Functional Neuroimaging of Cognitive Dysfunction in HIV-HCV Co-Infection

描述(申请人提供)：本研究的目的是调查注射吸毒者合并感染艾滋病毒和丙型肝炎(丙型肝炎)的中枢神经系统损伤。这项研究将包括肝病的生物标志物、最先进的神经成像方法和神经心理学结果。最近的初步研究，包括我们实验室的数据，表明艾滋病毒-丙型肝炎病毒混合感染比单独感染任何一种疾病都与更大的神经认知损害有关。到目前为止进行的研究还没有完全确定联合感染潜在协同效应的机制。此外，这些效应的神经功能基础还没有通过功能或结构神经成像来确定。我们实验室的最新数据表明，在合并感染的患者中，肝病标志物与认知结果之间以及神经影像异常与认知功能之间存在密切关系。本研究将扩展这些先导数据，并使用实验室、神经成像和神经认知数据检查合并感染个体的中枢神经系统异常。为了实现这些目标，我们将招募两组积极的注射吸毒者，包括：1)30名艾滋病毒单一感染者，2)30名艾滋病毒和丙型肝炎病毒混合感染者。所有个人都将接受实验室测试，包括外围肝病和艾滋病毒疾病的评估、功能核磁共振、结构神经成像和神经认知评估。这项横断面关联研究将是第一个针对HIV-丙型肝炎病毒混合感染的跨学科方法，并将为这一人群中认知障碍增加的可能机制提供重要的见解。

DESCRIPTION (provided by applicant): The purpose of the present study is to investigate CNS injury among injection drug abusers co-infected with HIV and Hepatitis C (HCV). The study will incorporate btomarkers of hepatic disease, state-of-the-art neuroimaging methods, and neuropsychological outcomes. Recent preliminary studies, including data from our lab, indicate that HIV-HCV co-infection is associated with greater neurocognitive compromise than either disease alone. Studies conducted to date have not fully determined the mechanisms underlying the potentially synergistic effect of co-infection. Further, the neurofunctional underpinnings of these effects have not been identified using functional or structural neuroimaging. Recent data from our laboratory identified strong relationships between markers of hepatic disease and cognitive outcome as well as relationships between neuroimaging abnormalities and cognitive function in co-infected individuals. The present study will extend these pilot data and examine CNS abnormalities in co-infected individuals using laboratory, neuroimaging and neurocognitive data. To accomplish these goals we will recruit two groups of active injection drug abusers including: 1) 30 HIV mono-infected patients, and 2) 30 HIV-HCV co-infected patients. All individuals will undergo laboratory testing including assessment of hepatic disease and HIV disease in the periphery, functional MRI, structural neuroimaging and neurocognitive assessment. This cross-sectional association study will be the first transdiciplinary approach to HIV-HCV co-infection, and will provide important insight into the putative mechanisms underlying increased cognitive impairment in this population.