Neurobehavioral Effects of HIV & Host Genetics in China

描述(申请人提供)：西方国家的研究表明，神经心理(NP)损害是艾滋病毒感染的常见后果，与日常功能下降和更糟糕的医疗预后(早期死亡)有关。中国(13亿人口)的艾滋病疫情呈指数级增长。尽管宿主遗传、治疗和辅助因素(如其他感染)的差异可能会导致中国不同的神经行为结果，但目前还没有关于神经艾滋病的研究。中国政府高度重视艾滋病的防治工作。在美国国立卫生研究院的支持下，中国疾控中心启动了中国艾滋病综合国际研究计划，并正在开始对中国的两个主要艾滋病毒高危人群：注射吸毒者和前血浆献血者进行一系列研究。 在此，我们提出了首次对中国进行的艾滋病相关神经行为障碍的研究。我们将与中国疾控中心的同事合作，利用CIPRA和中国CARE(另一个针对艾滋病毒/艾滋病的疾控中心项目)的基础设施，在FPD和1DU人群(4组，每组n=200)中识别人口统计匹配的艾滋病毒+和艾滋病毒参与者的大样本。在为期5年的研究期间，我们将阐明这些群体中HIV相关NP损害的患病率、性质、临床意义和变化模式。我们将确定NP损伤的差异是否可以通过宿主遗传特征来预测，包括特定的人类白细胞抗原类型和编码趋化因子受体、趋化因子和细胞因子的基因的多态。丙型肝炎病毒(丙型肝炎病毒)合并感染的影响也将被检测，因为丙型肝炎病毒是NP损害的独立风险，并且在IDU和FPD人群中高度流行。 该项目扩展了中美调查人员之间的现有关系。在组织层面，美方负责总体研究进度、培训、质量保证和数据管理，中国方负责招募、跟踪和评估参与者。这项拟议的研究将为中国艾滋病的神经认知和神经精神并发症提供详细的新信息。中国对这些并发症及其决定因素的临床意义的理解的增加，应该会更好地为受影响人群的临床管理提供信息。

DESCRIPTION (provided by applicant): Research in Western countries indicates that neuropsychological (NP) impairment is a common consequence of HIV infection and is associated with reduced everyday functioning and worse medical prognosis (early mortality). China (population 1.3 billion) is seeing an exponential growth in its HIV epidemic. Although differences in host genetics, treatment, and cofactors (e.g., other infections) may result in different neurobehavioral outcomes in China, there has been no research on neuroAIDS there. The Chinese government has placed a high priority on HIV prevention and treatment. With support of the U.S. NIH, the China CDC has initiated the China Comprehensive International Program for Research on AIDS (CIPRA), and is beginning a series of studies on two major HIV risk populations in China: injection drug users (IDUs) and former plasma donors (FPDs). Here we propose the first study of HIV related neurobehavioral disorders in China. In collaboration with colleagues at the China CDC, we will utilize the infrastructure of CIPRA and China CARES (another CDC program for HIV/AIDS) to identifiy large samples of demographically matched HIV+ and HIV- participants within the FPD and 1DU populations (4 groups, each with n=200). Over a 5-year study period, we will clarify the prevalence, nature, clinical significance, and patterns of change in HIV associated NP impairments in these groups. We will determine whether differences in NP impairment are predicted by host genetic characteristics, including specific HLA types and polymorphisms in genes encoding for chemokine receptors, chemokines, and cytokines. Effects of comorbid infection with hepatitis C virus (HCV) also will be examined, because HCV is an independent risk for NP impairment and is highly prevalent in both the IDU and FPD populations. This project extends an existing relationship between the Chinese and U.S. investigators. At an organizational level, the U.S. side will be responsible for overall study progress, training, quality assurance, and data management, while the China side will recruit, track and assess participants. The proposed research will provide detailed new information about neurocognitive and neuropsychiatric complications of HIV disease in China. This increased understanding of the clinical significance of these complications and their determinants in China should better inform clinical management of affected populations.