Pathophysiology of HIV Dementia in Women

说明(申请人提供)：由于艾滋病毒感染流行病学的变化，感染艾滋病的妇女人口继续增加。目前，它是美国年轻女性死亡的主要原因，在美国，艾滋病毒感染的发病率增加最多的是非裔美国人和西班牙裔人口。艾滋病毒相关性痴呆(HAD)仍然是艾滋病的主要并发症之一，人们对决定女性HAD的因素知之甚少。因此，这一人群在生物因素和激素调节剂的评估方面提出了几个挑战，这可能会影响妇女HAD的发展和严重程度。在波多黎各大学医学校区，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，将确定感染艾滋病毒的女性患HAD的风险很高，并将确定性腺功能障碍和氧化应激是否导致痴呆症。因此，我们建议：a)招募一组HIV感染的女性，并对她们的神经和神经心理状态进行表征，b)确定性激素功能障碍是否与HAD相关，以及c)确定脑脊液中氧化应激和HAD标记物的贡献。我们选择了这些参数，因为它们最容易受到治疗干预的影响。可以用来纠正这些异常的潜在药物是或可以以仓库的形式提供，即使是在依从性较差的患者群体中也可以使用。我们的长期目标是开发在波多黎各妇女群体中早期诊断、预防和治疗艾滋病毒相关性痴呆症的方法。

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.