HIV-1 & HIV-2 CO-INFECTI0N: NEUROLOGICAL PROGRESSION

描述(由申请人提供)：本申请的主要目的是 目的：探讨神经内分泌性和非神经内分泌性疾病的患病率和进展。 印度南部与艾滋病毒感染相关的神经系统并发症。这个 第一例HIV感染病例是在1987年由基督教医学会报道的 学院，(CMC)Vellore，印度，这项拟议的研究项目的地点。完毕 多年来，艾滋病毒感染一直在侵略性地传播，据估计 印度至少有410万艾滋病毒感染者。据估计， 在接下来的5-10年里，印度的感染人数可能 超越当今全世界的盛行，构成一个国际化的 公共卫生威胁。令人惊讶的是，高达25%的感染者 印度有HIV-1和HIV-2的混合感染。 感染后，艾滋病毒立即越过血脑屏障，成为 在海马体中有很高的浓度，并对变量 在大脑的其他区域获得学位。因为海马体扮演着重要的角色 在调节各种内分泌系统、记忆和其他神经系统中的作用 函数，此应用程序建议纵向调查 这些系统中与疾病进展相关的异常的流行率 HIV-1和HIV-2混合感染以及HIV-1或HIV-2单一感染的情况 CMC的集水区。这项研究将跟踪N=240人；HIV-1/2 混合感染，N=60；HIV-1+，N=60；HIV-2+，N=60；HIV血清阴性 个人，N=60人。男性和女性，年龄在20-45岁之间，都将被登记和跟踪 最长3年，每隔6个月。内分泌异常 系统将通过去甲肾上腺素、肾上腺素、促肾上腺皮质激素和皮质醇进行研究。 对α-肾上腺素能刺激的反应，AM和PM血浆水平 内分泌和脑脊液中的细胞因子和激素水平。使用路径分析 程序，内分泌功能将作为进展的中介进行测试 神经精神病学和神经心理学损伤的诊断 标准化认知测试电池。 这些数据将对设计干预措施和制定 有效的健康政策。

DESCRIPTION (Provided by applicant): The main objective of this application is to investigate the prevalence and progression of neuroendocrinologic and neurological complications associated with HIV-infection in South India. The first case of HIV-infection was reported in1987 from the Christian Medical College, (CMC) Vellore, India the site of this proposed research project. Over the years, HIV-infection has spread aggressively and there are estimated to be at least 4.1 million HIV-infected individuals in India. It is estimated that during the next 5-10 years the number of infected individuals in India may exceed the present prevalence of the entire world and pose an international public health threat. Surprisingly, up to 25 percent of infected individuals in India have co-infections of both HIV-1 and 2. Immediately after infection, HIV crosses the blood-brain-barrier and is localized in very high concentrations in the hippocampus and to variable degrees in other areas of the brain. Since the hippocampus plays an important role in regulating various endocrine systems, memory and other neurological functions, this application proposes to investigate longitudinally the prevalence of abnormalities in these systems as associated with the progression of HIV-1 & HIV-2 co-infection as well as with HIV-1 or HIV-2 mono-infections in the catchment area of CMC. This study will follow N= 240 individuals; HIV-1/2 co-infected, N= 60; HIV-1+, N=60; HIV-2+, N=60; and HIV-seronegative individuals, N=60. Both men and women, age 20-45, will be enrolled and followed for up to 3 years at six -month intervals. Abnormalities in the endocrine systems will be investigated via norepinephrine, epinephrine, ACTH and cortisol responses to an alpha-adrenergic challenge, AM and PM plasma levels of endocrines and CSF levels of cytokines and hormones. Using path analytic procedures, endocrine functions will be tested as mediators of the progression of neuropsychiatric and neuropsychology impairments determined using standardized cognitive test batteries. The data will be useful in designing interventions and for instituting an effective health policy.