Longitudinal Study of HIV and Aging in Brazil

项目总结 本研究将对急性脑梗塞后神经认知症状的流行病学和免疫学进行研究。 新冠肺炎(PASC)对老年艾滋病毒携带者的后遗症认知衰退 仍然是艾滋病毒老化的常见和重要的并发症，并与不良后果有关 包括虚弱、生活质量差、残疾和死亡。新冠肺炎持续性神经认知症状可能 考虑到PASC的危险因素以及潜在免疫力的差异，更常见于老年PWH 衰老和发炎。然而，神经认知障碍的临床负担和免疫学表型 到目前为止，PASC在较老的PWH中的症状还没有被描述。这些信息在以下方面尤其需要 异种SARS-CoV-2疫苗接种和新冠肺炎高的中低收入国家 观察两组的发生率。这项研究将检查(1)临床表型和决定因素 测量患有PASC的老年PWH患者的神经精神预后，并将寻求确定(2) 伴有SARS免疫学和临床后遗症的老年PWH的免疫学和临床特征 冠状病毒2型感染。一项嵌套的横断面研究，使用了丰富的基线临床数据和生物显微镜 NIA资助的巴西艾滋病毒与老龄化纵向研究将收集新冠肺炎感染的详细数据， 症状，以及之前接种疫苗以识别患有PASC的老年PWH。300名参与者，其中包括 没有PASC，PASC将接受额外的神经认知测试，以描述老年人的特定认知表型 带和不带PASC的PWH。此外，我们将使用储存的生物标本来识别较旧的PWH和较差的PWH 新冠肺炎感染和疫苗接种以及有无PASC to的免疫学反应 检查适应性免疫衰老和神经系统炎症的系统性措施的差异，以确定 该人群中导致新冠肺炎不良结局的免疫学机制的线索。设于 在新冠肺炎大流行的震中之一，由艾滋病毒和新冠肺炎流行病学专家领导 免疫学，这项研究将为新冠肺炎的一个关键并发症提供新的和必要的见解 威尔斯亲王医院大流行。

PROJECT SUMMARY This study will investigate the epidemiology and immunology of neurocognitive symptoms of post-acute sequelae of COVID-19 (PASC, or “long COVID”) in older people living with HIV (PWH). Cognitive decline remains a common and important complication of aging with HIV and is associated with adverse outcomes including frailty, poor quality of life, disability, and death. Lasting neurocognitive symptoms of COVID-19 may be more common in older PWH given their risk factors for PASC as well as differences in underlying immune senescence and inflammation. However, the clinical burden and immunologic phenotypes of neurocognitive symptoms of PASC in older PWH have not been described to date. This information is particularly needed in low- and middle-income countries where heterologous SARS-CoV-2 vaccinations and high COVID-19 incidence were observed. This study will examine (1) the clinical phenotypes and determinants of neuropsychiatric outcomes measures among older PWH with PASC and will seek to determine (2) the immunologic and clinical profiles of older PWH with discordant immunologic and clinical sequelae of SARS- CoV-2 infection. A nested, cross-sectional study using the rich baseline clinical data and biospecimens of the NIA-funded Longitudinal Study of HIV and Aging in Brazil will collect detailed data of COVID-19 infections, symptoms, and prior vaccination to identify older PWH with PASC. A cohort of 300 participants with and without PASC will undergo additional neurocognitive testing to describe specific cognitive phenotypes in older PWH with and without PASC. Further, we will use stored biospecimens to identify older PWH with poor immunologic response to COVID-19 infection and vaccination as well as those with and without PASC to examine differences in adaptive immune senescence and systemic measures of neuroinflammation to identify clues of the immunologic mechanisms contributing to adverse COVID-19 outcomes in this population. Located in one of the epicenters of the COVID-19 pandemic and led by experts in HIV and COVID-19 epidemiology and immunology, this study will offer novel and needed insights into a critical complication of the COVID-19 pandemic in PWH.