Pathophysiology of HIV Dementia in Women

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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.