PACTG P1055: PSYCHIATRIC CO-MORBIDITY IN PERINATALLY HIV-INFECTED CHILDREN

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。HIV（人类免疫缺陷病毒）是一种嗜神经病毒，在围产期感染的个体中，在出生时就存在，并且能够穿过血脑屏障，这表明其影响可能在不同的发育阶段存在差异。病毒对中枢神经系统（CNS）的影响可能不仅是由于直接的细胞损伤，还可能与治疗神经毒性和暴露于抗逆转录病毒治疗的时间有关。作为这些更广泛的中枢神经系统影响的一个例子，最近的数据表明，围产期HIV感染的儿童和青少年与HIV暴露但未感染的儿童和青少年以及一般儿科人群相比，精神病住院率显着更高，强调了病毒的持续累积毒性，可能是其治疗。 P1055是一项多中心、非治疗、观察性研究，在400例围产期HIV感染儿童和青少年（6 - 12 - 18岁）中研究HIV对精神症状的患病率和严重程度的影响，然后选择对照受试者，在按性别和年龄组创建的四个分层中进行频率匹配。将在入组时以及入组后约1年（48周）和2年（96周）评估所有800例受试者的精神症状患病率和严重程度。此外，200-240名HIV感染受试者和对照受试者（每组100 - 120名）及其父母/主要照顾者的子集将参加半结构化精神病学访谈，以临床评价基于DSM-IV（精神疾病诊断和统计手册-第四版）定义的疾病的临时精神病诊断。该子集将仅限于某些预选研究中心，并且可能仅限于英语受试者。 了解艾滋病毒感染人群与对照人群相比共同出现症状的方式，可以为预防和早期干预工作提供信息，以减少这些儿童和青少年不得不应对额外心理社会压力的可能性。 .

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. HIV (Human Immunodeficiency Virus) is a neurotropic virus which, in perinatally-infected individuals, is present at the time of birth and is able to cross the blood brain barrier, suggesting that its effects may present differently at different developmental stages. Central Nervous System (CNS) effects of the virus may not just be due to direct cellular damage, but may also be related to treatment neurotoxicities and length of exposure to antiretroviral therapies. As an example of these more diffuse CNS effects, recent data suggest that perinatally HIV-infected children and adolescents have significantly higher rates of psychiatric hospitalizations when compared to both HIV-exposed but uninfected children and adolescents, as well as the general pediatric population, underscoring the ongoing cumulative toxicity of the virus, and perhaps its treatments. P1055 is a multicenter, non-treatment, observational study of the effect of HIV on the prevalence and severity of psychiatric symptoms in 400 perinatally HIV-infected children and adolescents ages 6 to 12 to 18), and then control subjects will be selected to be frequency matched within the four strata created by gender and age group. All 800 subjects will be assessed for the prevalence and severity of psychiatric symptoms at entry and at approximately 1 year (48 weeks) and 2 years (96 weeks) after entry. In addition, a subset of 200-240 HIV-infected subjects and control subjects (100 - 120 in each group) and their parents/primary caregivers will participate in semi-structured psychiatric interviews to clinically evaluate tentative psychiatric diagnoses based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition) defined disorders. This subset will be limited to certain pre-selected sites, and may be limited to English-speaking subjects. Understanding the means by which co-occurring symptoms develop in the HIV-infected population, as compared to the control population, could inform prevention and early intervention efforts to decrease the likelihood that these children and adolescents would have to deal with additional psychosocial stressors. .