Vascular contributions to cognitive impairments and dementia (VCID) among people living with HIV in the country of Georgia

格鲁吉亚艾滋病毒感染者的血管对认知障碍和痴呆症 (VCID) 的影响

• 批准号: 10648790
• 负责人: Jack A DeHovitz
• 金额: $ 10万
• 依托单位: PARTNERSHIP FOR RESEARCH/ACTION/HEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-22 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10648790
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adverse effects; Age; Age-Years; Aging; Alcohol consumption; Blood Vessels; CD4 Lymphocyte Count; Central Asia; Cerebrovascular Disorders; Clinical; Continuity of Patient Care; Country; Dementia; Development; Disease; Elderly; European; Event; Future; Gender; Goals; Grant; HIV; HIV Infections; Hepatitis C co-infection; Hyperlipidemia; Hypertension; Impaired cognition; Infection; Knowledge; Measures; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Observational Study; Outcome; Participant; Peripheral; Persons; Pilot Projects; Prevalence; Process; Recording of previous events; Research; Research Personnel; Research Project Grants; Research Training; Risk; Risk Factors; Severities; Standardization; Stratification; Stroke; Substance abuse problem; Training; Viral Load result; age group; anxiety symptoms; blood-based biomarker; brain health; cigarette smoking; clinically relevant; cognitive performance; dementia risk; depressive symptoms; injection drug use; innovation; investigator training; prospective; sex; sociodemographics; therapy development; vascular cognitive impairment and dementia

Limited knowledge exists about vascular contributions to cognitive impairments and dementia (VCID) among PLWH or older adults without infection in the Eastern European and Central Asia (EECA) region including Georgia. The intersection of VCID with the HIV care continuum has never been estimated in Georgia and the EECA, and not evaluated among PLWH who are living to older ‘at risk’ ages. To mitigate adverse effects of VCID among PLWH, the prevalence of VCID and other aging-related risk factors must be estimated and characterized across the HIV care continuum. This application is a supplement to Fogarty HIV Research Training Grant (1D43TW011532; Strategic Training Partnership to End AIDS in Georgia). We propose to address the surging ‘HIV + noncommunicable disease (NCD)’ care continuum in Georgia. Early Stage Investigator (ESI) training will be operationalized via: Aim 1. Advanced didactic training in HIV-aging, VCID measures, and brain health outcomes; and Aim 2. Hands- on training in research project development, implementation and analysis via conducting a cross-sectional pilot study of 150 PLWH age >40 years. Among these participants, the goals of the pilot study are to: Aim 2.a. Characterize sociodemographic and HIV (e.g., HIV viral load, CD4+ count) factors; Aim 2.b. Estimate the prevalence of VCID and brain health using pilot study measures. VCID include obesity, hypertension, Type 2 diabetes, and hyperlipidemias; history of cardio- and peripheral vascular events; cigarette smoking; alcohol use; and substance abuse. Brain health outcomes include cognitive performance and impairment, severity and clinically-relevant depression and anxiety symptoms, and history of cerebrovascular disease and stroke. Aim 2.c. Evaluate VCID risk and history with stratification by HIV severity (viral load and CD4+ count), HCV coinfection (yes/no), injection drug use (yes/no), 10-year age group, and sex and gender. This innovative pilot study is the first in Georgia and the EECA region among aging PLWH that uses standardized and validated clinical and blood-based biomarker approaches. Our results will inform development of interventions to reduce VCID and adverse brain health outcomes related to the HIV+NCD care continuum among PLWH; and prospective observational studies to compare aging processes between PLWH and people without HIV infection. These future deliverables will be achieved through HIV research capacity building of one Georgian ESI, a recent doctoral graduate, who will receive advanced didactic and hands-on training in the development of a strategic skillset.

关于血管对认知障碍和痴呆的作用，目前的知识有限 在东欧和中欧的艾滋病毒携带者和无感染的老年人中， 亚洲（EECA）地区，包括格鲁吉亚。VCID与艾滋病毒护理连续体的交叉点 在格鲁吉亚和EECA中从未估计过，也没有在PLWH中进行过评估， 都活到了"危险“年龄为减轻暴力冲突对艾滋病毒携带者的不良影响， 必须估计和描述VCID和其他与年龄相关的危险因素的患病率 在艾滋病护理连续体中。此应用程序是福格蒂艾滋病毒研究的补充 培训赠款（1D 43 TW 011532;格鲁吉亚消除艾滋病战略培训伙伴关系）。 我们建议解决激增的“艾滋病毒+非传染性疾病（NCD）”护理连续体 在格鲁吉亚。早期研究者（ESI）培训将通过以下方式实施：目标1。先进 艾滋病毒老化，VCID措施和大脑健康结果的教学培训;和目标2。手- 在研究项目的开发、执行和分析方面进行培训， 对150名年龄>40岁的PLWH进行横断面初步研究。在这些参与者中， 目标2.a.描述社会人口和艾滋病毒的特征（例如，HIV病毒载量， CD 4+计数）因素;目标2.b.使用试点评估VCID的患病率和脑健康 研究措施。VCID包括肥胖、高血压、2型糖尿病和高血压; 心脏和外周血管事件史;吸烟;饮酒;和 滥用药物大脑健康结果包括认知能力和障碍， 严重程度和临床相关的抑郁和焦虑症状，以及 脑血管疾病和中风。目标2.c。分层评估VCID风险和病史 按HIV严重程度（病毒载量和CD 4+计数）、HCV合并感染（是/否）、注射吸毒 (yes/否）、10岁年龄组、性别和性别。这项创新的试点研究是第一次在 格鲁吉亚和EECA地区的老龄化PLWH，使用标准化和验证 临床和基于血液的生物标志物方法。我们的研究结果将为开发 采取干预措施，减少VCID和与HIV+NCD护理相关的不良脑健康结果 PLWH之间的连续性;以及比较衰老过程的前瞻性观察研究 艾滋病毒感染者和未感染者之间的差异。这些未来的可交付成果将在 通过一名格鲁吉亚的艾滋病毒研究能力建设，一名最近的博士毕业生， 将接受先进的教学和实践培训，以发展战略技能。