Pathophysiology of HIV Dementia in Women

描述（由申请人提供）：由于艾滋病毒感染流行病学的变化，艾滋病妇女患者人数继续增加。目前，它是美国年轻妇女死亡的主要原因，其中非洲裔美国人和西班牙裔人口的艾滋病毒感染率增加最多。艾滋病毒相关性痴呆症（HAD）仍然是艾滋病的主要并发症之一，但对决定女性HAD的因素知之甚少。因此，这一人群在评估生物因素和激素调节剂方面提出了一些挑战，这些因素可能会影响女性HAD的发展和严重程度。在波多黎各大学医学院，我们有独特的机会研究感染艾滋病毒的西班牙裔妇女。我们设计了一项横断面研究，将确定艾滋病毒感染的妇女在发展HAD的高风险，并将确定性腺功能障碍和氧化应激是否有助于痴呆症。因此，我们建议：a）招募一组HIV感染妇女并表征她们的神经学和神经心理学状态，B）确定性腺激素功能障碍是否与HAD相关，和c）确定氧化应激和HAD的CSF标志物的贡献。我们选择了这些参数，因为它们最适合治疗干预。可用于纠正这些异常的潜在药物以储库形式提供或可以以储库形式提供，甚至可以用于依从性较低的患者群体。我们的长期目标是制定波多黎各妇女艾滋病毒相关痴呆症的早期诊断、预防和治疗方法。

DESCRIPTION (provided by applicant): The population of women with AIDS continues to increase as a consequence of changes in the epidemiology of HIV infection. Currently it is a leading cause of death amongst young women in the United States where the largest increase in incidence of HIV infection is in the African-American and Hispanic populations. HIV associated dementia (HAD) continues to be one of the major complications of AIDS and little is known about the factors that determine HAD in women. Therefore, this population poses several challenges in the evaluation of biological factors and hormonal modifiers, which can impact on the development and severity of HAD in women. At the University of Puerto Rico Medical Sciences Campus we have the unique opportunity to study Hispanic women with HIV infection. We have designed a cross sectional study that will identify HIV infected women at high risk of developing HAD and will determine if gonadal dysfuction and oxidative stress contribute to the dementia. We therefore propose to: a) recruit a cohort of HIV infected women and characterize their neurological and neuropsychological status, b) determine if gonadal hormone dysfunction is associated with HAD, and c) determine the contribution of CSF markers of oxidative stress and HAD. We have chosen these parameters since they are most amenable to therapeutic intervention. Potential drugs that could be used to correct these abnormalities are or can be made available in depot forms that could be used even in less compliant patient populations. Our long-range goal is to develop methods for the early diagnosis, prevention, and treatment of HIV Associated Dementia in the Puerto Rican women population.