Building research capacity in aging HIV-infected persons

描述(申请人提供)：艾滋病毒和老龄化的多学科临床研究取得进展的一个关键障碍是，到目前为止，对真正年长的艾滋病毒感染者(艾滋病毒+)的临床研究很少，在这些人中，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影响。尽管美国的HIV+患者现在正在接受长期联合抗逆转录病毒治疗(CART)的老年生活，美国疾病控制与预防中心估计，到2015年，超过10%的HIV+患者将超过65岁(即老年HIV+患者)，但实际上很少有这样的人被纳入已发表的报告中。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+患者的独特地理集中度，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+患者的神经功能。我们将加强和发展沙漠社区积极分子和HNRC研究人员之间的新兴联盟。我们将利用NIMH资助的成熟的HNRC基础设施来建立这个新的队列，并提供适度的支持。我们将通过培训当地人员进行高质量的临床研究评估，并通过建立20人的初始队列来证明可行性 特点良好的艾滋病毒+老年人群。这些初步工作将支持建立一个扩大的临床研究基础设施，为计划中的未来干预研究提供支持，以最大限度地提高“高龄”艾滋病毒感染者的神经健康、生产力和生活质量。

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.