Massage to Enhance Well-Being: HIV+ Dominican Children

描述(申请人提供)：全世界有130多万儿童感染艾滋病毒/艾滋病，这正在成为认知和发育迟缓的主要感染原因，特别是在有明显免疫功能障碍的婴儿和儿童中。有令人信服的证据表明，按摩疗法可能具有提高免疫状态和改变艾滋病毒疾病进程的潜力。为了支持这一概念，即使在没有抗逆转录病毒治疗的情况下，在HIV-1血清阳性的青少年和成年人接受推拿治疗后，也证明了免疫细胞毒能力的增强和艾滋病毒疾病进展标记的改善。尽管目前还没有对按摩疗法增强HIV-1感染儿童免疫功能的能力进行研究，但在早产儿的研究中，有报道称按摩疗法增加了体重增加，减少了应激行为，并使认知和运动发育更加优化。这项拟议的发展研究赠款的目的是审查按摩疗法的效果，这是一种负担得起的、可能有益的补充/替代疗法，以促进多米尼加共和国艾滋病毒-1血清阳性儿童的健康和福祉，多米尼加共和国是一个饱受艾滋病毒/艾滋病蹂躏的发展中国家。在多米尼加共和国，儿童艾滋病毒/艾滋病病例的数量一直在迅速上升，目前还没有现成的抗逆转录病毒疗法来减缓疾病的进展。我们建议随机选择54名3-7岁感染HIV-1的多米尼加儿童，接受按摩治疗或标准护理/友好访问，每周两次，为期12周。将收集初步数据以评估对按摩治疗的接受度、安全性和依从性，并检查按摩治疗是否会改善免疫功能、发育表现和行为功能。我们假设按摩疗法将是一种有效、安全和可持续的护理形式。如果被证明有效，这可能会得到广泛的应用，重点是培训家庭/护理人员进行按摩治疗。从这个项目中获得的见解将被用于开发一个应用程序，用于未来的研究，以确定按摩疗法的有效性，它对免疫系统的影响，以及随着时间的推移，在HIV-1血清阳性儿童中保持健康状态的潜在机制。

DESCRIPTION (provided by applicant): Worldwide, more than 1.3 million children are living with HIV/AIDS, which is becoming the leading infectious cause of cognitive and developmental delays, especially in infants and children with marked immune dysfunction. There is compelling evidence that massage therapy may have the potential to enhance immune status and alter the course of HIV disease. In support of this concept, increased immune cytotoxic capacity and improvement in HIV disease progression markers have been demonstrated following massage therapy in HIV-1 seropositive adolescents and adults, even in the absence of antiretroviral treatments. Although the ability of massage therapy to enhance immune function in HIV-1 infected children has not yet been investigated, increased weight gain, decreased stress behavior, and more optimal cognitive and motor development have been reported following massage treatment in studies with premature newborns. The intent of this proposed developmental research grant is to examine the efficacy of massage therapy, an affordable and potentially beneficial complementary/alternative treatment, to promote health and enhance well being in HIV-1 seropositive children in the Dominican Republic, a developing country ravaged by HIV/AIDS. The number of pediatric HIV/AIDS cases has been rapidly rising in the Dominican Republic, and antiretroviral regimens are not yet readily available to slow disease progression. We propose to randomize 54 HIV-1 infected Dominican children aged 3-7 years, to receive massage therapy or standard care/friendly visits, twice weekly for 12 weeks. Preliminary data will be gathered to assess acceptance, safety, and compliance to massage therapy, and examine whether massage treatment will improve immune function, developmental performance and behavioral function. We hypothesize that massage therapy will be a valid, safe, and sustainable form of care. If proven effective, this may have widespread application with a focus on training of family/care givers to administer the massage treatment. Insights obtained from this project will be used to develop an application for future studies to determine the effectiveness of massage therapy, its impact on the immune system, and potential mechanisms involved in preserving health status over time in HIV-1 seropositive children.