HIV1 + IDU's--ENDOCRINE CONSEQUENCES & MEDICAL OUTCOMES

描述：(申请人提供)本申请拟调查 内分泌后果在心理健康发生中的中介作用 在HIV-1+注射吸毒者中发生的结果。注射吸毒(IDU)是 感染人类免疫缺陷病毒I型的主要危险因素， (HIV-1)感染。注射吸毒者各种内分泌系统的异常发展 和HIV-1+注射吸毒者，并可能与心理健康结果的数量有关。我们的 早期的报道表明，ACTH和皮质醇对冷加压的反应 挑战在HIV-1+个体中减弱，因此支持拟议的 假设。一系列结果，包括焦虑、抑郁和感知 HIV-1+患者出现心理困扰和适应压力困难 注射吸毒者。因为艾滋病毒在感染后不久就存在于大脑中，而且 海马区浓度较高，提示不同的内分泌 系统很可能在艾滋病毒-1感染中受到集中的不利影响。它是 重要的是要了解参与发展的机制 神经内分泌异常--中枢或外周--以干预N 与心理健康相关的问题。 这项为期五年的计划调查了甲状腺和性腺对 营养激素、促性腺激素释放激素(TRH)与黄体生成 激素释放激素(LHRH)和肾上腺活性 小剂量ACTH挑战。这项调查将使用 三组交叉设计(HIV-I+1DU，N+100，HIV-1-IDU，N=100， HIV-1-非吸毒者，N=100)，总数N=300，X 3个民族 (非裔美国人、西班牙裔、高加索人)X 2性别(女性和男性)。仅限 那些没有艾滋病定义症状的艾滋病毒血清抗体阳性患者 未接受三联疗法治疗的患者将被纳入，因为 三联疗法对内分泌系统的影响目前尚不清楚。它是 建议调查内分泌反应是否与心理健康有关 结果(即抑郁、焦虑和感知的心理痛苦)。 这些数据将有助于设计适当的干预措施。

DESCRIPTION: (provided by applicant) This application proposes to investigate the mediating role of endocrine consequences on the occurrence of mental health outcomes that take place among HIV-1+ IDUs. Injecting drug use (IDU) is one of the major risk factors for contracting human-immunodeficiency virus, type-i, (HIV-1) infection. abnormalities in various endocrine systems develop in IDUs and HIV-1+IDUs and may be associated with number of mental health outcomes. Our earlier reports show that the ACTH and cortisol responses to a cold pressor challenge are attenuated in HIV-1 + individuals and, thus, support the proposed hypothesis. An array of outcomes including, anxiety, depression, and perceived psychological distress and difficulty adapting to stressors occurs in HIV-1 + IDUs. Since HIV is present in the brain soon after infection and esides in very high concentrations in the hippocampus, it is proposed that different endocrine systems are likely to be adversely impacted centrally in HIV-1 infection. It is important to understand the mechanisms involved in the development of neuroendocrine abnormalities - central or peripheral - in order to intervene n mental health-related problems. This five-year proposal investigates the responses of the thyroid and gonads to trophic hormones, hyroid releasing hormone (TRH), and luteinizing hormone-releasing hormone (LHRH), as well as adrenal Aictivity in response to a low-dose ACTH challenge. This investigation will be carried out using a crossectional three-group design (HIV-i+ lDUs, N+1OO, HIV-1- IDUs, N=100, and HIV-1- non-IDUs, N=100) with the total N = 300, X 3 ethnicitlies (African-Americans, Hispanics, Caucasians) X 2 genders (Women and Men). Only those HIV seropostiive subjects who do not have AIDS-defining symptoms and are not being treated with triple-drug therapy will be enrolled since the effect of triple-drug therapy on the endocrine system is unknown at this time. It is proposed to investigate whether the endocrine responses nediate mental health outcomes (i.e., depression, anxiety, and perceived psychological distress). These data will be useful in designing suitable interventions.