NEUROPROTECTION WITH SELENIUM THERAPY IN HIV+ IDUS

hiv疾病的主要神经精神并发症是认知运动障碍，据报道，HIV-1血清阳性吸毒者发生hiv相关痴呆的风险更高，神经功能障碍进展更快。可导致神经元变性的氧化应激在HIV-1疾病中增加，并且似乎因滥用药物而增强。这项辅助研究的主要目的是确定补充硒（一种保护细胞免受氧化损伤所需的生物抗氧化剂）是否可以为hiv - 1血清阳性慢性吸毒者提供神经保护并帮助维持认知功能。补充硒已被证明可以改善艾滋病毒/艾滋病患者的氧化防御系统，并抑制神经系统患者的精神退化。我们对HIV- 1感染吸毒者的初步调查表明，低水平的硒与精神表现下降有关，短期补充硒可以改善精神功能和情绪状态。这些数据表明，服用硒可能是防止认知能力丧失的有效策略。我们建议扩展目前nida资助的临床试验，“硒治疗减缓HIV+ IDUs的疾病进展”，以比较硒或安慰剂对神经心理功能的影响。同意hiv - 1感染的吸毒者（n=120）将在母体研究的基线访问时入组，在补充之前，每6个月进行一次社会心理和认知电池治疗，持续30个月。药物使用、营养、免疫、氧化应激和健康状况数据将由父母研究在与认知和社会心理电池访问时收集，并提供给拟议的项目。这两项研究之间没有直接的科学重叠。拟议的合作和具有成本效益的研究提供了一个独特的机会，以进一步了解滥用药物的HIV-1血清阳性男性和女性的神经心理功能，并为管理HIV-1疾病的认知障碍提供必要的重要信息。

The major neuropsychiatric complication in HIV-disease is cognitive-motor impairment, with HIV-1 seropositive drug users reported to be at higher risk for the development of HIV-associated dementia and more rapid progression in neurologic disability. Oxidative stress, which can lead to neuronal degeneration, is increased in HIV-1 disease and appears to be potentiated by drugs of abuse. The primary objective of this ancillary study is to determine whether supplementation with selenium, a biologic antioxidant that is required for protecting cells from oxidative damage, can provide neuroprotection and help maintain cognitive function in HIV-l seropositive chronic drug users. Supplementation with selenium has been shown to improve oxidative defense systems in HIV/AIDS patients, and inhibit mental deterioration in neurologic patients. Our preliminary investigations in HIV- l infected drug users indicate that low levels of selenium are associated with decreased mental performance, and that short-term selenium supplementation results in a strong potential for improvement in mental function and mood state. These data suggest that administration of selenium may be an effective strategy to prevent loss of cognitive ability. We propose to extend our currently NIDA-funded, clinical trial, "Selenium Therapy to Slow Disease Progression in HIV+ IDUs", to compare the effects of selenium or placebo on neuropsychological function. Consented HIV-l infected drug users (n=120) will be enrolled at the baseline visit of the parent study, prior to supplementation, and administered a psychosocial and cognitive battery every 6 months for 30 months. Drug use, nutritional, immunologic, oxidative stress, and health status data will be collected by the parent study at the same visit as the cognitive and psychosocial battery, and made available for the proposed project. There is no direct scientific overlap between the two studies. The proposed collaborative and cost-effective research provides a unique opportunity to further our understanding of neuropsychological function in HIV-l seropositive men and women who abuse drugs, as well as provide important information necessary for the management of cognitive impairment in HIV-1 disease.