate the association between cannabis use and bothersome physical and mental health symptoms using both self-report and a direct biomarker for cannabis use.

Method: The Medications, Alcohol and Substance use in HIV Study (MASH) is a cross-cohort study focused on polypharmacy and substance use among PWH.

Genome-wide association study of prostate-specific antigen levels in 392,522 men identifies new loci and improves prediction across ancestry groups.

We conducted a multiancestry genome-wide association study of prostate-specific antigen (PSA) levels in 296,754 men (211,342 European ancestry, 58,236 African ancestry, 23,546 Hispanic/Latino and 3,630 Asian ancestry; 96.5% of participants were from the Million Veteran Program). We identified 318 independent genome-wide significant (P ≤ 5 × 10) variants, 184 of which were novel.

Comparative Performance of Machine Learning Models in Reducing Unnecessary Targeted Prostate Biopsies.

Background And Objective: Conventional core needle biopsy for prostate cancer diagnosis can lead to diagnostic uncertainty and complications, prompting exploration of alternative risk assessment approaches that use clinical and imaging features. Our aim was to evaluate the effectiveness of machine learning (ML) models in reducing unnecessary biopsies.

Methods: We conducted a retrospective analysis of data for 1884 patients across two academic centers who underwent prostate magnetic resonance imaging and biopsy between 2016 and 2020 or 2004 and 2011.

Corrigendum: Combining Charlson comorbidity and VACS indices improves prognostic accuracy for all-cause mortality for patients with and without HIV in the Veterans Health Administration.

[This corrects the article DOI: 10.3389/fmed.2023.

Utility of Candidate Genes From an Algorithm Designed to Predict Genetic Risk for Opioid Use Disorder.

Importance: Recently, the US Food and Drug Administration gave premarketing approval to an algorithm based on its purported ability to identify individuals at genetic risk for opioid use disorder (OUD). However, the clinical utility of the candidate genetic variants included in the algorithm has not been independently demonstrated.

Objective: To assess the utility of 15 genetic variants from an algorithm intended to predict OUD risk.

Epigenome-Wide and Methylation Risk Score Analysis of Body Mass Index Among People with HIV.

People with HIV (PWH) on antiretroviral therapy (ART) often gain weight, which increases their risk of type 2 diabetes and cardiovascular disease. The role of DNA methylation (DNAm) markers in obesity among PWH is understudied. This research explores the relationship between body mass index (BMI) and epigenetic patterns to better understand and manage obesity-related risks in PWH.

Effectiveness of dolutegravir-based regimens compared to raltegravir-, elvitegravir-, bictegravir, and darunavir-based regimens among older adults with HIV in the Veterans Aging Cohort Study (VACS).

Background: Real-world data on treatment patterns and clinical outcomes for newer drugs, including integrase strand transfer inhibitors, among older people with human immunodeficiency virus (PWH) are limited.

Methods: This cohort study included PWH enrolled in the Veterans Aging Cohort Study (VACS) who were prescribed a standard 3-drug antiretroviral therapy (ART) regimen containing dolutegravir (DTG), bictegravir (BIC), cobicistat boosted elvitegravir (EVG), raltegravir (RAL), or darunavir/ritonavir (DRV) plus 2 nucleoside reverse transcriptase inhibitors between January 1, 2014, and March 31, 2020, and who were ≥50 years at regimen initiation. The association between regimen and virologic effectiveness or discontinuation was assessed using logistic regression models with inverse probability of treatment weights.

Multiomic Network Analysis Identifies Dysregulated Neurobiological Pathways in Opioid Addiction.

Background: Opioid addiction is a worldwide public health crisis. In the United States, for example, opioids cause more drug overdose deaths than any other substance. However, opioid addiction treatments have limited efficacy, meaning that additional treatments are needed.

A Mendelian randomization study of alcohol use and cardiometabolic disease risk in a multi-ancestry population from the Million Veteran Program.

Background: Observational studies link moderate alcohol consumption to reduced risk of cardiometabolic diseases, including coronary heart disease (CHD) and type 2 diabetes mellitus (T2D). Mendelian randomization (MR) studies suggest that these associations are due to confounding. We present observed and genetically proxied associations between alcohol consumption and the incidence of CHD and T2D among African Americans (AA), European Americans (EA), and Hispanic Americans (HA) from the Million Veteran Program.

A landmark federal interagency collaboration to promote data science in health care: Million Veteran Program-Computational Health Analytics for Medical Precision to Improve Outcomes Now.

Objectives: In 2016, the Department of Veterans Affairs (VA) and the Department of Energy (DOE) established an Interagency Agreement (IAA), the Million Veteran Program-Computational Health Analytics for Medical Precision to Improve Outcomes Now (MVP-CHAMPION) research collaboration.

Materials And Methods: Oversight fell under the VA Office of Research Development (VA ORD) and DOE headquarters. An Executive Committee and 2 senior scientific liaisons work with VA and DOE leadership to optimize efforts in the service of shared scientific goals.

Risk Score for Hepatocellular Cancer in Adults Without Viral Hepatitis or Cirrhosis.

Importance: Hepatocellular carcinoma (HCC) is typically detected only at advanced stages when treatment options are limited. Most of the current HCC risk models focus on patients with viral hepatitis or diagnosed cirrhosis or require variables not routinely available in clinical care.

Objective: To identify modifiable HCC risk factors in the general population and to develop a risk score to inform HCC screening and risk-factor modification interventions for high-risk individuals without viral hepatitis or decompensated cirrhosis.

Using Phosphatidylethanol as an Adjunct to Self-Reported Alcohol Use Improves Identification of Liver Fibrosis Risk.

Introduction: Accurate assessment of alcohol use informs prevention and management of liver disease. We examined whether phosphatidylethanol (PEth, an alcohol metabolite) blood concentrations are associated with liver fibrosis risk independently of self-reported alcohol use, among persons with and without HIV.

Methods: We pooled individual-level data from 12 studies from the United States, Russia, Uganda, and South Africa with PEth, Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and fibrosis-4 (FIB-4) measurements.

The Feasibility and Acceptability of a Clinical Pharmacist-delivered Intervention to Reduce Bothersome Health Symptoms from Polypharmacy and Alcohol Use and Communicate Risk among People with HIV: Pilot Study Protocol.

Among persons with HIV (PWH), unhealthy alcohol use and polypharmacy contribute to bothersome symptoms (e.g., fatigue, dizziness, memory loss).