Building research capacity in aging HIV-infected persons

描述（由申请人提供）：艾滋病毒和衰老多学科临床研究进展的一个关键障碍是，迄今为止，对真正的老年艾滋病毒感染（HIV+）个体的临床研究缺乏，这些个体最有可能观察到艾滋病毒和年龄对大脑结构和功能的协同效应。尽管美国的HIV阳性患者现在通过长期联合抗逆转录病毒治疗（CART）进入老年，美国疾病控制与预防中心估计，到2015年，超过10%的HIV阳性患者将超过65岁（即老年HIV阳性患者），但在已发表的报告中，这类患者实际上很少被包括在内。我们建议利用圣地亚哥附近沙漠社区中65岁以上艾滋病毒感染者的独特地理集中，他们的比例已经超过10%。我们将在河滨县的老年HIV+社区和多学科的UCSD HIV神经行为研究中心（HNRC）之间建立富有成效的合作伙伴关系，以调查老年HIV+个体的神经功能。我们将加强和发展沙漠社区活动人士和HNRC研究人员之间正在形成的联盟。我们将利用完善的、nimh资助的HNRC基础设施，在适度的支持下建立这个新的队列。我们将通过培训当地人员进行高质量的临床研究评估和建立20人的初始队列来证明可行性

DESCRIPTION (provided by applicant): A critical barrier to progress in multidisciplinary clinical research on HIV and aging is the paucity in clinical studies to date of truly older HIV-infected (HIV+) individuals - those in whom the synergistic effects of HIV and age on brain structure and function are most likely to be observed. Although HIV+ people in the U.S. are now living into old age with long-term combination antiretroviral treatment (CART) and the U.S. CDC estimates that by 2015 more than 10% of all HIV+ individuals will exceed 65 years of age (i.e., older HIV+), very few such individuals have actually been included in published reports. We propose to capitalize on a unique geographic concentration of HIV+ individuals over age 65 in a cluster of desert communities nearby to San Diego, where their proportion has already exceeded 10%. We will establish a productive, collaborative partnership between the aging HIV+ community in Riverside County and the multidisciplinary UCSD HIV Neurobehavioral Research Center (HNRC) to investigate neurological functioning among older HIV+ individuals. We will strengthen and evolve an emerging alliance between desert community activists and HNRC researchers. We will leverage the well- established, NIMH-funded HNRC infrastructure to establish this new cohort with modest support. We will demonstrate feasibility by training local personnel in high-quality clinical research evaluations and by establishing an initial cohort of 20 well-characterized older HIV+ persons. These preliminary efforts will support the establishment of an expanded clinical research infrastructure for planned future studies on interventions to maximize neurological health, productivity and quality of life in the "oldest old" HIV+ persons.