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）损伤是HIV感染的常见后果，与日常功能下降和较差的医疗预后（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）的差异可能导致中国不同的神经行为结果，但尚未有关于神经艾滋病的研究。中国政府高度重视艾滋病的预防和治疗。在美国国立卫生研究院的支持下，中国疾病预防控制中心启动了中国艾滋病国际综合研究项目，并正在开始对中国两个主要的艾滋病毒高危人群——注射吸毒者和前血浆献血者——进行一系列研究。

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.