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

描述（申请人提供）：本申请的主要目的是 研究神经内分泌和 与印度南部艾滋病毒感染相关的神经系统并发症。的 1987年，基督教医疗中心报告了第一例艾滋病毒感染病例。 学院，（CMC）韦洛雷，印度的网站，这一拟议的研究项目。超过 这些年来，艾滋病毒感染迅速蔓延，据估计， 印度至少有410万艾滋病毒感染者。据估计 在未来5-10年内，印度的感染人数可能会增加， 超过了目前整个世界的流行程度，构成了一个国际 公共健康威胁。令人惊讶的是，在美国， 印度同时感染HIV-1和2。 感染后，艾滋病毒立即穿过血脑屏障， 在海马体中有很高的浓度， 在大脑的其他区域。由于海马体在大脑中起着重要的作用， 在调节各种内分泌系统、记忆和其他神经系统中的作用 功能，本申请建议纵向调查 这些系统异常的患病率与进展相关 HIV-1和HIV-2合并感染以及HIV-1或HIV-2单一感染， CMC的集水区。本研究将随访N= 240例HIV-1/2患者 合并感染，N= 60; HIV-1+，N=60; HIV-2+，N=60;和HIV血清阴性 个体，N=60。年龄在20-45岁之间的男性和女性都将被招募并随访 每隔六个月进行一次为期三年的培训。内分泌失调 将通过去甲肾上腺素、肾上腺素、ACTH和皮质醇研究系统 对α-肾上腺素能激发的反应，AM和PM的血浆水平 内分泌和CSF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介质进行检测 神经精神和神经心理学损伤 标准化认知测试组合。 这些数据将有助于设计干预措施和建立一个 有效的卫生政策。

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.