Advancing and applying peripheral and central auditory findings in HIV/AIDS.

在NIH的支持下，Ubongo Sikivu队列的艾滋病毒感染者（PLWH）和未感染对照组 在坦桑尼亚成立，并定期评估他们的周边听力超过10+ 在过去5年中增加了详细的中枢听觉和神经认知评估。本队列 具有独特的地位，以解决PAR-20-127“在全球范围内推进艾滋病毒/艾滋病研究”提出的问题。 NIDCD的使命”。来自该队列的数据已经回答了关于耳毒性的重要问题。 抗逆转录病毒药物，HIV感染和治疗对外周和中枢听力参数的影响， 以及中枢听觉测试（CAT）结果与神经认知能力的关系。使用此 队列纵向询问CAT如何用于预测或跟踪神经认知表现 以及年龄和长期抗逆转录病毒治疗如何影响听觉系统的问题都可以得到解答。迄今为止 最有意义的结果已经证明CAT结果与认知表现相关。这 CAT结果可能有助于预测或跟踪随着时间的推移认知能力的下降。下一个重要 步骤是确定CAT表现的恶化是否先于认知功能的后期发展， PLWH的缺陷，以及中枢听觉测试和其他变量可以预测神经认知缺陷 准确地神经认知筛查测试通常对教育，识字和文化敏感。充分 神经认知测试组合可能很难使用，特别是在发展中国家， 有限，受过训练的人员很少，规范性数据往往不存在。使用CAT将是一个 因为CAT可以很短（间隙检测测试需要5分钟），所以对HIV+患者的随访取得了重大进展。 分钟），易于解释（噪音听力测试和三位数任务涉及识别单词或数字， 背景噪声），或者对于受试者而言毫不费力（FFR测试根本不需要受试者输入）。此项目的 目标是跟踪外周听觉、中枢听觉和神经认知性能随时间的变化轨迹 通过继续跟踪这个群体。有了这些纵向数据，机器学习和其他统计 技术将被应用于评估哪些因素预测认知缺陷的后续发展 以及哪些因素或因素的组合识别出存在神经认知缺陷的人。国际 我们已经组建了一个在PLWH的中枢听觉测试和神经认知测试方面具有经验的团队。博士 Nina Kraus和她的西北大学团队是国际公认的听觉FFR专家。达累斯萨拉姆 萨拉姆团队在耳鼻喉科和外周听觉，中枢听觉， 和神经认知测试Roth和Boivin博士是评估神经认知功能的专家。桂医生 丰富的生物统计学经验。Niemczak博士是外周和中枢听觉处理方面的专家。这 团队和纵向队列提供了独特的能力，以评估使用CAT在评估认知以及 随着年龄的增长和药物对PLWH中枢和外周听觉功能的影响。

With NIH support, the Ubongo Sikivu cohort of both people living with HIV (PLWH) and uninfected controls was established in Tanzania and has had regular assessments of their peripheral hearing ability over 10+ years with detailed central auditory and neurocognitive assessments added over the last 5 years. This cohort is uniquely positioned to address the issues posed by PAR-20-127 “Advancing HIV/AIDS Research within the Mission of the NIDCD.” Data from the cohort has already answered important questions about the ototoxicity of anti-retrovirals, the effects of HIV infection and treatment on both peripheral and central hearing parameters, and the relationship of central auditory test (CAT) results to neurocognitive performance. By following this cohort longitudinally questions about how CATs could be used to predict or track neurocognitive performance and how age and long-term anti-retroviral treatment affect the auditory system can be answered. To date, the most significant result has been demonstrating that CAT results correlate with cognitive performance. This suggests CAT results might be useful for forecasting or tracking cognitive decline over time. The next important steps are determining whether worsening CAT performance precedes the later development of cognitive deficits in PLWH and which central auditory tests and other variables can predict neurocognitive deficits accurately. Neurocognitive screening tests are often sensitive to education, literacy, and culture. Full neurocognitive test batteries can be difficult to employ, particularly in the developing world where clinician time is limited, few trained personnel are available, and normative data often do not exist. Using CATs would be a major advance for following HIV+ patients because the CATs can be short (a gap detection test takes 5 minutes), easy to explain (the hearing-in-noise test and triple digit task involve identifying words or numbers in background noise), or effortless for the subject (the FFR test requires no subject input at all). This project’s goal is tracking the trajectory of peripheral auditory, central auditory, and neurocognitive performance over time by continuing to follow this cohort. With these longitudinal data machine learning and other statistical techniques will be applied to assess which factors forecast the subsequent development of cognitive deficits and which factors or combination of factors identify those with existing neurocognitive deficits. An international team with experience in central auditory testing and neurocognitive testing in PLWH has been assembled. Dr. Nina Kraus and her Northwestern team are internationally recognized experts in the auditory FFR. The Dar es Salaam team has extensive experience in otolaryngology and performing peripheral auditory, central auditory, and neurocognitive tests. Drs. Roth and Boivin are experts in assessing neurocognitive function. Dr. Gui has diverse biostatistical experience. Dr. Niemczak is an expert in peripheral and central auditory processing. This team and longitudinal cohort offer the unique ability to assess the use of CATs in evaluating cognition as well as the effects of aging and medications on both central and peripheral auditory function in PLWH.