Functional Neuroimaging of Cognitive Dysfunction in HIV-HCV Co-Infection

描述（由申请人提供）：本研究的目的是调查注射药物滥用者同时感染HIV和丙型肝炎（HCV）的中枢神经系统损伤。该研究将纳入肝脏疾病的生物标志物、最先进的神经影像学方法和神经心理学结果。最近的初步研究，包括我们实验室的数据，表明HIV-HCV合并感染比单独感染任何一种疾病更容易导致神经认知损害。迄今为止进行的研究尚未完全确定共同感染潜在协同效应的机制。此外，这些影响的神经功能基础尚未通过功能或结构神经影像学确定。我们实验室最近的数据表明，在合并感染的个体中，肝脏疾病标志物与认知结果之间存在密切关系，神经影像学异常与认知功能之间也存在密切关系。本研究将扩展这些试点数据，并使用实验室、神经成像和神经认知数据检查合并感染个体的中枢神经系统异常。为了实现这些目标，我们将招募两组活跃的注射药物滥用者，包括：1)30名单HIV感染患者和2)30名HIV- hcv合并感染患者。所有个体都将接受实验室检测，包括肝疾病和周边HIV疾病的评估、功能性MRI、结构神经成像和神经认知评估。这项横断面关联研究将是HIV-HCV合并感染的第一个跨学科方法，并将为这一人群中认知障碍增加的假定机制提供重要见解。

DESCRIPTION (provided by applicant): The purpose of the present study is to investigate CNS injury among injection drug abusers co-infected with HIV and Hepatitis C (HCV). The study will incorporate btomarkers of hepatic disease, state-of-the-art neuroimaging methods, and neuropsychological outcomes. Recent preliminary studies, including data from our lab, indicate that HIV-HCV co-infection is associated with greater neurocognitive compromise than either disease alone. Studies conducted to date have not fully determined the mechanisms underlying the potentially synergistic effect of co-infection. Further, the neurofunctional underpinnings of these effects have not been identified using functional or structural neuroimaging. Recent data from our laboratory identified strong relationships between markers of hepatic disease and cognitive outcome as well as relationships between neuroimaging abnormalities and cognitive function in co-infected individuals. The present study will extend these pilot data and examine CNS abnormalities in co-infected individuals using laboratory, neuroimaging and neurocognitive data. To accomplish these goals we will recruit two groups of active injection drug abusers including: 1) 30 HIV mono-infected patients, and 2) 30 HIV-HCV co-infected patients. All individuals will undergo laboratory testing including assessment of hepatic disease and HIV disease in the periphery, functional MRI, structural neuroimaging and neurocognitive assessment. This cross-sectional association study will be the first transdiciplinary approach to HIV-HCV co-infection, and will provide important insight into the putative mechanisms underlying increased cognitive impairment in this population.